摘要目的 评估REZ-Ⅰ型国产人工耳蜗植入对成人残余听力的影响,探讨该人工耳蜗植入的听力学安全性及其损伤的特点.方法 回顾性分析复旦大学附属眼耳鼻喉科医院2009年9月至2009年11月间16例单侧REZ-Ⅰ型(22通道)人工耳蜗植入者在手术前后的纯音测听、听觉稳态反应(auditory steady-state response,ASSR)、畸变产物耳声发射(DPOAE)及听觉脑干反应(ABR)的资料,比较手术前后残余听力的变化情况.结果 纯音测听植入侧术后残余听力保留率为41.67%;术后植人侧250、500、1000、2000及4000 Hz的残余听力较术前下降,差异具有统计学意义,其中500 Hz下降较明显,平均下降15.3 dB HL,P<0.01;通过与非植入侧对比发现500和1000 Hz的听力损失有统计学意义(P值均<0.05).植入侧术后ASSR阈值在250和500 Hz处较术前升高,差异具有统计学意义(P值均<0.05)),经与非植入侧对比发现500 Hz处ASSR阈值升高有统计学意义(P值<0.05).DPOAE及ABR植入前后差异均无统计学意义(P值均>0.05).结论 REZ-Ⅰ型人工耳蜗植入会对植入侧残余听力造成一定程度的损伤.

abstractsObjective To evaluate the effect of cochlear implantation with REZ-Ⅰ straight electrodes on residual hearing of postlingually deafened adults, and to explore the audiologically safety and injury characteristics of cochlear implantation. Methods Sixteen unilateral REZ-Ⅰ (22 channels) cochlear implantation recipients from September 2009 to December 2009 were picked out. Their pre-and postimplantation audiometry data including pure-tone audiometry (PTA), auditory steady-state responses (ASSR), auditory brainstem responses(ABR) and distortion product otoacoustic emissions(DPOAE) were retrospectively analyzed, in order to compare the change between pre- and post-implantation residual hearing. Results Among the 12 recipients who had some measurable residual hearing before implantation,5 (41.6%) patients had conserved some measurable hearing but the other 7 (58.4%) recipients had lost all measurable hearing after implantation on the implanted side. The implanted ears had an average PTA threshold drop of 9.5 dB HL and a statistically significant difference between pre- and post-implantation (P<0.05) PTA thresholds in the frequencies of 250 Hz,500 Hz, 1000 Hz,2000 Hz and 4000 Hz.Compared to non-implanted ears, the drop in 500 Hz and1kHz had a statistically significant difference between pre- and post-implantation PTA thresholds (P < 0. 05 ). The ASSR residual hearing theshold elevation were statistically significant ( P < 0.05 ) between pre- and post-implantation ASSR at 250 Hz and 500 Hz on the implanted side, while the The ASSR residual hearing theshold elevation were statistically significant (P <0. 05 ) at 500 Hz when compared to non-implanted side. The difference of residual hearing between pre- and post-implantation was not statistically significant for both DPOAE and ABR. Conclusion There will be a certain degree of damage to residual hearing of the implanted side following REZ-Ⅰ cochlear implantation.