先天性聋患儿人工耳蜗植入后大脑皮层活动演变与康复效果研究

发布时间：2018-05-07 21:31

本文选题：聋 + 先天性　；参考：《临床耳鼻咽喉头颈外科杂志》2017年21期

【摘要】：目的:针对先天性聋患儿群体在人工耳蜗植入(CI)后听觉功能恢复效果存在较大差异的问题,从诱发脑电源活动角度探讨影响患儿CI术后听觉功能恢复效果的内在机制。方法:首先征集先天性聋患儿23例以及正常对照儿童10例,于术前(0个月)及术后3、6、9和12个月定期采集视觉诱发的事件相关电位(ERP)数据,在CI术后12个月依据听觉功能恢复评估情况,将患儿划分为恢复"良好"与"较差"组。然后采用标准低分辨率层析成像(sLORETA)源定位分析技术,呈现出2组患儿相关大脑皮层的ERP演化情况,同时与正常对照组相比较。结果:先天性聋患儿耳聋期间存在大脑皮层跨模态功能重组;在CI术后患儿大脑皮层跨模态功能重组逐渐退化,相关脑区活动随之趋于正常,在术后第12个月听觉功能恢复"良好"与"较差"组患者在颞叶和顶叶周边联合皮层活动差异有统计学意义(P0.05)。结论:先天性聋患儿大脑皮层跨模态重组的正常化逆转与CI术后患儿听觉功能的恢复情况相关,特别是患儿颞叶和顶叶周边视听联合皮层的异常活动的正常化在一定程度上影响了听觉功能的恢复效果,对指导患者CI术后听力恢复训练和康复评估具有重要意义。
[Abstract]:Objective: to investigate the effect of CI on the recovery of hearing function in children with congenital deafness. Methods: first, 23 cases of congenital deafness and 10 cases of normal control were collected. The data of ERP were collected regularly before (0 months) and 3 months after operation (9 and 12 months). At 12 months after CI, according to the assessment of auditory function, the children were divided into good recovery group and poor recovery group. Then the ERP evolution of cortical cortex of the two groups was demonstrated by using the standard low resolution tomography (Lorreta) source localization analysis technique, and compared with the normal control group at the same time. Results: during the deafness of congenital deafness, there was transmodal functional recombination of cerebral cortex in children with congenital deafness, and the recombination of transmodal function of cerebral cortex gradually degenerated after CI, and the activity of related brain regions tended to be normal. At the 12th month after operation, there was a statistically significant difference in the activity of the temporal lobe and parietal cortex between the "good" group and the "poor" group (P 0.05). Conclusion: the normalization of transmodal recombination of cerebral cortex in children with congenital deafness is related to the recovery of auditory function after CI. In particular, the normalization of abnormal activities in the temporal lobe and parietal cortex affected the recovery of auditory function to a certain extent. It is of great significance to guide the training and evaluation of hearing recovery after CI.
【作者单位】：四川大学电气信息学院;中山大学孙逸仙纪念医院耳鼻咽喉科;
【分类号】：R764.43

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