Choudhury Baishakhi, Adunka Oliver Franz, Awan Omar, Pike John Maxwell, Buchman Craig A, Fitzpatrick Douglas C
Department of Otolaryngology/Head and Neck Surgery, The University of North Carolina at Chapel Hill; Chapel Hill North Carolina, U.S.A.
Otol Neurotol. 2014 Mar;35(3):519-25. doi: 10.1097/MAO.0b013e31829bdf2b.
Flexible electrode interaction with intracochlear structures in a noise-damaged region of the cochlea can lead to measureable electrophysiologic changes.
An emerging goal in cochlear implantation is preservation of residual hearing subsequently allowing for combined electric and acoustic stimulation (EAS). However, residual hearing is at least partially lost in most patients as a result of electrode insertion. A gerbil model was used to examine changes to acoustically evoked cochlear potentials during simulated cochlear implantation.
Gerbils were partially deafened by noise exposure to mimic residual hearing in human cochlear implant candidates. After 1 month, round window and intracochlear recordings during flexible electrode insertion were made in response to 1 kHz tone burst stimuli at 80 dB SPL. After the insertion, the cochleas were histologically examined for hair cell loss because of the noise exposure and trauma because of the electrode insertion.
Anatomic damage from the flexible electrode was not observable in most cases. However, insertions caused response declines that were, on average, greater than the controls, although some losses were similar to the controls. The CM was more sensitive than the CAP for detecting cochlear disturbance.
Because response reductions occurred in the absence of anatomic damage, disturbances in the fluid at the base appear to affect responses from the apex. The losses were less than in previous experiments where the basilar membrane was penetrated.
在耳蜗噪声损伤区域,柔性电极与耳蜗内结构的相互作用可导致可测量的电生理变化。
人工耳蜗植入的一个新目标是保留残余听力,从而实现电刺激和声刺激联合使用(EAS)。然而,在大多数患者中,由于电极插入,残余听力至少会部分丧失。使用沙鼠模型来研究模拟人工耳蜗植入过程中声诱发耳蜗电位的变化。
通过噪声暴露使沙鼠部分失聪,以模拟人工耳蜗植入候选者的残余听力。1个月后,在插入柔性电极期间,针对80 dB SPL的1 kHz短音刺激,进行圆窗和耳蜗内记录。插入后,对耳蜗进行组织学检查,以确定因噪声暴露导致的毛细胞损失以及因电极插入造成的损伤。
在大多数情况下,未观察到柔性电极造成的解剖损伤。然而,尽管有些插入造成的反应损失与对照组相似,但平均而言,插入导致的反应下降幅度大于对照组。在检测耳蜗干扰方面,CM比CAP更敏感。
由于在没有解剖损伤的情况下出现反应降低,因此基底处液体的干扰似乎会影响顶端的反应。这些损失小于先前穿透基底膜的实验中的损失。