Balkany Thomas J, Eshraghi Adrien A, Jiao He, Polak Marek, Mou Caihong, Dietrich Dalton W, Van De Water Thomas R
Department of Otolaryngology, University Ear Institute, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
Laryngoscope. 2005 Sep;115(9):1543-7. doi: 10.1097/01.mlg.0000173169.45262.ae.
OBJECTIVE/HYPOTHESIS: Loss of auditory function after cochlear implant (CI) electrode insertion occurs in two stages in the laboratory rat. An immediate loss is followed by a progressive loss over 7 days. Similar stages of acute and progressive neuronal loss occur after trauma in the central nervous system where hypothermia has been shown to have a protective effect. We hypothesize that hypothermia has a similar protective effect against loss of auditory function caused by CI electrode insertion trauma.
Thirty rats underwent surgery in one cochlea; the contralateral ear was an unoperated control. In the normothermia group, CI electrode insertion trauma was generated with rectal temperature maintained at 37 degrees C throughout the experiment. In the mild hypothermia group, electrode trauma was generated with rectal temperature lowered to 34 degrees C. In the surgical control group, mock surgery was performed at 37 degrees C. Multiple frequency auditory brainstem response (ABR) and distortion product otoacoustic emission (DPOAE) testing of all ears was performed before surgery, immediately afterward, and on postoperative days 3, 5, and 7.
Both ABR and DPOAE testing demonstrated partial loss of auditory function after electrode insertion trauma. However, the hypothermia group had significantly less functional loss in the immediate stage and no significant loss in the progressive stage.
Mild hypothermia protects auditory function during CI electrode insertion.
目的/假设:在实验室大鼠中,人工耳蜗(CI)电极插入后听觉功能丧失分两个阶段发生。先是立即丧失,随后在7天内逐渐丧失。在中枢神经系统创伤后也会出现类似的急性和渐进性神经元丧失阶段,低温已被证明在其中具有保护作用。我们假设低温对CI电极插入创伤导致的听觉功能丧失具有类似的保护作用。
30只大鼠一侧耳蜗接受手术;对侧耳朵作为未手术的对照。在正常体温组中,在整个实验过程中直肠温度维持在37摄氏度时进行CI电极插入创伤。在轻度低温组中,直肠温度降至34摄氏度时进行电极创伤。在手术对照组中,在37摄氏度下进行假手术。在手术前、术后立即以及术后第3、5和7天对所有耳朵进行多频听觉脑干反应(ABR)和畸变产物耳声发射(DPOAE)测试。
ABR和DPOAE测试均表明电极插入创伤后听觉功能部分丧失。然而,低温组在即刻阶段功能丧失明显较少,在渐进阶段无明显丧失。
轻度低温在CI电极插入过程中可保护听觉功能。