儿童人工耳蜗植入术后电诱发复合动作电位分析

目的 应用神经反应遥测(NRT)技术，观察人工耳蜗植入后不同时间段的电诱发复合动作电位(ECAP)阈值变化，探讨其对人工耳蜗术后调机的指导意义。方法 对33例使用Nucleus CI24R(CA)型人工耳蜗植入的患儿，于术中及术后1、1.5、2、4、6个月进行ECAP 阈值测试，统计分析其变化规律。结果 33例165个电极的波形检出率为93.3%。电极1、7、11、17、22的术中ECAP阈值与术后30d开机时的ECAP阈值的差异有统计学意义。同一测试电极，随术后开机时间的增长，ECAP阈值呈逐渐增加的趋势。经单因素方差分析，术后不同测试时间ECAP阈值差异有统计学意义。结论 ECAP检出率高，术中可用于检测神经反应；术后可协助估算患者的行为反应T、C级，指导调机，尤其对儿童患者更为重要。

Change of ECAP thresholds in children with cochlear implant

Objective Using the neural response telemetry (NRT) software, to investigate the change of the thresholds of electrically evoked compound action potentials at different time points after cochlear implantation. Methods 33 Nucleus CI24R(CA)cochlear implant children participated in this study. ECAPs were recorded intraoperatively and 1,1.5,2,4,6 months after surgery. Results Typical ECAPs were recorded in 154 electrodes in all 165 testing electrodes(93.3%). No. 1,7,11,17,22 electrodes were tested for each patient.The initial stimulated ECAP thresholds were the lowest. The ECAP thresholds of the same electrode increased during subsequent mapping session, and there were significant differences among different sessions. Conclusion ECAPs is very useful in adjusting the stimulation parameters for cochlear implant and can maximize the individual performance with the device, especially in young children.