Nikolopoulos T P, Mason S M, Gibbin K P, O'Donoghue G M
Department of Otolaryngology, University Hospital, Queen's Medical Center NHS Trust, Nottingham, United Kingdom.
Ear Hear. 2000 Jun;21(3):236-41. doi: 10.1097/00003446-200006000-00007.
To test the hypothesis that children with clear promontory electrically evoked auditory brain stem responses (prom-EABRs) would outperform, after cochlear implantation, children who had no prom-EABR preoperatively.
A prospective study was undertaken on 47 implanted children assigning them to two groups (group A: 35 children with a clear wave e-V in the preoperative prom-EABR and group B: 12 children with no prom-EABR). Speech perception and speech intelligibility were assessed annually up to 3 yr after implantation with the IOWA sentence test (level A and level B), Connected Discourse Tracking, Categories of Auditory Performance, and Speech Intelligibility Rating. t-test and Mann-Whitney U test were used to compare the above outcome measures in the two groups.
There was no statistically significant difference between the two groups on any of the outcome measures at any interval. Moreover, the small differences observed showed no consistent trend toward either group of children. Further analysis revealed that the outcomes have not been affected by possible confounding factors (age at implantation, duration of deafness, preoperative unaided pure-tone thresholds, and number of inserted electrodes).
The results suggest that children with no prom-EABR performed at levels comparable with children who had clear promontory responses preoperatively. The prognostic value of prom-EABR is limited and absence of a prom-EABR is not, by itself, a contraindication for cochlear implantation. However, in selected cases (congenital malformations, cochlear nerve dysplasia or suspected aplasia, narrow internal auditory canal, etc.) the presence of a prom-EABR is a positive finding in the assessment of candidates for cochlear implantation as it confirms the existence of intact auditory neurones.
验证以下假设：在接受人工耳蜗植入后，具有清晰岬电诱发听觉脑干反应（prom - EABR）的儿童在表现上会优于术前无prom - EABR的儿童。
对47名接受植入手术的儿童进行了一项前瞻性研究，将他们分为两组（A组：35名术前prom - EABR中有清晰的e - V波的儿童；B组：12名无prom - EABR的儿童）。在植入后长达3年的时间里，每年使用爱荷华语句测试（A级和B级）、连贯话语追踪、听觉表现类别和言语可懂度评分来评估言语感知和言语可懂度。使用t检验和曼 - 惠特尼U检验来比较两组的上述结果指标。
在任何时间间隔的任何结果指标上，两组之间均无统计学上的显著差异。此外，观察到的微小差异在两组儿童中均未显示出一致的趋势。进一步分析表明，结果未受可能的混杂因素（植入时年龄、耳聋持续时间、术前未佩戴助听器时的纯音阈值以及插入电极数量）的影响。
结果表明，无prom - EABR的儿童的表现与术前有清晰岬反应的儿童相当。prom - EABR的预后价值有限，术前无prom - EABR本身并非人工耳蜗植入的禁忌症。然而，在某些特定病例（先天性畸形、耳蜗神经发育异常或疑似发育不全、内耳道狭窄等）中，prom - EABR的存在在人工耳蜗植入候选人评估中是一个积极的发现，因为它证实了完整听觉神经元的存在。
