人工耳蜗植入儿童中的咬肌前庭诱发肌源性电位：双刺激模式分析

文献信息

中文摘要

背景： 人工耳蜗（CI）广泛用于听觉康复，但常与前庭损伤相关。尽管颈性前庭诱发肌源性电位（cVEMP）和眼性前庭诱发肌源性电位（oVEMP）已有研究，但人工耳蜗植入儿童中经咬肌前庭诱发肌源性电位（mVEMP）评估的前庭-三叉通路仍未被探索。本研究采用双刺激模式（气导和骨导刺激模式）探讨了人工耳蜗植入儿童的mVEMP反应。
方法： 研究纳入15名使用单侧人工耳蜗的儿童（年龄6-10岁），植入年龄>6个月且无影像学异常。参考组由15名同年龄段、无合并症的听力正常儿童组成。mVEMP采用500 Hz窄带啁啾刺激，气导模式在95 dBnHL、骨导模式在55 dBnHL下记录。
结果： 在本研究中，气导刺激导致植入耳无反应，非植入耳反应减弱。骨导刺激显示植入耳与非植入耳之间无显著差异，反应率分别为86.6%和93.3%。人工耳蜗植入儿童与参考组之间的mVEMP波幅存在显著差异。未观察到实际年龄与mVEMP反应之间、或植入年龄与植入耳mVEMP反应之间存在显著关系。然而，在非植入耳中，植入年龄与mVEMP波幅之间呈中度正相关。
结论： 本研究发现人工耳蜗植入儿童对气导刺激的mVEMP反应减弱，而骨导刺激引发更稳健的反应，支持其在评估植入耳耳石功能方面具有更优效能。

英文摘要

BACKGROUND: Cochlear implants (CIs) are widely used for auditory rehabilitation but have often been linked to adverse vestibular insults. While cervical vestibular-evoked myogenic potential (cVEMP) and ocular vestibular-evoked myogenic potential (oVEMP) have been studied, the vestibulo-trigeminal pathway via masseteric vestibular-evoked myogenic potential (mVEMP) in children with CIs remains unexplored. The present study explored the mVEMP responses among children with CIs using dual stimulation modes (air and bone conduction modes of stimulation).
METHODS: The study included 15 children (aged 6-10 years) using unilateral CI, having implant age >6 months and no radiological impairments. A reference group constituted 15 normal hearing children of the same age range with no comorbidities. mVEMP was recorded at 95 dBnHL for air conduction mode and 55 dBnHL for bone conduction mode using 500 Hz narrowband chirp stimulus.
RESULTS: In the study, air conduction resulted in a lack of response in implanted ear and reduced responses in non-implanted ears. Bone conduction revealed no significant variation between implanted and non-implanted ears, with response rate of 86.6% and 93.3%, respectively. A significant difference was found in mVEMP amplitude between children using CI and the reference group. No significant relationship was observed between chronological age and mVEMP responses, or between implant age and mVEMP responses in implanted ear. However, a moderate positive relationship was noted between implant age and mVEMP amplitude in non-implanted ear.
CONCLUSION: This study identified diminished mVEMP responses to air conduction stimulation in children with CIs, while bone conduction elicited more robust responses, supporting its superior efficacy in evaluating otolith function in implanted ears.