术前多频稳态听觉诱发电位与人工耳蜗植入术后神经反应遥测相关性研究

发布时间：2018-02-10 13:05

本文关键词： 多频稳态人工耳蜗植入神经反应遥测术前评估　出处：《安徽医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的多频稳态听觉诱发电位（ASSR）是目前重度及极重度耳聋患者行诊断、术前常规检查项目之一，对残余听力具有良好评估效果。神经反应遥测技术(neuralresponse telemetry, NRT)是一种记录电诱发听神经复合动作电位(electricallyevokedcompound action potential, ECAP)的客观测试,，应用于人工耳蜗植入术的术中检测和术后开机，是确定电刺激阈值和最大刺激阈值的重要参考标准。本文通过分析25例澳大利亚人工耳蜗植入者的检查结果，探讨术前ASSR与术后神经反应遥测之间的相关性的研究。方法分析2005-2011年4月期间在我院行人工耳蜗植入术的25例澳大利亚人工耳蜗植入者在频率500HZ、1KHZ、2KHZ、4KHZ的ASSR检测结果，对其术后第1、3、6月开机、调试时选取第5、10、15、20电极行神经反应遥测(neuralresponse telemetry, NRT)检测，测定ASSR、电诱发听神经复合动作电位(ECAP)、主观阈值(T-levels)和主观最大舒适强度(C-levels)，根据术耳术前ASSR在500Hz和2000Hz有无引出将数据分为两组，两者之一可引出或者两者均可引出分为A组，两个频率都没有引出分为B组，将两组术后第20和10通道的NRT的主观阈值T结果对比做统计学分析。结果 1.术后听力听阈调试结果为 A组术后第1、3、6月的第20通道的T值平均值分别为149.42dB，150.70dB，151.89dB。第10通道的T值分别为157.24dB，158.53dB，159.75dB。 B组术后第1、3、6月的第20通道T值平均值分别为151.12dB，151.84dB，153.25dB。第10通道的T值分别为158.69dB，161.20dB，163.98dB。通过SPASS13.0软件用t检验分析比对，发现术后1月和3月、6月时在通道10和通道20的T值A组值均比B组较低，差异均有统计学意义。 2.电话随访结果今年2月份进行末次电话随访时，，有12例已进入普通小学、幼儿园上学，13例仍在言语康复学校训练，均可和家人正常交流,家属满意度优。结论术前多频稳态与术后神经反应遥测具有良好的相关性，对预行人工耳蜗植入术患者术前进行多频稳态检测，可以对其术后听力反应具有良好的评估，可作为术耳选择参考条件之一。
[Abstract]:Objective Multi-frequency steady-state auditory evoked potential (ASSRS) is one of the routine preoperative examinations for the diagnosis of severe and extremely severe deafness. Neural response telemetry (NRTT) is an objective test for recording electrically-evoked compound action potential (ECAP), which is used for the intraoperative detection and operation of cochlear implants. It is an important reference standard to determine the electrical stimulation threshold and the maximum stimulation threshold. By analyzing the results of 25 Australian cochlear implants, the correlation between preoperative ASSR and postoperative nerve response telemetry was studied. Methods the ASSR results of 25 Australian cochlear implants who underwent cochlear implants in our hospital from April 2005 to 2011 were analyzed at the frequency of 500HZ1KHZ2KHZ2KHZ2KHZ 4KHZ. The first operation was performed on the 3rd day after operation, and the operation was performed on June. Nerve response telemetry and neuralresponse telemetrymetry (NRTs) were performed at the 5th 10h 1520 electrode during debugging. ASSRs, electrically evoked auditory nerve complex action potentials (ECAPs), subjective threshold values (T-level) and subjective maximum comfort intensity (C-level sn) were measured. The data were divided into two groups according to whether the preoperative ASSR was obtained at 500Hz and 2000Hz. One of them can be induced or both can be divided into A group and neither frequency is divided into B group. The subjective threshold T results of NRT in the 20th and 10th channels after operation in both groups were compared and analyzed statistically. Results. 1. The results of hearing threshold debugging after operation are as follows: 1. In group A, the mean T values of the 20th channel were 149.42 dB ~ 150.70 dB ~ 151.89 dB and 157.24 dB ~ 158.53 dB ~ 159.75 dB, respectively. In group B, the mean T values of the 20th channel were 151.12 dB1, 151.84 dB and 153.25 dB, respectively, and the T values of the 10th channel were 161.20 dB and 163.98 dB, respectively. The T-value of group A was lower than that of group B on January, March and June by SPASS13.0 software, and the difference was statistically significant between group A and group B. the T value of group A was significantly lower than that of group B on January, March and June. 2. Telephone follow-up results. At the last telephone follow-up in February this year, 12 cases had entered ordinary primary school, 13 cases in kindergarten were still training in speech rehabilitation school, they could communicate with their families normally, and the satisfaction of the families was excellent. Conclusion there is a good correlation between preoperative multifrequency steady-state and postoperative nerve response telemetering. The multifrequency steady-state detection before cochlear implantation can be used to evaluate the postoperative hearing response of cochlear implants. It can be used as one of the reference conditions for ear selection.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R764

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