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人工耳蜗植入儿童1000Hz探测音ESR测试刺激持续时间的研究

Study on Optimal Setting of Stimulus Duration in ESR Measurement with 1 000 Hz Probe Tone for Cochlear Implant Users

郭浩伟;危艳萍;林碧玉;李燕萍;陈婷;

1:福建医科大学省立临床医学院福建省立医院耳鼻咽喉科

2:福建省立金山医院耳鼻咽喉科

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摘要

目的探讨人工耳蜗植入术后1 000 Hz探测音电诱发镫骨肌反射(electrically evoked stapedius reflex, ESR)测试中刺激持续时间的最佳设置,及其阈值(electrically evoked stapedius reflex threshold, ESRT)与最大舒适阈值(most comfortable level, MCL值)之间的关系。方法选取植入MED-EL SonataTi100型人工耳蜗的患儿21例(年龄2～11岁,平均7.80±2.21岁,人工耳蜗至少使用一年且效果良好)。对17例受试者进行刺激持续时间分别为300、500、800和1 000 ms的1 000 Hz探测音ESR测试,对其余4例受试者进行500 ms刺激持续时间的ESR测试,测试电极为2、6、11号电极,获取相应的ESRT,并记录相应电极的MCL值。对三个电极四种刺激持续时间的ESRT进行重复测量方差分析,对500 ms刺激持续时间的ESRT和MCL值进行相关性和线性回归分析。结果 21例受试者500 ms刺激持续时间的ESR总引出率为90.48%(57/63)。17例受试者每个电极300 ms刺激持续时间的ESRT均显著高于500、800和1 000 ms刺激持续时间的ESRT(P<0.05);而每个电极500、800及1 000 ms刺激持续时间的ESRT之间均无显著差异(P>0.05);每种刺激持续时间的三个电极之间的ESRT差异有统计学意义(P<0.05),11号电极的ESRT最大,6号次之,2号最小。500 ms刺激持续时间的三个电极的ESRT与MCL值均显著相关(P<0.01)。结论人工耳蜗植入儿童1 000 Hz探测音ESR测试中推荐使用≥500 ms的刺激持续时间,其阈值可指导MCL值的调试。

关键词

电诱发镫骨肌反射;刺激持续时间;最大舒适阈值;人工耳蜗植入

基金项目(Foundation):

福建医科大学启航基金项目（2018QH1163）

作者

郭浩伟;危艳萍;林碧玉;李燕萍;陈婷;

参考文献

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电诱发镫骨肌反射刺激持续时间最大舒适阈值人工耳蜗植入

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郭浩伟危艳萍林碧玉李燕萍陈婷