人工耳蜗植入术中电诱发镫骨肌反射及听觉神经反应遥测监测分析

摘要

目的：探讨在人工耳蜗植入术中应用电诱发镫骨肌反射（electrically elicited stapedius reflex ，ESR）及听觉神经反应遥测（auditory nerve response telemetry ，ART ）判断听觉通路功能的临床意义。方法对20例行SONATATI100型人工耳蜗植入者，于术中应用MEDEL公司的Maestro软件分别进行 ESR和ART 检测，分别检测蜗底（10、12号电极）、蜗中（6、8号电极）及蜗顶（2、4号电极）的ESR阈值和电诱发复合动作电位（electrically e-voked compound action potentials ，ECAP）。结果20例患者120个电极中，ESR和ART 检出率分别为96．67％（116/120）和95．0％（114/120）；刺激蜗底、蜗中和蜗顶时，ES R、EC A P阈值均逐渐下降，但 ES R阈值均显著高于ECAP阈值（P＜0．05）；ECAP幅值及幅值增长曲线斜率逐渐上升。结论人工耳蜗植入术中应用 ESR和 ART监测可以及时判断植入体是否完好及听觉传导通路是否正常。%Objective Using maestro software to analyze the application of electrically elicited stapedius reflex and auditory nerve response in assessing acoustic function intraoperatively .Methods 20 SONATATI100cochlear im-plant patients participated in this study .Both ESRT and ECAP were recorded intraoperatively by using MED -EL Maestro software and analyzed .Results 96 .67% typical ESR and 95 .0% typical ECAP were recorded .Certain properties of ECAP recordings varied depending on the stimulation sites in the cochlea .There was strong relation-ship between ESRT and ECAP thresholds .Conclusion ESR and ART were proved to be most beneficial in assessing the functions of the implanted as well as proving that the auditory pathway is stimulated during the cochlear implan-tation surgery .