电诱发听性脑干反应在人工耳蜗再植入术中的应用
Application of electrically evoked auditory brainstem responses in cochlear reimplantation.
文献信息
| PMID | 42846831 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ying Jin |
| 作者单位 | Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China. |
| 期刊 | Frontiers in neuroscience |
| SCI 分区 | Q2 |
| IF | 4.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 评估电诱发听性脑干反应（EABR）在评估接受人工耳蜗再植入术（CRI）患者听觉通路完整性及预测听觉与言语结局中的作用，尤其是伴有耳蜗骨化或复杂解剖结构的患者。
方法： 对2019年至2024年间40例CRI患者（12例骨化，28例非骨化）进行回顾性分析。术中和术后进行EABR评估，以评价神经反应并指导耳蜗开窗。参数包括引出率、V波振幅、阈值和Gibson评分。听觉-言语表现通过听觉能力分级和言语可懂度分级量表以及单词识别分数进行测量。回归分析确定术后结局的预测因素。
结果： EABR引出率在非骨化病例中为100%，在骨化病例中为80%。非骨化耳的Gibson评分更高，V波阈值更低（p < 0.05）。潜伏期和振幅无显著差异。非骨化患者的听觉-言语结局更优。植入年龄、耳蜗骨化和中电极Gibson评分显著预测术后表现；中电极Gibson评分与双音节词识别率相关性最强（R2 = 0.406，p = 0.0007）。
结论： EABR能够可靠地评估听觉通路完整性，为手术提供指导，并预测CRI患者的术后听觉-言语结局，尤其是在骨化或解剖结构复杂的耳蜗中。
意义： 研究结果支持将EABR作为临床辅助手段，以提高具有挑战性的CRI病例的手术精确度和功能结局。
英文摘要
OBJECTIVES: To evaluate the role of electrically evoked auditory brainstem responses (EABRs) in assessing auditory pathway integrity and predicting auditory and speech outcomes in patients undergoing cochlear reimplantation (CRI), especially those with cochlear ossification or complex anatomy.
METHODS: A retrospective analysis was conducted of 40 CRI patients (12 ossification, 28 non-ossification) from 2019 to 2024. Intraoperative and postoperative EABR assessments were performed to evaluate neural responses and guide cochleostomy. Parameters included the elicitation rate, V-wave amplitude, threshold, and Gibson score. Auditory-speech performance was measured by the Categories of Auditory Performance and Speech Intelligibility Rating scales, and word-recognition scores. Regression analyses identified predictors of postoperative outcomes.
RESULTS: The EABR elicitation rate was 100% in non-ossification cases and 80% in ossification cases. Gibson scores were higher, and V-wave thresholds lower, in non-ossification ears (p < 0.05). Latencies and amplitudes did not differ significantly. Auditory-speech outcomes were superior in non-ossification patients. Implantation age, cochlear ossification, and middle-electrode Gibson score significantly predicted postoperative performance; middle-electrode Gibson score correlated most strongly with the disyllabic word recognition rate (R2 = 0.406, p = 0.0007).
CONCLUSIONS: EABRs reliably assess auditory pathway integrity, inform surgical guidance, and predict postoperative auditory-speech outcomes in CRI, especially in ossified or anatomically complex cochleae.
SIGNIFICANCE: The findings support the use of EABRs as a clinical adjunct to improve surgical precision and functional outcomes in challenging CRI cases.