1. 中国医学科学院北京协和医院耳鼻喉科
2. 解放军总医院第三医学中心眼科医学部
3. 北京大学第一医院耳鼻咽喉头颈外科
纸质出版:2022
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王斌, 郭晓会, 曹克利, 等. Waardenburg综合征患者人工耳蜗术前EABR检测及术后生活质量评估[J]. 中国听力语言康复科学杂志, 2022,20(4):289-293.
王斌, 郭晓会, 曹克利, et al. Detection of EABR before Cochlear Implantation for Deafness with Waardenburg Syndrome and Postoperative Quality of Life Assessment[J]. 2022, 20(4): 289-293.
目的 探讨Waardenburg综合征(waardenburgsyndrome
WS)患者人工耳蜗植入术前采用电刺激听觉脑干诱发电位(EABR)检测方法评估听觉通路的可行性及患者术后效果的评估。方法 收集2008年~2018年在我院行人工耳蜗手术的WS患者10例,回顾性分析患者术前听力资料、合并眼病情况,术前行EABR检测听觉通路功能,随访术后神经反应遥测(neuralresponse telemetry
NRT)测试结果及开机调试结果,使用听力植入体儿童的家庭生活质量问卷(children using hearing implants quality of life
CuHIQol)评估植入者术后生活质量。另选择相同听觉年龄的耳蜗结构正常植入患者10例作为对照组,对两组测试结果进行统计学分析。结果 10例WS合并双侧极重度神经性聋患者术前EABR测试听觉通路功能好,EABR波形分化2~4级,植入不同类型人工耳蜗,V波平均阈值179.35±12.21CL,平均动态范围26.28±11.45CL,Ⅴ波I/O曲线斜率0.026±0.015和对照组统计分析有显著差异;20例患者术后无面瘫、脑脊液漏等手术并发症;10例WS患者术后均获得不同程度电听性反应,开机测试NRT引出率30%,低于对照组90%;开机12月平均调机C值WS组177.57±20.45CL;对照组167.85±22.38CL(P<0.05);两组患者的EABR阈值和开机C值有显著相关性(P<0.05)。WS组患者在父母期望、家庭影响及生活质量3方面得分均较术前明显提高,CuHIQol评分术前总分37.55±7.81,术后59.04±7.63(P<0.05)。两组患者术前EABR检测V波I/O曲线斜率和术后CuHIQol有显著相关性(P<0.05)。结论 Waardengburg综合征伴双侧极重度神经性聋患者术前生活质量差,人工耳蜗植入术前EABR检测可以筛选手术适应症,患者植入人工耳蜗后生活质量显著好于术前,独立生活能力和自信心均有明显提高。
Objective To explore the method of electrically evoked auditory brainstem responses(EABR) evaluation of auditory pathway before cochlear implantation in patients with deafness combined with Waardenburg syndrome(WS) and the effect of quality of life rehabilitation after cochlear implantation. Methods 10 cases of deaf patients with WS who underwent cochlear implantation in our hospital from 2008 to 2018 were collected
and the preoperative hearing data and eye diseases were retrospectively analyzed. The function of auditory pathway was detected by EABR. The results of postoperative NRT test and mapping were followed up. Hearing Implants Quality of life questionnaire(CuHIQol) was used to evaluate the quality of life of the patients.Another 10 patients with normal cochlear structure of the same age were selected as the normal control group
and the test results were compared and analyzed. Results For the patients with severe sensorineural hearing loss combined with WS
the function of auditory pathway was good by EABR test preoperation
and cochlear implants with different types of electrodes were implanted. The wave differentiation of EABR was grade 2-4 in the WS group. There were significant differences in the average threshold of V wave 179.35±12.21 CL
the average dynamic range 26.28 ±11.45 CL
and the slope of V wave I/O curve(0.026±0.015) between the two groups. There were no postoperative complications
such as facial paralysis and cerebrospinal fluid leakage in 20 patients. Ten patients with deafness combined with WS had different degrees of electroacoustic response after operation
and the NRT extraction rate(3/10)was 30%
which was lower than 90% in the control group(9/10). The average C value of 12 months after operation was a significant difference between the two groups(177.57±20.45CL vs 167.85±22.38CL
P<0.05). There was a significant correlation between the EABR threshold and C value of the two groups(P<0.05). The CuHIQol score of 10 patients with WS was 37.55±7.81 preoperatively and 59.04±7.63 postoperatively(P<0.05)
significantly higher than those before operation in terms of parental expectation
family influence and quality of life. There was significant correlation between the slope of V wave I/O curve detected by EABR preoperation and CuHIQol postoperation. Conclusion The preoperative quality of life of patients with bilateral severe deafness combined with WS is poor
and EABR detection before cochlear implantation can screen surgical indications
the quality of life of patients with WS after cochlear implantation is significantly better than that before cochlear implantation
independent life and self-confidence are significantly improved.
孙懿,邱建新,刘业海,余得志,童步升.人工耳蜗植入术后听力、言语及生活质量的评估[J].临床耳鼻咽喉头颈外科杂志,2015(18).
杨烨,陈杰,钱晓云,曹永晖,戴艳红,高下.神经反应遥测用于人工耳蜗植入患儿术后康复效果预估和编程的意义[J].听力学及言语疾病杂志,2015(05).
王斌,曹克利,魏朝刚,王轶,路远.人工耳蜗植入前电刺激听神经复合动作电位检测方法的建立和初步应用[J].中国听力语言康复科学杂志,2012(02).
薛静.第二次全国残疾人抽样调查最新数据公报[J].中国听力语言康复科学,2007(01).
杨淑芝,曹菊阳,张锐宁,刘新,刘丽贤,张欣,康东洋,戴朴,袁慧军.Waardenburg综合征II型中国家系MITF基因突变分析[J].中国听力语言康复科学杂志,2006(02).
Bayrak Feda,Çatlı Tolgahan,Atsal Görkem,Tokat Taşkın,Olgun Levent.Waardenburg Syndrome: An Unusual Indication of Cochlear Implantation Experienced in 11 Patients.[J].The journal of international advanced otology,2017.
Valerie Looi,Zheng Zheng Lee,Jenny H.Y. Loo.Quality of life outcomes for children with hearing impairment in Singapore[J].International Journal of Pediatric Otorhinolaryngology,2016.
Lammers Marc J W,van Eijl Ruben H M,van Zanten Gijsbert A,Versnel Huib,Grolman Wilko.Delayed Auditory Brainstem Responses in Prelingually Deaf and Late-Implanted Cochlear Implant Users.[J].Journal of the Association for Research in Otolaryngology : JARO,2015.
Bryan E. Pfingst,Aaron P. Hughes,Deborah J. Colesa,Melissa M. Watts,Stefan B. Strahl,Yehoash Raphael.Insertion trauma and recovery of function after cochlear implantation: Evidence from objective functional measures[J].Hearing Research,2015.
Ahn Joong Ho,Lim Hyun Woo,Lee Kwang-Sun.Hearing improvement after cochlear implantation in common cavity malformed cochleae: long-term follow-up results.[J].Acta oto-laryngologica,2011.
Song Mee Hyun,Bae Mi Ran,Kim Hee Nam,Lee Won-Sang,Yang Won Sun,Choi Jae Young.Value of intracochlear electrically evoked auditory brainstem response after cochlear implantation in patients with narrow internal auditory canal.[J].The Laryngoscope,2010.
Gibson William P R,Sanli Halit,Psarros Colleen.The use of intra-operative electrical auditory brainstem responses to predict the speech perception outcome after cochlear implantation.[J].Cochlear implants international,2009.
Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL).[J].Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation,1993(2).
Arias S.Genetic heterogeneity in the Waardenburg syndrome.[J].Birth defects original article series,1971(4).
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