[人工耳蜗植入术中蜗神经孔狭窄及闭锁的诊断]
[Diagnosis of cochlear nerve foramen stenosis and atresia of the cochlear implantation].
作者信息
Zhang Daoxing
出版信息
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014 Aug;28(15):1101-4.
OBJECTIVE
To summarize methods on diagnosis of congenital cochlear nerve canal (CNC) stenosis or atresia and to report results of post-operation such as auditory electrophysiological test and speech test.
METHOD
Based on temporal bone HRCT and internal acoustic canal MRI, 27 bilateral congenital CNC stenosis/bony atresia cases were distinguished from 3 700 CI cases. Unilateral cochlear implantations were conducted above 27 cases. Post-operation tests such as auditory nerve response telemetry, EABR test, hearing threshold in sound field and speech recognition test were applied in the cases above.
RESULT
Incidence of CNC stenosis/bony atresia was observed at 0.73% (27 in 3700 CI cases). Impedance values were in the normal range accounting for 27 cases. Intro operative auditory nerve response telemetry were conducted accounting for 21 cases while 6 cases which were implanted with Combi40 + were not available for this test. Atypical ART response wave was observed for 14 cases, while no response for 7 cases. EABR test was completed in 27 cases within post-operation during 3 months and atypical EABR was identified in all cases. Hearing threshold in sound field was confirmed at 75 dB which was the average value of 500 Hz,1000 Hz,and 2000 Hz in all 27 cases. Speech recognition test result reached to both 65% (21 cases, simple finals test) and fewer than 10% (21 cases, simple initials test).
CONCLUSION
By temporal bone HRCT pre-operation, CNC stenosis/bony atresia can be diagnosed. According to both relatively poor auditory and speech test results, further research and discussion are requisite to identify CI indication among the cases above.
目的
总结先天性耳蜗神经管(CNC)狭窄或闭锁的诊断方法,并报告术后听觉电生理测试和言语测试等结果。
方法
基于颞骨高分辨率CT(HRCT)和内耳道MRI,从3700例人工耳蜗植入(CI)病例中鉴别出27例双侧先天性CNC狭窄/骨性闭锁病例。对这27例患者进行了单侧人工耳蜗植入。对上述病例进行了术后测试,如听神经反应遥测、电刺激听性脑干反应(EABR)测试、声场听阈和言语识别测试。
结果
观察到CNC狭窄/骨性闭锁的发生率为0.73%(3700例CI病例中有27例)。27例的阻抗值均在正常范围内。21例进行了术中听神经反应遥测,6例植入Combi40 +的患者未进行此测试。14例观察到非典型听神经反应遥测波,7例无反应。27例患者术后3个月内均完成了EABR测试,所有病例均识别出非典型EABR。所有27例患者的声场听阈在500Hz、1000Hz和2000Hz时的平均值为75dB。言语识别测试结果在简单韵母测试中达到65%(21例),在简单声母测试中低于10%(21例)。
结论
通过术前颞骨HRCT可诊断CNC狭窄/骨性闭锁。根据听觉和言语测试结果相对较差的情况,对于上述病例确定人工耳蜗植入适应证需要进一步研究和讨论。