Peran implanted electrically evoked auditory brainstem responses(Imp-eABR) pada pasien tuli kongenital

Fikri Mirza Putranto, Jenny Bashiruddin, Semiramis Zizlavsky, Irawan Mangunatmadja, Jacub Pandelaki, Saptawati Bardosono, Wijana Hasansulama

Abstract


Latar belakang: Variasi performa pasca implan koklea menunjukkan adanya variasi patologi yang belum dapat dijelaskan melalui pemeriksaan standar pra-operasi. Untuk itu dibutuhkan pemeriksaan yang dapat menunjukkan variasi integritas jaras auditori sebagai petunjuk variasi potensi internal tiap individu. Tujuan: Mendapatkan variasi respons jaras auditori terhadap stimulus listrik pasca implan berdasarkan pemeriksaan Implanted Electrically evoked Auditory Brainstem Respons (Imp-eABR), serta korelasinya dengan faktor internal pra-implan lain berupa usia, luas area n. koklearis dan kemampuan komunikasi pra-operasi. Metode: Kriteria subjek penelitian adalah pasien operasi implan koklea berusia kurang dari 10 tahun, memiliki koklea dan n. koklearis normal, dan pada pasien berusia lebih dari 4 tahun sudah memakai alat bantu dengar minimal 1 tahun. Pemeriksaan Imp-eABR dilakukan terhadap 5 elektrode yang mewakili area apikal, medial dan basal koklea. Dicari hubungan respons dari stimulasi terhadap ketiga faktor internal.Hasil:Pemeriksaan Imp-eABR dilakukan terhadap 28 telinga dari 19 pasien yang dilakukan operasi secara unilateral dan bilateral. Rerata skor total respons Imp-eABR adalah 6,3 + 2,63; dengan 60,7% telinga memiliki skor total kurang dari 8. Uji regresi linear menunjukkan faktor usia, luas area n. koklearis dan kemampuan komunikasi berkorelasi secara bermakna dan dapat memprediksi variasi skor Imp-eABR sebanyak 49,2%. Kesimpulan:Variasi skor total Imp-eABR pada pasien dengan faktor internal pra-operasi menunjukkan adanya patogenesis lain yang mendasari kemampuan transmisi jaras pendengaran retrokoklea terhadap stimulasi listrik dari implan koklea. Faktor internal pra-operasi dapat menjelaskan kurang dari 50% variasi respons Imp-eABR. 

Kata kunci: Imp-eABR, luas area n. koklearis, implant koklea, integritas jaras auditori ABSTRACT 

Background:Variations in performance after cochlear implant indicates pathology variations that cannot be explained through standard preoperative examination. Therefore, an examination is needed to show variations in the integrity of auditory pathways as a guide to internal potential variations of each individual. Objectives: To show variations of auditory pathways responses to electrical stimulation from cochlear implant by performing Implanted Electrically evoked Auditory Brainstem Response (Imp-eABR) examination and to find its correlation to age, cochlear nerve area and preoperative communication skills. Methods: Subjects were cochlear implant patients with age less than 10 years, had normal cochlear and cochlear nerve,and patients over 4 years old with history of wearing hearing aids for at least 1 year. The Imp-eABR examination was performed to 5 electrodes representing the apical, medial and basal areas of the cochlea. Results:Imp-eABR examination was performed on 28 ears from 19 patients who underwent unilateral and bilateral surgery. The average total score of Imp-eABR responses was 6.3 + 2.63; with 60.7% of the ears having a total score of less than 8. Linear regression tests showed age,cochlear nerve area,andcommunicationabilitysignificantlycorrelate,it canexplain49.2%ofthevariationinthetotal Imp-eABR score. Conclusion: The variation in the total Imp-eABR score in patients with preoperative internal factors indicated that another pathogenesis also underlines the ability of transmission of the retrocochlear auditory pathway to electrical stimulation from the cochlear implant. Preoperative internal factors can only explain less than 50% of the variation of the Imp-eABR response. 

 

 


Keywords


Imp-eABR, cochlear nerve area, cochlear implant, integrity of auditory pathway

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DOI: https://doi.org/10.32637/orli.v49i20.320

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