Kemink J L, Kileny P R, Niparko J K, Telian S A
Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor.
Am J Otol. 1991 Jan;12(1):7-10.
For many years labyrinthectomy has been used as a reliable surgical treatment for patients with unilateral nonserviceable hearing associated with episodic vertigo. In view of the rehabilitative potential of the cochlear implant, the role of labyrinthectomy has been questioned because of a concern to preserve structures of the auditory periphery. However, recent reports demonstrate substantial survival of spiral ganglion cells after labyrinthectomy, suggesting that such patients might be candidates for rehabilitation with cochlear implants if necessary. To address this question from a physiologic approach, we investigated the electrical stimulability of the operated ear in patients who underwent transmastoid labyrinthectomy for the management of vertigo. Ten patients were studied intraoperatively with electrically evoked middle latency response (MLR) potentials. Six of these patients were studied between 3 and 15 months postoperatively via transtympanic stimulation. Postoperatively all patients demonstrated an excitable auditory periphery and behavioral thresholds were similar to intraoperative electrophysiologic thresholds for the same stimuli. These results suggest the persistence of excitable auditory neural elements following labyrinthectomy.
多年来，迷路切除术一直被用作治疗伴有发作性眩晕的单侧失聪患者的可靠手术方法。鉴于人工耳蜗的康复潜力，由于担心破坏听觉外周结构，迷路切除术的作用受到了质疑。然而，最近的报告表明迷路切除术后螺旋神经节细胞大量存活，这表明如有必要，此类患者可能是人工耳蜗康复的候选者。为了从生理学角度解决这个问题，我们研究了因眩晕接受经乳突迷路切除术患者患侧耳朵的电刺激能力。对10例患者术中进行电诱发中潜伏期反应（MLR）电位研究。其中6例患者在术后3至15个月通过经鼓膜刺激进行研究。术后所有患者均表现出可兴奋的听觉外周，行为阈值与相同刺激的术中电生理阈值相似。这些结果表明迷路切除术后可兴奋的听觉神经元持续存在。
