蜗神经管狭窄患者人工耳蜗植入术后听觉康复效果分析

发布时间：2018-07-22 21:06

【摘要】：目的分析蜗神经管狭窄患者人工耳蜗植入术(cochlear implantation,CI)后康复效果。方法对30例术前颞骨高分辨率CT诊断为蜗神经管狭窄的双耳极重度感音神经性聋患者术中和CI术后3、6、9个月行听神经复合动作电位(evoked compound action potential,ECAP)和电刺激脑干诱发电位(evoked auditory brainstem response,EABR)检测,并于术前、术后3、6、9个月行声场测听,其中17例3岁以上(含3岁)患者行封闭式言语识别率测试,分析其听觉康复效果。结果 130例患者术后3、6、9个月ECAP和EABR的波形均无明显变化。2术后3、6、9个月声场听阈分别为65±8、62±4、61±7dB HL,较术前(100±5dB HL)明显改善。317例术后3、6及9个月的单韵母识别率分别为55%±7%、56%±8%、80%±4%,术后9个月时较术前(52%±8%)明显改善;单声母识别率分别为9%±3%、8%±4%、9%±2%,较术前(8%±2%)无明显改善。结论双侧蜗神经管狭窄患者CI术中、术后ECAP与EABR检测均不能引出典型波形,术后主观听力及言语识别率较差,语言交流存在障碍。
[Abstract]:Objective to analyze the rehabilitation effect of cochlear canal stenosis patients after cochlear implantation (CI). Methods Thirty patients with extremely severe auricular sensorineural hearing loss diagnosed as cochlear canal stenosis by high resolution CT of temporal bone before operation were examined by auditory nerve compound action potential (evoked compound action) and brainstem evoked potential (evoked auditory brainstem) at 9 months. Acoustic field audiometry was performed in 6 months and 9 months before and after operation. Among them, 17 patients over 3 years old (including 3 years old) underwent closed speech recognition test to analyze the effect of auditory rehabilitation. Results there were no significant changes in ECAP and EABR waveforms in 130 patients at 3 and 9 months postoperatively. The auditory threshold of sound field in 9 months was 65 卤862 卤461 卤7dB HL2 respectively, which was significantly better than that before operation (100 卤5dB HL). The recognition rate of single vowel was 55% 卤756% 卤856% 卤80.0% 卤4dB respectively in 317 patients after operation for 3 months and 9 months after operation. 9 months after operation (52% 卤8%). The recognition rate of mono-consonant was 9% 卤3% 卤4% 卤4% 卤2%, which was not significantly improved compared with that before operation (8% 卤2%). Conclusion in CI patients with bilateral cochlear canal stenosis, the detection of ECAP and EABR after operation can not elicit typical waveforms, the subjective hearing and speech recognition rates are poor after operation, and language communication is impaired.
【作者单位】：首都医科大学宣武医院耳鼻咽喉头颈外科;
【分类号】：R764.9

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