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不同方法检测听神经功能异常的敏感性。

The sensitivity of different methods for detecting abnormalities in auditory nerve function.

机构信息

Department of Otolaryngology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.

NHC Key Laboratory of Hearing Medicine, Shanghai, China.

出版信息

Biomed Eng Online. 2020 Feb 3;19(1):7. doi: 10.1186/s12938-020-0750-2.

Abstract

BACKGROUND

Cochlear implants (CIs) have become important for the treatment of severe-to-profound sensorineural hearing loss (SNHL). Meanwhile, electrically evoked compound action potentials (ECAPs) and electrically evoked auditory brainstem responses (EABRs), which can be examined and evaluated with minimal patient cooperation, have become more reliable for tone measurement and speech recognition postoperatively. However, few studies have compared the electrophysiological characteristics of the auditory nerve using ECAPs and EABRs under different functional states of the auditory nerve (FSANs). We used guinea pig models in which six electrodes were implanted unilaterally with continuous electrical stimulation (ES) for 4 h. The amplitude growth functions (AGFs) of the alternating polarity ECAP (AP-ECAP) and forward-masking subtraction ECAP (FM-ECAP), as well as the EABR waves under "normal" and "abnormal" FSANs, were obtained.

RESULTS

Both the AP-ECAP and FM-ECAP thresholds were significantly higher than those measured by EABR under both "normal" FSAN and "abnormal" FSANs (p < 0.05). There was a significant difference in the slope values between electrodes 1 and 2 and electrodes 3 and 4 in terms of the AP-ECAP under the "abnormal" FSAN (p < 0.05). The threshold gaps between the AP-ECAP and FM-ECAP were significantly larger under the "abnormal" FSAN than under the "normal" FSAN (p < 0.05).

CONCLUSIONS

Both of the ECAP thresholds were higher than the EABR thresholds. The AP-ECAP was more sensitive than the FM-ECAP under the "abnormal" FSAN.

摘要

背景

人工耳蜗已成为治疗重度至极重度感音神经性听力损失(SNHL)的重要手段。同时,电诱发复合动作电位(ECAPs)和电诱发听觉脑干反应(EABRs)可以在最小的患者配合下进行检查和评估,并且在术后对于音调测量和言语识别变得更加可靠。然而,很少有研究比较使用 ECAP 和 EABR 在不同听神经功能状态(FSANs)下的听神经电生理特征。我们使用豚鼠模型,其中在一侧植入了 6 个电极,并进行持续电刺激(ES)4 小时。获得了交替极性 ECAP(AP-ECAP)和前向掩蔽减法 ECAP(FM-ECAP)的幅度增长函数(AGFs),以及“正常”和“异常”FSAN 下的 EABR 波。

结果

在“正常”FSAN 和“异常”FSAN 下,AP-ECAP 和 FM-ECAP 的阈值均明显高于 EABR 测量值(p<0.05)。在“异常”FSAN 下,AP-ECAP 中电极 1 和 2 与电极 3 和 4 之间的斜率值存在显著差异(p<0.05)。在“异常”FSAN 下,AP-ECAP 和 FM-ECAP 之间的阈值差距明显大于“正常”FSAN 下的阈值差距(p<0.05)。

结论

两种 ECAP 阈值均高于 EABR 阈值。在“异常”FSAN 下,AP-ECAP 比 FM-ECAP 更敏感。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7222/6998811/21118280faf8/12938_2020_750_Fig1_HTML.jpg

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