皮层听觉诱发电位评估耳聋儿童助听器验配效果的意义

The Application of Cortical Auditory Evoked Potentials in the Assessment of Hearing Aid Fitting for Hearing-impaired Children

郭倩倩;陈雪清;莫玲燕;孟超;

1:首都医科大学附属北京同仁医院耳鼻咽喉头颈外科北京市耳鼻咽喉科研究所耳鼻咽喉头颈外科学教育部重点实验室(首都医科大学)

2:北京和睦家医院耳鼻咽喉科

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摘要

目的探讨皮层听觉诱发电位(cortical auditory evoked potential,CAEP)在助听器验配效果评估中的应用价值,为临床耳聋儿童听觉言语康复效果评估提供参考。方法 26例语前聋患儿均双耳选配助听器,分别测试患儿助听条件下的CAEP及助听听阈;根据助听后三个刺激声/m/、/g/、/t/在55dB SPL强度下是否全部引出波形将患儿分为A组和B组,全部引出波形的患儿为A组,其余患儿为B组,比较二组的助听听阈。结果 26例患儿CAEP波形引出率为96.15%(25/26),A组(11例)0.25、0.5、1、2、4kHz助听听阈均值分别为32.73±7.54、27.27±5.18、35.00±5.48、35.91±7.35、35.45±4.72dB HL;B组(15例),除1例未引出CAEP外,有9例在65dB SPL强度下全部引出CAEP波形,其0.254kHz各频率助听听阈均值分别为36.11±7.82、35.00±4.33、38.89±6.51、40.00±7.07、43.33±8.66dB HL;有5例在75dB SPL强度下全部引出CAEP波形,其0.254kHz各频率助听听阈均值分别为36.11±7.82、35.00±4.33、38.89±6.51、40.00±7.07、43.33±8.66dB HL;有5例在75dB SPL强度下全部引出CAEP波形,其0.254kHz各频率助听听阈均值分别为44.00±12.94、39.00±7.41、49.00±6.52、44.00±6.52、54.00±11.94dB HL,且A组患儿各刺激声对应频段助听听阈均低于B组,差异有统计学意义(P<0.05)。阈值强度下低频声/m/、中频声/g/、高频声/t/的P1波潜伏期均值分别为130.16±24.85、114.80±25.99、122.88±27.05ms,幅值分别为6.58±4.53、6.41±3.97、5.58±3.56μV,相应频段助听听阈分别为34.30±7.69、40.20±8.48、41.40±8.07dB HL,P1波潜伏期与相应频段助听听阈均无显著相关(P>0.05),P1波幅值与相应频段助听听阈呈显著负相关(P<0.05)。结论 CAEP测试可用于评估儿童助听器选配效果,55dB SPL强度下能够引出CAEP波形可作为评估助听器选配效果良好的指标之一。

关键词

皮层听觉诱发电位;助听听阈;助听器;儿童

基金项目(Foundation):

首都卫生发展科研专项项目(首发2011-1017-01);; 卫生行业科研专项基金(201202001);; 首都市民健康项目培育专项(Z141100002114033);; 北京市卫生系统高层次卫生技术人才培养计划基金(2009-3-29);; 首都医科大学基础-临床科研合作基金重点项目(12JL12);; 北京市医院管理局临床医学发展专项-2015年度“扬帆”计划临床技术创新项目(XMLX201514)资助

作者

郭倩倩;陈雪清;莫玲燕;孟超;

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