EABR辅助31例Mondini畸形人工耳蜗植入及术后效果分析

发布时间：2018-11-09 21:25

【摘要】：目的探讨电刺激听觉脑干诱发电位(electrical evoked auditory brainstem responses,EABR)辅助Mondini畸形患者人工耳蜗植入手术的方法及术后效果分析。方法我院自2001年开始为Mondini畸形患者植入人工耳蜗,收集2012年至2015年在我院行人工耳蜗手术的Mondini畸形患者31例,回顾性分析Mondini畸形患者术前听力学特征,术前EABR特点,术中手术特点、术后NRT测试结果及开机调试结果,随访术后听觉言语康复能力CAP(categories of auditory performance)和SIR(speech intelligibility rating)评分。另选择相似耳聋年龄的耳蜗结构正常耳蜗植入患者20例作为正常对照组,测试结果进行对比分析。结果 31例Mondini畸形患者术前听力均为极重度感音神经性聋,其中14例无残余听力,对照组7例无残余听力,术前行EABR测试,引出率100%,有反应者植入不同类型电极的人工耳蜗;术中电极全部植入耳蜗内,其中4例出现脑脊液井喷,颞肌封堵,术后无面瘫、脑脊液漏、脑膜炎等手术并发症;所有Mondini畸形患者术后均获得听觉,开机测试神经反射遥测(neural response telemetry,NRT),引出率41.94%低于对照组95%;开机6月平均T值Mondini组171.37±13.14CL;对照组145.34±17.43CL;动态范围Mondini组33.24±10.73CL,对照组43.55±15.36CL,经统计学分析P0.05,有显著差异;随访6月~4年,Mondini组CAP平均得分6.13±1.15,SIR平均得分3.05±0.62;对照组CAP平均得分7.12±0.80,SIR平均得分4.03±0.91,经两样本比较t检验,P0.05有显著性差异。结论 Mondini畸形的双侧极重度感音神经性聋患者可以根据残余听力情况在EABR辅助下行人工耳蜗植入,术后听力言语康复较正常耳蜗结构患者效果稍差,但明显好于术前听觉和言语能力。
[Abstract]:Objective to explore the method and effect of cochlear implantation in patients with Mondini malformation assisted by electrical stimulation of auditory brainstem evoked potential (electrical evoked auditory brainstem responses,EABR). Methods from 2001, 31 patients with Mondini malformation underwent cochlear implantation in our hospital from 2012 to 2015. The characteristics of preoperative auditory mechanics and preoperative EABR were analyzed retrospectively in the patients with Mondini malformation. The operative features, postoperative NRT test results and commissioning results, CAP (categories of auditory performance) and SIR (speech intelligibility rating) scores of hearing and speech rehabilitation were followed up. Another 20 patients with normal cochlear implant with similar deafness age were selected as normal control group. The results were compared and analyzed. Results all the 31 patients with Mondini malformation had extremely severe sensorineural deafness before operation, 14 of them had no residual hearing, and 7 of the control group had no residual hearing. The EABR test was performed before operation, and the extraction rate was 100%. Cochlear implants with different electrodes were implanted in the patients. All the electrodes were implanted into cochlea during the operation. Among them, 4 cases had cerebrospinal fluid blowout, temporalis muscle occlusion, no postoperative complications such as facial paralysis, cerebrospinal fluid leakage, meningitis and so on. Hearing was obtained in all patients with Mondini malformation after operation. The rate of extraction was 41.94% lower than that of the control group (95. 94%), the mean T value of Mondini group was 171.37 卤13. 14 CLs, and that of control group was 145.34 卤17. 43 CLs. The dynamic range of CAP was 33.24 卤10.73 CLin in Mondini group and 43.55 卤15.36 CLin in control group. The average score of CAP in the control group was 7.12 卤0.80 and the average score of Sir was 4.03 卤0.91. There was significant difference between the two samples by t test. Conclusion the patients with bilateral extremely severe sensorineural hearing loss with Mondini malformation can be implanted in EABR assisted cochlear implant according to the residual hearing condition. The recovery of hearing and speech after operation is a little worse than that in patients with normal cochlear structure. But the ability of hearing and speech was better than that before operation.
【作者单位】：北京协和医院耳鼻喉科;
【分类号】：R764.92

【相似文献】