中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2008年
9期
653-659
,共7页
程靖宁%曹克利%魏朝刚%杨立军%栾岚%李欢%李原%张秋航
程靖寧%曹剋利%魏朝剛%楊立軍%欒嵐%李歡%李原%張鞦航
정정저%조극리%위조강%양립군%란람%리환%리원%장추항
诱发电位,听觉,脑干%蜗窗%耳蜗植入术
誘髮電位,聽覺,腦榦%蝸窗%耳蝸植入術
유발전위,은각,뇌간%와창%이와식입술
Evoked potentials,auditory,brain stem%Round window%Cochlear implantation
目的 建立人工耳蜗手术中经蜗窗龛电刺激记录听性脑干反应的方法.方法 应用自制铂铱合金球形电极作为刺激电极,改装的人工耳蜗植入体连接体外言语处理器作为电刺激仪及Bio-logic Navigator Pro诱发电位仪,对17例不同病因(包括听神经病2例、耳蜗骨化1例、内耳畸形5例、脑白质异常1例,原因不明8例),不同年龄的人工耳蜗植入患者在手术中进行测试.植入人工耳蜗装置前,将刺激电极放置在蜗窗龛内,用电荷平衡双相脉冲电流经蜗窗龛进行电刺激,记录电诱发听性脑干反应.结果 17例患者均记录到明确的电诱发听性脑干反应波形,Ⅲ波和Ⅴ波的潜伏期分别为(2.12±0.18)ms 和(4.18±0.19)ms,阈值为(220.00±16.04)CL.其中2例听神经病、5例内耳畸形、1例耳蜗骨化、1例脑白质异常患者均记录到分化良好的波形.结论 电诱发听性脑干反应是一项能够较准确地反映听觉传导通路功能完整性的客观神经电生理测试方法,对于判断人工耳蜗植入后患者能否获得听性反应,具有重要的应用价值.本研究方法的安全性符合要求,听性反应的引出率高,值得推广应用.
目的 建立人工耳蝸手術中經蝸窗龕電刺激記錄聽性腦榦反應的方法.方法 應用自製鉑銥閤金毬形電極作為刺激電極,改裝的人工耳蝸植入體連接體外言語處理器作為電刺激儀及Bio-logic Navigator Pro誘髮電位儀,對17例不同病因(包括聽神經病2例、耳蝸骨化1例、內耳畸形5例、腦白質異常1例,原因不明8例),不同年齡的人工耳蝸植入患者在手術中進行測試.植入人工耳蝸裝置前,將刺激電極放置在蝸窗龕內,用電荷平衡雙相脈遲電流經蝸窗龕進行電刺激,記錄電誘髮聽性腦榦反應.結果 17例患者均記錄到明確的電誘髮聽性腦榦反應波形,Ⅲ波和Ⅴ波的潛伏期分彆為(2.12±0.18)ms 和(4.18±0.19)ms,閾值為(220.00±16.04)CL.其中2例聽神經病、5例內耳畸形、1例耳蝸骨化、1例腦白質異常患者均記錄到分化良好的波形.結論 電誘髮聽性腦榦反應是一項能夠較準確地反映聽覺傳導通路功能完整性的客觀神經電生理測試方法,對于判斷人工耳蝸植入後患者能否穫得聽性反應,具有重要的應用價值.本研究方法的安全性符閤要求,聽性反應的引齣率高,值得推廣應用.
목적 건립인공이와수술중경와창감전자격기록은성뇌간반응적방법.방법 응용자제박의합금구형전겁작위자격전겁,개장적인공이와식입체련접체외언어처리기작위전자격의급Bio-logic Navigator Pro유발전위의,대17례불동병인(포괄은신경병2례、이와골화1례、내이기형5례、뇌백질이상1례,원인불명8례),불동년령적인공이와식입환자재수술중진행측시.식입인공이와장치전,장자격전겁방치재와창감내,용전하평형쌍상맥충전류경와창감진행전자격,기록전유발은성뇌간반응.결과 17례환자균기록도명학적전유발은성뇌간반응파형,Ⅲ파화Ⅴ파적잠복기분별위(2.12±0.18)ms 화(4.18±0.19)ms,역치위(220.00±16.04)CL.기중2례은신경병、5례내이기형、1례이와골화、1례뇌백질이상환자균기록도분화량호적파형.결론 전유발은성뇌간반응시일항능구교준학지반영은각전도통로공능완정성적객관신경전생리측시방법,대우판단인공이와식입후환자능부획득은성반응,구유중요적응용개치.본연구방법적안전성부합요구,은성반응적인출솔고,치득추엄응용.
Objective To establish the method of recording auditory bralnstem responseselectrically stimulated via round·window niche in cochlear implants.Methods Self-made phfinum iridiumauoy as a spherical electrode stimulation electrode,modified cochlear implants connected to in vitro speech processor 88 a electro·stimulator and evoke potential instrument for Bio-logic Navigator Pro,17 cechlear implant patients with various ages and of d～erent CaUlS,including auditory neuropathy(2 CS84gS),08si6ed cochlea(1 case),inner ear malformation(5 cases),leukodystrophy(1 case),unknown and reason(8 cases)were investigated during cochlear implant surgery.Before cochlear implantation,stimulation electrode was placod in the round.wiMow niche while charge balanced biphasic constant current Was used as electrical stimulation via round window niche,and then electrically evoked auditory brainstem responge was recorded.Results Electrically evoked auditory brainstem response waveforms were clearlv recorded in all 17 cases.The Iatencies of Ⅲ and Ⅴ waves were(2.12±0.18)ms and(4.18±0.19)ms respectively,with threshold as (220.0±16.04)CL.Thewaveforms of the 2 patientswith auditory neuropathy,5 pailentswithinner ear malformation.1 patient with ossifiod cochlea and 1 patient with leukodystrophy were well differentiated.Conclusions Monitoting electrically evoked auditory brainstem response was an obiective nerve electmphysiological testing method that accurately reflects function complexness of auditory pathway.It had important value for helping making the judgment whether patients could acquire auditory response after cochlear implantation.This method Was safe and gave high emission of auditory response,therefore should be spread widely.
