Wiet R J, O'Connor C A, Martone L
Northwestern University Medical School, Chicago, Illinois, USA.
Otolaryngol Head Neck Surg. 1996 Jul;115(1):98-106. doi: 10.1016/S0194-5998(96)70144-4.
Intraoperative auditory monitoring is a useful adjunct that is currently evolving. Near-field monitoring techniques such as electrocochleography and direct eighth nerve compound action potential are being used more frequently. The use of these two techniques is compared in 26 patients undergoing hearing preservation acoustic neuroma resection. Overall, 9 (35%) of the 26 patients had their hearing preserved. Three (23%) of the 13 with electrocochleography monitoring and 6 (46%) of the 13 with direct compound action potential monitoring had hearing preserved after surgery. Although there was a suggestion of improved results with direct compound action potential monitoring, the results were not statistically different. It was noted that lack of electrical response at the completion of the procedure (regardless of monitoring technique) was correlated with poor postoperative hearing, whereas the presence of a waveform at termination in no way predicted satisfactory postoperative hearing. The two techniques and their advantages and disadvantages are discussed.
术中听觉监测是一种目前仍在不断发展的有用辅助手段。近场监测技术，如耳蜗电图和直接听神经复合动作电位，正得到更频繁的应用。对26例接受保留听力的听神经瘤切除术的患者使用这两种技术进行了比较。总体而言，26例患者中有9例（35%）听力得以保留。在13例采用耳蜗电图监测的患者中，有3例（23%）术后听力得以保留；在13例采用直接复合动作电位监测的患者中，有6例（46%）术后听力得以保留。尽管直接复合动作电位监测显示出更好的结果，但结果并无统计学差异。值得注意的是，手术结束时无电反应（无论监测技术如何）与术后听力不佳相关，而终止时出现波形并不能预测术后听力良好。文中讨论了这两种技术及其优缺点。
