DPOAE部分异常患者人工耳蜗植入的ECAP研究

发布时间：2018-03-12 22:14

本文选题：畸变产物耳声发射　切入点：听性脑干反应　出处：《福建医科大学》2011年硕士论文　论文类型：学位论文

【摘要】：目的: 通过对听力学检查表现为DPOAE部分异常而听性脑干反应ABR无波反应的患者行人工耳蜗术后NRT检测中ECAP的研究来探讨此类听力学特征是否为耳蜗伴有蜗后性聋的诊断依据,用MAIS评价这类患者人工耳蜗植入的效果。方法: 采取回顾性病例对照研究的方法,在2002-2010年行人工耳蜗植入的226名患者中选取符合纳入和排除标准的DPOAE部分异常患者18例和DPOAE完全异常患者18例。分析DPOAE的引出情况,比较两组ECAP未引出率、ECAP阈值,及MAIS得分。结果: 1、研究组A中患者的DPOAE有3个、4个及5个频率引出,引出的频率主要集中在中、高频区。 2、各电极ECAP未引出数比较,术中2号电极A组高于B组,差异有统计学意义(P0.05)。总的ECAP未引出数比较,术中、开机、复诊及三次检测A组均高于B组,差异有统计学意义(P0.05)。按直弯电极构成校正三次总ECAP未引出率,A组大于B组,差异有统计学意义(P0.05)。A、B两组组内不同时间ECAP检出率比较,其中术中与开机、术中与复诊所得P0.05差异均有统计学意义,但开机与复诊P0.05差异均无统计学意义。各电极ECAP阈值比较,术中22号电极、复诊2、6、18、22号电极A组大于B组差异有统计学意义(P0.05)。 3、MAIS得分比较,A、B两组3-10题得分术后均高于术前,差异有统计学意义(P0.05)。A、B两组术后得分比较,差异无统计学意义P0.05。 4、A1与B1、A2与B2、A与B的年龄比较,差异无统计学意义P0.05。结论: DPOAE部分异常患者耳蜗外毛细胞有病变,但在中高频对应的耳蜗区域仍残存部分有功能的外毛细胞。在人工耳蜗植入候选患者中可能存在耳蜗与蜗后病变并存性耳聋,DPOAE部分异常(中高频正常)且ABR无波反应是这一类患者的诊断依据之一。本研究中DPOAE部分异常且ABR无波反应的患者其蜗后病变部位在螺旋神经节细胞或听神经或两者病变共存。本研究中DPOAE部分异常且ABR无波反应不可看做人工耳蜗植入的禁忌症,这类患者人工耳蜗植入效果良好,适宜行人工耳蜗植入。
[Abstract]:Objective:. The study of ECAP in the NRT examination of auditory brainstem response (ABR) with partial abnormality of DPOAE in cochlear implants was conducted to investigate whether the characteristics of hearing mechanics were the diagnostic basis for cochlear cochlear deafness with retrocochlear deafness. MAIS was used to evaluate the effect of cochlear implants in these patients. Methods:. A retrospective case-control study was conducted to select 18 patients with partial abnormal DPOAE and 18 patients with complete abnormality of DPOAE in the cochlear implants from 2002 to 2010. The ECAP threshold and MAIS score were compared between the two groups. Results:. 1. There were 3, 4 and 5 frequencies of DPOAE in study group A, and the frequencies were mainly in the middle and high frequency regions. 2. The number of ECAP in group A was higher than that in group B during operation, and the difference was statistically significant (P 0.05). The total number of ECAP was higher in group A than in group B, and in group A, the number of ECAP was higher than that in group B during operation, boot up, rediagnosis and three times examination. The difference was statistically significant (P 0.05). The rate of total ECAP in group A was higher than that in group B according to the composition of straight bend electrode. The difference was statistically significant. The detectable rate of ECAP in group A was significantly higher than that in group B at different times, in which the rate of ECAP during operation and operation was higher than that in group B. There were significant differences in P05 between operation and follow-up, but there was no significant difference between the two groups. The ECAP threshold of each electrode was significantly higher than that of group B (P 0.05), and that of electrode 22 was significantly higher than that of group B (P 0.05), and that of electrode 22 was significantly higher than that of group B (P < 0.05). 3Compared with the score of Mais in group A and B, the scores of 3-10 questions in group A were higher than those before operation, and the difference was statistically significant (P 0.05). There was no significant difference between group A and group B (P 0.05). 4 there was no significant difference in age between A 1 and B 1 A 2 and B 2 A and B (P 0.05). Conclusion:. There were pathological changes in the outer hair cells of cochlea in some patients with abnormal DPOAE. But there are still some functional outer hair cells in cochlear region corresponding to middle and high frequency. Cochlear and retrocochlear lesion cochlear cochlear and retrocochlear lesion cochlear cochlear cochlear and retrocochlear lesion cochlear deafness may exist in the cochlea cochlear and cochlear lesion cochlear cochlear cochlear deaf@@. Reaction is one of the diagnostic bases for this group of patients. The retrocochlear lesions of patients with partially abnormal DPOAE and no wave response of ABR in this study are co-existing in spiral ganglion cells or acoustic nerves or both. In this study, some abnormalities of DPOAE are found. Moreover, ABR without wave response could not be regarded as contraindication of cochlear implantation. Cochlear implants in these patients have a good effect and are suitable for cochlear implants.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R764.29

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