Pasanisi Enrico, Vincenti Vincenzo, Bacciu Andrea, Guida Maurizio, Bacciu Salvatore
Department of Otolaryngology, University of Parma, Italy.
Laryngoscope. 2002 Sep;112(9):1653-6. doi: 10.1097/00005537-200209000-00023.
OBJECTIVE/HYPOTHESIS: Positioning intracochlear electrodes adjacent to the modiolus would lead to a reduction in threshold levels and latencies, as measured with electrically evoked auditory brainstems responses. Recently, Cochlear Corporation introduced a new perimodiolar array (Contour electrode) characterized by a platinum stylet inserted into the array's silicone carrier that keeps the electrode in a straightened configuration before insertion. After completion of the insertion, the withdrawal of the stylet allows the array to coil within the cochlea positioning electrodes closer to the modiolus. The purpose of the study was to analyze the stimulation properties of the Contour electrode by evaluating the effects of the withdrawal of the stylet on electrical auditory brainstem response (EABR) characteristics.
Electrical auditory brainstem response registrations were performed intraoperatively on three electrodes (1 apical, 1 medial, 1 basal) before and after the removal of the stylet in 10 patients implanted with the Nucleus 24 Contour device. A within-patient comparison of EABR characteristics was performed. The Student test was used to assess differences in EABR measures obtained before and after the stylet removal.
Mean EABR thresholds were significantly lower after the removal of the stylet than with the stylet in situ for all three electrodes tested. After the removal of the stylet, latencies of waves III and V significantly decreased, whereas amplitudes significantly increased.
Reduction in EABR threshold levels and latencies as well as an increase in waves III and V amplitudes after the stylet removal all demonstrate the effectiveness of the Contour system in positioning intracochlear electrodes closer to auditory neurons.
目的/假设:将人工耳蜗电极置于蜗轴附近,通过电诱发听性脑干反应测量,可降低阈值水平并缩短潜伏期。最近,科利耳公司推出了一种新的蜗轴周围阵列(轮廓电极),其特点是在阵列的硅胶载体中插入一根铂制管心针,在插入前可使电极保持伸直状态。插入完成后,拔出管心针可使阵列在耳蜗内盘绕,将电极定位得更靠近蜗轴。本研究的目的是通过评估拔出管心针对电诱发听性脑干反应(EABR)特征的影响,来分析轮廓电极的刺激特性。
对10例植入Nucleus 24轮廓装置的患者,在拔出管心针前后,术中对三个电极(1个顶端电极、1个中间电极、1个基底电极)进行电诱发听性脑干反应记录。对患者自身的EABR特征进行比较。采用学生检验评估拔出管心针前后获得的EABR测量值的差异。
对于所有测试的三个电极,拔出管心针后的平均EABR阈值显著低于管心针在位时。拔出管心针后,波III和波V的潜伏期显著缩短,而波幅显著增加。
拔出管心针后EABR阈值水平和潜伏期降低,以及波III和波V波幅增加,均表明轮廓系统在将人工耳蜗电极定位得更靠近听觉神经元方面的有效性。