中国听力语言康复科学杂志
中國聽力語言康複科學雜誌
중국은력어언강복과학잡지
CHINESE SCIENTIFIC JOURNAL OF HEARING AND SPEECH REHABILITATION
2014年
1期
30-32
,共3页
王林娥%李悦%王伟%张道行
王林娥%李悅%王偉%張道行
왕림아%리열%왕위%장도행
蜗神经管狭窄%人工耳蜗植入%听觉康复效果
蝸神經管狹窄%人工耳蝸植入%聽覺康複效果
와신경관협착%인공이와식입%은각강복효과
Cochlear nerve canal stenosis%Cochlear implantation,Auditory rehabilitation outcome
目的评估极重度感音神经性聋伴蜗神经管狭窄患者人工耳蜗植入术后的听觉康复效果。方法回顾分析10例极重度感音神经性聋伴蜗神经管狭窄患者的临床资料，包括听力学、影像学、术中神经反应测试及术后听觉康复效果评估结果。结果10例患者术耳人工耳蜗植入前听性脑干反应、40 Hz听觉事件相关电位、畸变产物耳声发射均未引出，颞骨薄层CT示不同程度的蜗轴与内听道之间的蜗神经管狭窄。术中神经反应测试2例患者有3个电极可引出神经反应波形，1例患者有2个电极可引出神经反应波形，6例患者有1个电极可以引出神经反应波形，1例患者术中未引出神经反应波形。8例患者术后超过2年，其3个月、6个月、9个月、1年、2年时的平均单元音识别率分别为60.3%、60.4%、60.3%、60.2%、60.2%，单辅音识别率分别为19.0%、19.1%、19.1%、19.2%、19.2%。2例患者术后仅3个月，其平均单元音、单辅音识别率分别为60.1%、18.2%。结论10例极重度感音神经性聋伴蜗神经管狭窄患者术前无残余听力，术中神经反应测试只有部分电极可以引出神经反应波形，术后听觉康复效果较差。
目的評估極重度感音神經性聾伴蝸神經管狹窄患者人工耳蝸植入術後的聽覺康複效果。方法迴顧分析10例極重度感音神經性聾伴蝸神經管狹窄患者的臨床資料，包括聽力學、影像學、術中神經反應測試及術後聽覺康複效果評估結果。結果10例患者術耳人工耳蝸植入前聽性腦榦反應、40 Hz聽覺事件相關電位、畸變產物耳聲髮射均未引齣，顳骨薄層CT示不同程度的蝸軸與內聽道之間的蝸神經管狹窄。術中神經反應測試2例患者有3箇電極可引齣神經反應波形，1例患者有2箇電極可引齣神經反應波形，6例患者有1箇電極可以引齣神經反應波形，1例患者術中未引齣神經反應波形。8例患者術後超過2年，其3箇月、6箇月、9箇月、1年、2年時的平均單元音識彆率分彆為60.3%、60.4%、60.3%、60.2%、60.2%，單輔音識彆率分彆為19.0%、19.1%、19.1%、19.2%、19.2%。2例患者術後僅3箇月，其平均單元音、單輔音識彆率分彆為60.1%、18.2%。結論10例極重度感音神經性聾伴蝸神經管狹窄患者術前無殘餘聽力，術中神經反應測試隻有部分電極可以引齣神經反應波形，術後聽覺康複效果較差。
목적평고겁중도감음신경성롱반와신경관협착환자인공이와식입술후적은각강복효과。방법회고분석10례겁중도감음신경성롱반와신경관협착환자적림상자료，포괄은역학、영상학、술중신경반응측시급술후은각강복효과평고결과。결과10례환자술이인공이와식입전은성뇌간반응、40 Hz은각사건상관전위、기변산물이성발사균미인출，섭골박층CT시불동정도적와축여내은도지간적와신경관협착。술중신경반응측시2례환자유3개전겁가인출신경반응파형，1례환자유2개전겁가인출신경반응파형，6례환자유1개전겁가이인출신경반응파형，1례환자술중미인출신경반응파형。8례환자술후초과2년，기3개월、6개월、9개월、1년、2년시적평균단원음식별솔분별위60.3%、60.4%、60.3%、60.2%、60.2%，단보음식별솔분별위19.0%、19.1%、19.1%、19.2%、19.2%。2례환자술후부3개월，기평균단원음、단보음식별솔분별위60.1%、18.2%。결론10례겁중도감음신경성롱반와신경관협착환자술전무잔여은력，술중신경반응측시지유부분전겁가이인출신경반응파형，술후은각강복효과교차。
Objective To evaluate the auditory rehabilitation outcomes of profoundly sensorineural hearing-impaired patients with cochlear nerve canal stenosis after cochlear implantation. Methods The clinical data of 10 cases were analyzed including audiologic data, imaging findings, intraoperative neural responses and postoperative auditory performance. Results The auditory brainstem response, 40 Hz auditory event related potential and distortion product otoacoustic emissions (DPOAE) were absent before cochlear implantation in all the 10 cases. The temporal bone CT showed different degrees of cochlear nerve canal stenosis between the internal auditory canal and cochlear modiolus. The electrically evoked compound action potentials(ECAP)of auditory nerves can be elicited by 3 electrodes in 2 cases, 2 electrodes in 1 case and 1 electrode in 6 cases, but no ECAP waveform was observed in 1 case during surgery. The average vowel recognition rates of 8 patients 3 months,6 months,9 months,1 year and 2 years after cochlear implantation were 60.3%,60.4%,60.3%,60.2%and 60.2%,and the average consonant recognition rates were 19.0%,19,1%,19.1%,19.2% and 19.2%.The average vowel and consonant recognition rate of the 2 patients 3 months after cochlear implantation was 60.1% and 18.2%, respectively. Conclusion The 10 profoundly sensorineural hearing-impaired patients with cochlear nerve canal stenosis have no residual hearing before cochlear implantation and the intraoperative ECAPs can be evoked by only part of the electrodes. After cochlear implantation, the patients have poor auditory rehabilitation outcomes.
