Tucker A, Slattery W H, Solcyk L, Brackmann D E
House Ear Clinic, Los Angeles, California, USA.
J Am Acad Audiol. 2001 Oct;12(9):471-7.
The purpose of this study was to determine the association of intraoperative auditory brainstem responses (ABRs) and near-field cochlear nerve action potentials (CNAPs) with postoperative hearing preservation in acoustic tumor surgery. Thirty-three consecutive patients undergoing middle fossa surgery had intraoperative surface ABR and direct CNAP assessments. Postoperatively, hearing was assessed. Hearing preservation was defined as any measurable hearing at any frequency and also by the American Academy of Otolaryngology--Head and Neck Surgery (AAO-HNS) hearing preservation classification system. The presence of an ABR or CNAP was associated with hearing preservation and the absence of an ABR, and CNAP was associated with no hearing preservation in 75.6 percent of the cases. The presence of either the ABR or CNAP was not related to AAO-HNS class outcome. ABR and CNAP had a useful rate of prediction of hearing preservation surgery outcome. However, in nearly one-quarter of the cases, no association between ABR or CNAP responses and hearing preservation was found. This finding must be taken into account when determining the clinical usefulness of these techniques.
本研究的目的是确定术中听觉脑干反应（ABR）和近场蜗神经动作电位（CNAP）与听神经瘤手术术后听力保留之间的关联。33例连续接受中颅窝手术的患者接受了术中表面ABR和直接CNAP评估。术后对听力进行评估。听力保留的定义为任何频率下的任何可测量听力，同时也依据美国耳鼻咽喉-头颈外科学会（AAO-HNS）听力保留分类系统来定义。ABR或CNAP的存在与听力保留相关，而ABR和CNAP均缺失则在75.6%的病例中与无听力保留相关。ABR或CNAP的存在与AAO-HNS分级结果无关。ABR和CNAP对听力保留手术结果具有有用的预测率。然而，在近四分之一的病例中，未发现ABR或CNAP反应与听力保留之间存在关联。在确定这些技术的临床实用性时，必须考虑到这一发现。
