听觉脑干置入用于双侧听神经瘤全聋患者的听力康复(附1例报告)

目的：探讨听觉脑干置入（ABI）用于双侧听神经瘤全聋患者的听力康复。方法：对1例双侧听神经瘤全聋患者，在经乙状窦枕下径路切除第2侧听神经瘤时，同期将12道听觉脑干装置的电极阵置入第4脑室的侧隐窝内，术中行第Ⅶ、Ⅸ脑神经监测，并且记录电刺激脑干诱发电位，以确定和校正电极位置。术后2个月开通电极并作调试。结果：术后头颅X线侧位片示电极位置正确，术后开通调试发现电刺激12个电极均能引起听觉反应，无一电极引起非听觉反应。结论：多道ABI能让双侧听神经瘤全聋患者产生有意义的听觉。术中电极阵准确地置入到脑干耳蜗核是手术成功的关键。

Auditory brainstem implantation in patient with bilateral acoustic neuromas

Objective:To restore auditory sensation for patient suffering loss of hearing due to bilateral acoustic neuromas.Method:One patient of bilateral acoustic neuromas received auditory brainstem implant(ABI)at the same surgery for resection of the second tumor.The retrosigmoid approach was used for resection of the tumor and to exposure the lateral recess of the fourth ventricle for placement of ABI electrode array.Intraoperative 7th and 9th nerves monitoring and electrically evoked auditory brainstem responses(EABR)were recorded to locatize the placement of ABI electrode array.Result:Initial ABI switch-on was performed eight weeks after the surgery under close monitoring of vital signs.Auditory sensation was perceived on stimulation of all channels.Conclusion:The multichannel ABI could effectively restore auditory sensation for patient deafened by bilateral acoustic neuromas.The accurate location of the cochlear complex during surgery was the critical factor for success of ABI.