聴性脳幹反応の耳垂-頭頂と鼓膜-頭頂の同時誘導記録

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Auditory brainstem electric response (ABR) is generally recorded as the potential difference between the electrode on the ear lobe and on the vertex [Lobe-Vertex recording]. Among the five waves recorded the latency and the presence or absence or Wave I and V are particularly important factors.The purpose of the present study was to obtain a clear appearance of Waves I and V even at the low intensity of sound by simultaneous performance of Lobe-Vertex and Membrane-Vertex recordings. As the tone stimulus is decreased toward the subjective threshold in Lobe-Vertex recording, each wave becomes smaller, and the waves, except for Wave V are frequently undetectable near the threshold.On the other hand, in the recording of the potential difference between the electrodes on the posterior marginal portion of the tympanic membrane and on the vertex [Membrane-Vertex recording], Wave I is larger and Wave V smaller than that of Lobe-Vertex recording, and the clearly detectable Wave I can be obtained by the tone stimulus near the subjective threshold. Namely, the detectability of Wave I and V depends on the site of the recording electrode and there is no statistical difference between the two recording methods regarding latencies of the two waves.Typical wave patterns recorded from three patients were demonstrated: two of acoustic tumor and the other of a C-P angle tumor.In one patient with an acoustic tumor and the one with an C-P angle tumor, although no waves were detected in Lobe-Vertex recording, Wave I was clearly detected in Membrane-Vertex recording.In the other patient with an acoustic tumor, Waves I and V were not so clearly detected in Love-Vertex recording, but in Membrane-Vertex recording, Waves I and V were clearly detected and the prolongation of the latency interval between Waves I and V could be measured.From these results, it is suggested that the simultaneous Lobe-Vertex and Membrane-Vertex recording technique in ABR is most useful for the detection of cochlear nerve and the brainstem disorders.

聴性脳幹反応の耳垂-頭頂と鼓膜-頭頂の同時誘導記録

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