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听觉诱发电位在人工耳蜗植入中的作用

The Role of Auditory Evoked Potentials in the Context of Cochlear Implant Provision.

作者信息

Hoth Sebastian, Dziemba Oliver Christian

机构信息

*Department of ENT, University of Heidelberg, Heidelberg †Department of ENT, Head & Neck Surgery, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald, Germany.

出版信息

Otol Neurotol. 2017 Dec;38(10):e522-e530. doi: 10.1097/MAO.0000000000001480.

Abstract

: Auditory evoked potentials (AEP) are highly demanded during the whole process of equipping patients with cochlear implants (CI). They play an essential role in preoperative diagnostics, intraoperative testing, and postoperative monitoring of auditory performance and success. The versatility of AEP's is essentially enhanced by their property to be evokable by acoustic as well as electric stimuli. Thus, the electric responses of the auditory system following acoustic stimulation and recorded by the conventional surface technique as well as by transtympanic derivation from the promontory (Electrocochleography [ECochG]) are used for the quantitative determination of hearing loss and, additionally, electrically evoked compound actions potentials (ECAP) can be recorded with the intracochlear electrodes of the implant just adjacent to the stimulation electrode to check the functional integrity of the device and its coupling to the auditory system. The profile of ECAP thresholds is used as basis for speech processor fitting, the spread of excitation (SOE) allows the identification of electrode mislocations such as array foldover, and recovery functions may serve to optimize stimulus pulse rate. These techniques as well as those relying on scalp surface activity originating in the brainstem or the auditory cortex accompany the CI recipient during its whole life span and they offer valuable insights into functioning and possible adverse effects of the CI for clinical and scientific purposes.

摘要

在为患者配备人工耳蜗(CI)的整个过程中,对听觉诱发电位(AEP)的需求很高。它们在术前诊断、术中测试以及术后听觉性能和效果监测中起着至关重要的作用。AEP的多功能性主要因其可被声学和电刺激诱发的特性而得到增强。因此,通过传统表面技术以及经鼓岬经鼓膜导出(电耳蜗图[ECochG])记录的声学刺激后听觉系统的电反应,用于定量测定听力损失,此外,还可以使用植入物的耳蜗内电极紧邻刺激电极记录电诱发复合动作电位(ECAP),以检查设备的功能完整性及其与听觉系统的耦合情况。ECAP阈值曲线用作言语处理器调试的基础,兴奋扩散(SOE)可用于识别电极错位,如阵列折叠,恢复功能可用于优化刺激脉冲率。这些技术以及那些依赖源自脑干或听觉皮层的头皮表面活动的技术,在人工耳蜗接受者的整个生命周期中都伴随着他们,并且它们为临床和科学目的提供了有关人工耳蜗功能和可能的不良影响的宝贵见解。

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