Tavartkiladze G A
Russian Research Centre for Audiology and Hearing Rehabilitation, Russian Medico-Biological Agency, Moscow, Russia, 117513; Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, Moscow, Russia, 123395.
Vestn Otorinolaringol. 2018;83(4):9-14. doi: 10.17116/otorino20188349.
The problems concerning the registration of late latency auditory responses to electric stimulation in the patients wearing cochlear implants are considered. The renewed interest to this class of evoked potentials is due to unexplained differences in the results of cochlear implantation in the patients with the similar audiological data, etiology, age and the history of deafness as well as cochlear implant surgery in children of first years of life and the extended possibilities for speech processor programming. It is maintained that the advantages of this method include the possibility to objectively evaluate the ability of brain to detect and discriminate between different stimulus characteristics, such as loudness differences, temporal changes or speech tokens. This method is of great clinical significance for the electrophysiological monitoring of brain plasticity and documentation of the clinical effectiveness of different rehabilitation methods. Based on our own experimental and clinical results and the literature data, we consider the application of different electrically evoked late latency potentials for the monitoring of the auditory pathway maturation dynamics during the electric stimulation as well for the estimation of the effectiveness of cochlear implantation. It is concluded that the longer duration of deafness and later age at implantation result in immature morphology and delayed peak latencies and that patients with shorter latencies and higher amplitudes have better speech perception. The use of different classes of electrically evoked responses of auditory cortex could provide the objective control of the effectiveness of the rehabilitative measured in the children following cochlear implantation.
本文探讨了佩戴人工耳蜗患者电刺激诱发的晚期听觉反应记录相关问题。对这类诱发电位重新产生兴趣的原因在于,在听力数据、病因、年龄和耳聋病史相似的患者中,人工耳蜗植入结果存在无法解释的差异,以及一岁儿童人工耳蜗植入手术和言语处理器编程可能性的扩展。有人认为,该方法的优点包括能够客观评估大脑检测和区分不同刺激特征(如响度差异、时间变化或语音标记)的能力。该方法对于大脑可塑性的电生理监测以及不同康复方法临床效果的记录具有重要临床意义。基于我们自己的实验和临床结果以及文献数据,我们考虑应用不同的电诱发晚期电位来监测电刺激期间听觉通路成熟动态以及评估人工耳蜗植入的效果。得出的结论是,耳聋持续时间越长和植入年龄越大,形态越不成熟且峰潜伏期延迟,潜伏期较短和波幅较高的患者言语感知能力更好。使用不同类型的听觉皮层电诱发反应可以客观控制人工耳蜗植入儿童康复措施的效果。