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目的应用脑磁图探讨听神经病患者大脑听觉皮层功能区的病变情况。方法应用全头型306通道生物磁仪,对10例(20耳)听神经病患者和15例(30耳)正常对照组进行大脑听觉皮层诱发磁场的测试,观察了左右耳分别给予0·5、1、2、4、6、8kHz纯音刺激诱发的双侧大脑半球听觉皮层磁反应波M100,将其脑磁图的电生理资料与磁共振成像的解剖结构资料叠加,获得听神经病患者大脑听觉皮层的磁源性影像。结果15例正常对照组除16耳8kHz未诱发出M100外,其他各频率双耳均可诱发出M100,而听神经病患者在0·5、1、2、4、6kHz20耳(40侧)大脑听觉皮层磁反应波M100引出率分别为27·5%(11/40)、22·5%(9/40)、7·5%(3/40)、5%(2/40)、5%(2/40);8kHz均未引出反应。与正常对照组相比较其潜伏期明显延长,波幅明显降低(P<0·01)。在初级听皮层1kHz纯音刺激诱发的M100位置听神经病患者较正常对照组更靠大脑半球的外侧。结论听神经病是一种临床表现主要为听力学异常的,包括耳蜗后第Ⅷ颅神经耳蜗支和听觉传导通路直至大脑听觉皮层在内的听觉系统疾患。脑磁图可作为其是否适合配带助听器和电子耳蜗植入治疗的参考。
Objective To investigate the lesion of auditory cortex in patients with auditory neuropathy using magnetoencephalography. Methods The whole-head 306-channel biomagnetic instrument was used to test the auditory cortex-evoked field in 10 cases (20 ears) of auditory neuropathy and 15 cases (30 ears) of normal control. The left and right ears were treated with 0.5, 1, 2, 4, 6, 8kHz pure tone stimulation-induced bilateral cerebral hemisphere auditory cortex magnetic resonance wave M100, the electrophysiological data of its magnetoencephalography and magnetic resonance imaging anatomical data superimposed to obtain auditory neuropathy auditory cortex of the brain Of the magnetism of the image. Results In 15 normal controls, M100 was induced in all ears except for M100 at 16kHz and 8kHz, while in auditory neuropathy patients at 20, 40, 20 ears The cortical magnetic resonance wave M100 extraction rates were 27.5% (11/40), 22.5% (9/40), 7.5% (3/40), 5% (2/40), 5% 2/40); 8kHz did not lead to reaction. Compared with the normal control group, the latency was significantly longer and the amplitude was significantly lower (P <0.01). In the primary auditory cortex 1kHz pure tone stimulation induced auditory neuropathy M100 position than the normal control group on the outside of the cerebral hemisphere. CONCLUSIONS: Auditory neuropathy is an auditory system disorder mainly characterized by abnormal audiology, including the cochlear Ⅷ cranial nerve cochlear branch and the auditory pathway leading to the auditory cortex of the brain. Magnetoencephalography can be used as a reference for its suitability for hearing aids and cochlear implants.