Jin Yi, Cao Keli, Wei Chaogang, Wang Bin
Department of Cochlear Implant Center, Otolaryngology of Peking Union Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013 Jul;27(13):694-7, 700.
To investigate the intra-operative electrical evoked auditory brain stem response (EABR) characteristics and the hearing and speech rehabilitation effects of cochlear implantation (CI) in patients with internal auditory canal stenosis (IACS).
A retrospective study was performed on 16 patients with IACS (IACS group) matched with 16 implanted without IACS (control group), who received multi- channel CI because of pre-lingual sensorineural hearing loss. The integrity and functional status of the auditory pathway were assessed by EABR, recording waveforms, thresholds and dynamic ranges intra-operation before CI. Interviewed the implanted parents or teachers, asking them to rate the implanted hearing and speech ability according to Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR). Paired T test was performed to compare scores of CAP and SIR between before and 1 year after CI, while Spearman test was performed to compare correlation between EABR grades and post-operative CAP scores.
Among the IACS group, 2 cases weren't recorded typical EABR waveforms and without auditory response 1 year after a successful CI. The EABR waveforms in the IACS group were poorer than that in the control group, their EABR thresholds higher than the control group, and their EABR dynamic ranges less than the control group. The hearing and speech rehabilitation after CI showed that the results of CAP and SIR values (3.47 +/- 1.09 and 1.62 +/- 0.50) scored significantly lower than the control group (5.06 +/- 0.79 and 2.59 +/- 0.58) (P < 0.05), but significantly increased compared with pre-operation. Intra-operative EABR grades and post-operative CAP scores showed significant correlation (r = 0.78 , P < 0.05).
Intra-operative EABR can accurately monitor the integrity and functional status of the auditory pathway, be of important clinical value in predicting whether patients can acquire auditory responses with the aid of CI. CI can help patients with IACS to improve the ability of hearing and speech with EABR to screen out compatible implanted.
探讨内耳道狭窄（IACS）患者人工耳蜗植入（CI）术中电诱发听觉脑干反应（EABR）特点及听力和言语康复效果。
对16例IACS患者（IACS组）和16例无IACS的植入患者（对照组）进行回顾性研究，这些患者因语前感音神经性听力损失接受多通道CI。通过EABR评估听觉通路的完整性和功能状态，在CI术前记录术中波形、阈值和动态范围。对植入患者的家长或教师进行访谈，要求他们根据听觉表现类别（CAP）和言语可懂度评分（SIR）对植入患者的听力和言语能力进行评分。采用配对t检验比较CI术前和术后1年CAP和SIR评分，采用Spearman检验比较EABR分级与术后CAP评分的相关性。
IACS组中，2例在CI成功后1年未记录到典型EABR波形且无听觉反应。IACS组的EABR波形比对照组差，EABR阈值高于对照组，EABR动态范围小于对照组。CI术后听力和言语康复显示，CAP和SIR值（3.47±1.09和1.62±0.50）评分显著低于对照组（5.06±0.79和2.59±0.58）（P<0.05），但与术前相比显著提高。术中EABR分级与术后CAP评分呈显著相关（r=0.78，P<0.05）。
术中EABR可准确监测听觉通路的完整性和功能状态，对预测患者能否借助CI获得听觉反应具有重要临床价值。CI可帮助IACS患者提高听力和言语能力，通过EABR筛选出合适的植入者。
