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Das Refraktärverhalten des elektrisch stimulierten Hörnervs

Refractory behaviour of the electrically stimulated auditory nerve

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Zusammenfassung

Hintergrund

Bei Kochleaimplantaten lassen sich die elektrisch evozierten Summenaktionspotenziale (TECAP) des Hörnervs messen. TECAP-Schwellen werden zur Schätzung von Schwellen bei der Sprachprozessorprogrammierung verwendet. Das Refraktärverhalten des Hörnervs kann diese beeinflussen.

Methoden

Erholungsfunktionen wurden an 84 Stimulationselektroden bei 14 mit Nucleus CI24 versorgten Patienten mit der Neural Response Telemetry (NRT) in modifizierter Vorwärtsmaskierung untersucht, welche das Referenz-Masker-Probe-Intervall (MPI) einführt.

Ergebnisse und Fazit

Hierfür ergab sich ein geeignetes Intervall zwischen 300 und 375 μs. Der Median der absoluten Refraktärzeit wurde zu 390 μs und der Median der Zeitkonstanten der Erholungsfunktion zu 425 μs bestimmt. In der Praxis sollten Erholungsfunktionen und Amplitudenwachstumsfunktionen (AGF) mit einem MPI von 300 μs gemessen werden. Da bisher die AGF bei 500 μs und somit meist in relativem Refraktärzustand gemessen wurde, sollte das Refraktärverhalten die TNRT beeinflussen. Die Form der in Standard-Vorwärtsmaskierung gemessenen Erholungsfunktion konnte durch die Latenzverschiebung der Hörnervantworten erklärt werden.

Abstract

Introduction

Electrically evoked compound action potentials (TECAP) of the auditory nerve can be recorded in cochlear implants. TECAP thresholds are used to predict threshold levels for speech processor maps. The auditory nerve’s refractory properties can influence these levels.

Methods

Recovery functions were investigated at 84 stimulation sites in 14 patients who had Nucleus CI24 implants; neural response telemetry (NRT) and a modified forward-masking technique were used for these investigations, introducing the reference masker–probe interval (MPI).

Results and conclusion

An interval between 300 and 375 μs was found to be suitable as the reference MPI in our study. The median of the absolute refractory period was determined as 390 s and the median time constant of the recovery function, at 425 s. In practice, a reference MPI of 300 s is suggested for measurement of recovery and amplitude growth functions. As up to now the amplitude growth function has been measured at 500 s and thus mostly in a relatively refractory condition, the refractory behaviour should influence the TNRT. In addition, it was possible to explain the shape of standard forward-masking recovery functions with reference to the latency shift of the neural response.

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Interessenkonflikt

M. Killian ist Angestellter der Cochlear AG, Basel. A. Morsnowski wurden Reisekosten durch Cochlear GmbH, Hannover ersetzt.

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Authors and Affiliations

  1. Klinik für Hals-, Nasen-, Ohren-, Heilkunde, Kopf- und Halschirurgie, Christian-Albrechts-Universität Kiel, Arnold-Heller-Straße 14, 24105, Kiel, Deutschland

    A. Morsnowski & J. Müller-Deile

  2. Institut für Experimentelle and Angewandte Physik, Christian-Albrechts-Universität zu Kiel, Kiel, Deutschland

    A. Morsnowski

  3. Neurosciences et systèmes sensoriels, CNRS UMR 5020, Hospital Edouard Herriot, Lyon, Frankreich

    B. Charasse & L. Collet

  4. Cochlear AG, Basel, Schweiz

    M. Killian

Authors
  1. A. Morsnowski
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  2. B. Charasse
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  3. L. Collet
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  4. M. Killian
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  5. J. Müller-Deile
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Correspondence to A. Morsnowski.

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Morsnowski, A., Charasse, B., Collet, L. et al. Das Refraktärverhalten des elektrisch stimulierten Hörnervs. HNO 56, 131–138 (2008). https://doi.org/10.1007/s00106-007-1660-3

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  • DOI: https://doi.org/10.1007/s00106-007-1660-3

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