人工耳蜗术后编程中神经反应遥测阈值及行为T值的比较分析

目的 了解人工耳蜗术后神经反应遥测(NRT)阈值的变化,NRT与行为T值之间的相关性,以及长期行为T值的变化,为人工耳蜗植入术后的患儿编程提供帮助。 方法 20例接受Nucleus CI24R型多导人工耳蜗植入的患儿,在开机时及6个月调试时对1、11、20号电极进行NRT阈值测试,通过NRT值进行电子耳蜗程序设置;开机后1年和2年对患儿进行行为T值测试,并设置程序;收集开机时及6个月的NRT值分别与1年及2年的行为T值比较。 结果 1号电极开机时和6个月时NRT相互比较差异无统计学意义,11号和22号电极开机时和6个月时NRT差异有统计学意义,三对电极1年与2年行为T值差异都无统计学意义;开机时NRT阈值与行为T值的相关关系中:开机时NRT阈值与行为T值只有22号电极呈正相关,其余两电极中无相关关系。6个月NRT阈值与行为T值的相关关系中:1号电极6个月NRT阈值与行为T值均为正相关;22号电极开机6个月NRT值与1年行为T值为正相关,其他无相关关系。 结论 各电极NRT阈值自开机时基本保持稳定,NRT阈值与行为T值部分电极具有相关性,开机时和最初几次调机时患儿不能配合进行行为测试可以选择NRT阈值来参考调试耳蜗;1年和2年的行为T值也基本稳定,说明患儿术后1年能较好配合行为T值测试,对于配合较好者的患儿可以适当延长调试时间。

Relationship between neural response telemetry threshold and T-level behavior in patients with cochlear implants

Objective To explore the relationship between neural response telemetry(NRT)threshold and T-level be-havior in patients with cochlear implants,and to explore how we can render NRT more useful for us to obtain the best map for patients with cochlear implants who may not cooperate well to obtain accurate T-level behavior.Methods Twenty children were implanted with the cochlear Nucleus CI24R system.At each mapping procedure,the NRT thresh-olds of electrodes 1,11,and 20 based on the evoked responses were tested.The children had accepted a time for experi-ence and training until they could cooperate well for testing and the T-level behavior could be used for mapping.The changes in the NRT threshold and the correlation between the NRT threshold and the T-level behavior at 12 and 24 months after switch-on were then compared.Results There was no significant difference in the NRT thresholds of elec-trodes 1 and 22 at 6 months,and there was a significant difference in the NRT threshold of electrode 11 at 6 months.There was no significant difference in the T-level behavior between the three pairs of electrodes at 1 and 2 years.The NRT threshold was compared with the T-level behavior after switch-on,and only electrode 22 exhibited a statistically significant difference,while the other two pairs of electrodes did not exhibit statistically significant differences.The 6-month NRT threshold was compared with the T-level behavior,and a significant difference was noted in electrode 1.The 6-month NRT thresholds of electrodes 11 and 22 and the 1-year T-level behavior was statistically significant,and the 2-year T-level behavior was not statistically significant.Conclusion The stability of the NRT threshold of each electrode is maintained from the time of initiation,and the correlation between NRT threshold and T-level behavior indicates that children cannot cooperate initially to perform the behavior test.The NRT threshold can be used to refer to the cochlea.The 2-year T-level behavior also remained stable,indicating that children can better match the 1-year T-lev-el behavior after testing,with the better children being appropriate to extend the debugging time.