人工耳蜗植入术前耳蜗神经及后通路功能评估

刘军

doi:10.3969/j.issn.1672-4933.2023.05.001

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人工耳蜗植入术前耳蜗神经及后通路功能评估

专家笔谈 | 更新时间：2023-11-03

- 人工耳蜗植入术前耳蜗神经及后通路功能评估
- Preoperative Evaluation of the Function of Cochlear Nerve and Posterior Pathway in Cochlear Implantation
- 中国听力语言康复科学杂志 2023年21卷第5期页码：449-455
- 作者机构：
  
  1.解放军总医院耳鼻咽喉头颈外科医学部/国家耳鼻咽喉疾病临床医学研究中心北京 100048
  2.解放军总医院第七医学中心耳鼻咽喉头颈外科北京 100700
- 作者简介：
  
  [ "刘军，解放军总医院耳鼻咽喉头颈外科医学部、国家耳鼻咽喉疾病研究中心主任医师、解放军总医院第七医学中心耳鼻喉科科室主任，享受军队优秀专业技术人才岗位津贴。医学博士，赴美博士后，研究生导师，耳显微外科、耳神经外科和人工听觉植入知名专家。《中国听力语言康复科学杂志》副总编，《医学参考报》耳鼻咽喉头颈外科频道副总编；《中华耳科学杂志》《听力学及言语疾病杂志》《中西医结合耳鼻喉科杂志》《中国应用生理学杂志》《中国耳鼻咽喉颅底外科杂志》《中国医学耳鼻咽喉科文摘》《中国耳鼻喉头颈外科杂志》和《中国医药科学杂志》编委；《中华耳鼻咽喉头颈外科杂志》《中华临床医师杂志》《临床耳鼻喉科杂志》和《中国现代医生杂志》审稿专家。中国听力医学发展基金会科普分会副主委、中国听力医学发展基金会专家委员、医促会耳鼻咽喉头颈外科分会及听觉植入专委会委员。美国ARO会员。北京市自然科学基金评审专家。发表论文70余篇，其中SCI 7篇。负责北京市科技计划首都市民健康项目培育基金、解放军总医院科技创新基金和解放军总医院苗圃基金各1项。荣获解放军总医院医疗成果一等奖、解放军总医院科技进步一等奖、武警科技进步二等奖、总装军队科技进步二等奖、北京市科技进步一等奖各1项。博士主任医师；研究方向：耳显微外科、耳神经外科和人工听觉植入 E-mail：liujunent@126.com" ]
- 基金信息：
  
  北京市科技计划首都市民健康项目培育基金(Z131100004013019);解放军总医院临床科研扶持基金课题(2012FC-TSYS-4017);解放军总医院科技创新基金项目(06ZY13)
- DOI：10.3969/j.issn.1672-4933.2023.05.001
  中图分类号：
- 纸质出版日期：2023-09-15，
  
  收稿日期：2023-07-03，
- 稿件说明：
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刘军.人工耳蜗植入术前耳蜗神经及后通路功能评估[J].中国听力语言康复科学杂志,2023,21(05):449-455.

LIU Jun.Preoperative Evaluation of the Function of Cochlear Nerve and Posterior Pathway in Cochlear Implantation[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2023,21(05):449-455.
刘军.人工耳蜗植入术前耳蜗神经及后通路功能评估[J].中国听力语言康复科学杂志,2023,21(05):449-455. DOI： 10.3969/j.issn.1672-4933.2023.05.001.

LIU Jun.Preoperative Evaluation of the Function of Cochlear Nerve and Posterior Pathway in Cochlear Implantation[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2023,21(05):449-455. DOI： 10.3969/j.issn.1672-4933.2023.05.001.

摘要

人工耳蜗植入（CI）是重度、极重度感音神经性聋且助听器验配无效或效果不佳患者有效地干预方法之一，CI术前对耳蜗神经及后通路功能的准确评估尤为重要，是一项涉及听力学、影像学和遗传学的综合评估。当常规听力学检测无听觉反应和（或）常规影像学检查提示耳蜗神经可能发育不良时，需重点评估耳蜗神经及后通路功能，可完善大功率助听器条件下测听、皮层听觉诱发电位（CAEP）、电诱发听性脑干反应（EABR）、电诱发听神经复合动作电位（ECAP）等特殊听力学检测，以及功能性磁共振成像（fMRI）、正电子发射断层显像（positron emission tomography，PET）等功能性影像学检查，判断是否有CI手术适应证和禁忌证，进而选择合适的人工耳蜗植入体、预估手术难度，并制订具体手术方案和并发症预案，同时可预估CI手术疗效。

Abstract

Cochlear implantation (CI) is one of the most effective interventions for patients with severe to profound sensorineural hearing loss who have ineffective or poor results with hearing aids. A preoperative accurate evaluation of cochlear nerve and auditory pathway function is particularly important. It involves a comprehensive evaluation of audiology

imaging

and genetics. When routine audiological testing shows no auditory response and/or routine imaging suggests poor cochlear nerve development

attention must be paid to evaluating cochlear nerve functions and the integrity of anatomical structures of auditory pathways. This can be done by testing auditory responses in high-power hearing aid conditions

conducting specialized audiology tests such as Cortical auditory evoked potential (CAEP)

Electrically-evoked auditory brainstem response (EABR)

and Electrically-evoked auditory nerve compound action potentials (ECAP)

as well as functional imaging tests such as functional magnetic resonance imaging (fMRI) and Positron emission tomography (PET). This is done to determine if there are indications or contraindications for CI

to select an appropriate cochlear implant device

estimate surgical difficulty

develop a surgical plan and complications prevention plans

and preoperative evaluation of CI efficacy.

关键词

耳蜗神经功能不良人工耳蜗植入评估疗效

Keywords

Cochlear nerveDysfunctionCochlear implantationEvaluationEfficacy

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