核式24型人工耳蝸使用者之電刺激誘發全神經活動電位

Electrically Evoked Whole Nerve Action Potentials in Users of the Nucleus 24 Cochlear Implant System

許權振(Chuan-Jen Hsu) ； 林凱南(Kai-Nan Lin) ； 洪美枝(Mei-Ji Horng)

《中華民國耳鼻喉科醫學雜誌》 35卷2期 (2000/03) Pp. 107-112

https://doi.org/10.6286/2000.35.2.107

摘要

背景：兩耳全聾者無法以聲音刺激來誘發全神經活動電位或腦幹聽性反應而得知其聽閾，但植入人工耳蝸（電子耳）後可以利用電刺激取代聲音刺激來誘發全神經活動電位和腦幹聽性反應，有助於瞭解植入的人工耳蝸的各電極的作用情形。核式24型人工耳蝸的特點是不只可測量電刺激誘發的腦幹聽性反應，還可測量電刺激誘發的全神經活動電位，更有利於相關的研究。
材料和方法：17例澳洲Nucleus24型人工耳蝸植入者，在清醒狀態下接受電刺激誘發全神經活動電位的測量，年齡最大的33歲2個月，最小的2歲1個月，男性10名，女性7名。選擇性測量經由人工耳蝸的第5、10、15和20電極（相對應的紀錄電極分別為第7、12、17和22電極）刺激誘發的全神經活動電位。
結果：經由人工耳蝸電極刺激而誘發的全神經活動電位呈雙相波形，先出現負波N1，然後正波P2。17例總共測得63個電極的電刺激誘發全神經活動電位，N1潛時範圍0.28~0.42ms，平均值0.34+-0.03ms；P2潛時範圍0.52~0.79ms，平均值0.67+-0.06ms，振幅範圍27.2~189.9uV，平均值87.5+-43.6uV。電刺激誘發全神經活動電位的潛時長短或振幅大小均不受刺激電極的位置影響。
結論：經由核式24型人工耳蝸電刺激誘發的全神經活動電位的再現性良好，利用本報告測量電刺激誘發全神經活動電位的方法與經驗，可進一步研究人工耳蝸電刺激誘發全神經活動電位與植入後聽知覺語言能力的關係。

關鍵字

電刺激誘發全神經活動電位 ； 人工耳蝸 ； 電刺激 ； 神經反應

並列摘要

BACKGROUND:Auditory behavioral threshold can be estimated by electrically evoked brainstem response(E-ABR)or electrically evoked whole nerve action potential in users of cochlear implants. Both E-ABR and EAP can be measured via the Nucleus 24 cochlear implant system. The purpose of this report is to describe our experience in performing EAP measurements in users of the Nucleus-24 CI.
MATERIALS AND METHODS:EAP was measured in 17 users of Nucleus 24 cochlear implant system. The age range of these patients was between 2 years 1 month and 33 years 2 months old. Electrodes 5, 10, 15 and 20 were selected as stimulation electrodes for EAP measurement. Electrodes 7, 12, 17 and 22 were selected as recording electrodes respect-tively. Parameters for EAP measurements were proposed.
RESULTS:The EAP was characterized by a single negative peak N1 followed by a posi-tive peak P2. The EAP was recorded in 63 of 68 tested electrodes. The mean N1 latency was 0.34+-0.03ms. The mean P2 latency was 0.67+-0.06ms. The mean EAP amplitude measured at the threshold level was 87.5+-43.6uV. The latencies and amplitudes of the EAP were not affected by the location of electric stimulation within the cochlea.
CONCLUSION:EAP measurement was repeatable, reliable and more feasible than E-ABR. EAP measurements may be related to the auditory and speech performance of cochlear implant patients. Further studies on threshold, the slope of the growth function and the rate of recovery of the EAP will be conducted.

並列關鍵字

electrically evoked whole merve potential ； cochlear implant ； electrical stimulation ； neural response