Wang Bin, Cao Keli, Wei Chaogang
CI Center of Otolaryngology, Peking Union Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013 May;27(10):449-54.
To evaluate the pathological position of auditory neuropathy and investigate the hearing and speech rehabilitation results of cochlear implantation in patients with auditory neuropathy.
In our hospital, among the patients received cochlear implantation, 8 cases with auditory neuropathy were selected, and 8 cases of non-auditory neuropathy patients with profound deafness were selected as matched control group with the background close to the study group. The preoperative hearing data of these two groups were retrospectively analyzed. During operation, the homemade stimulation electrodes were inserted to test the electric evoked auditory brainstem response(EABR) for assessing the auditory pathway; EABR and neural response telemetry(NRT) were tested after implantation, and T, C value were acquired 1 month later. CAP, SIR and speech recognition rate were used to assess hearing and speech rehabilitation effect 12 months after booting.
Intra-operative EABR wave can be derived in 8 cases of auditory neuropathy, but the wave pattern exhibited variations compared with normal wave. It needed increased stimulation or adjusted parameters, with variable V latency. After cochlear implantation, the waveforms of NRT and EABR were similar between the two groups, and the post-operative V waveform was close to the intra-operative EABR. 8 pairs of patients can present listening response after booting. There was no statistically significant difference in T, C value, CAP (6.50 +/- 0.94 and 6.90 +/- 0.77) and speech recognition rate (85.00% +/- 11.66% and 89.50% +/- 9.02%) between the auditory neuropathy group and the control group 1 year after booting.
Pre-operative EABR can be used as an effective tool to assess the auditory pathway of auditory neuropathy patients, improving the pre-operative examination and helping with selecting the suitable cochlear implant patient. Cochlear implantation can help patients with auditory neuropathy to improve hearing and speech.
评估听神经病的病理位置，并探讨听神经病患者人工耳蜗植入后的听力及言语康复效果。
选取我院行人工耳蜗植入的患者，其中听神经病患者8例，选取8例非听神经病的极重度聋患者作为匹配对照组，两组背景相近。回顾性分析两组患者术前听力资料。术中插入自制刺激电极测试电诱发听性脑干反应（EABR）以评估听觉通路；植入后测试EABR及神经反应遥测（NRT），1个月后获取T、C值。开机12个月后采用CAP、SIR及言语识别率评估听力及言语康复效果。
8例听神经病患者术中均可引出EABR波，但波形与正常波相比存在变异，需增加刺激或调整参数，V波潜伏期可变。人工耳蜗植入后，两组NRT及EABR波形相似，术后V波波形接近术中EABR。8对患者开机后可出现听觉反应。开机1年后，听神经病组与对照组的T、C值、CAP（6.50±0.94和6.90±0.77）及言语识别率（85.00%±11.66%和89.50%±9.02%）差异无统计学意义。
术前EABR可作为评估听神经病患者听觉通路的有效工具，完善术前检查，有助于筛选合适的人工耳蜗植入患者。人工耳蜗植入可帮助听神经病患者改善听力及言语功能。
