Smullen Jennifer L, Polak Marek, Hodges Annelle V, Payne Stacy B, King John E, Telischi Fred F, Balkany Thomas J
University of Miami Ear Institute, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida 33101, USA.
Laryngoscope. 2005 Jun;115(6):977-82. doi: 10.1097/01.MLG.0000163100.37713.C6.
This study was designed to compare the incidence and nature of facial nerve stimulation (FNS) in patients receiving cochlear implants (CI) manufactured by Cochlear Corporation, Advanced Bionics Corporation, and MedEl.
Retrospective chart review at a tertiary referral center.
The charts of 600 patients who received CIs from 1993 to 2003 with at least 1 year of follow-up were reviewed for significant FNS (FNS on at least 1 channel at functional stimulation levels). Data collected included age, sex, etiology of deafness, device type, electrode, FNS onset after initial stimulation, number and location of electrode contacts causing FNS, and loudness level at which FSN occurred. Nucleus straight and perimodiolar electrodes were also compared.
Thirty-nine of 600 (6.5%) patients had FNS on at least one channel, (MedEl 3 of 43 [7.0%], Nucleus 29 of 440 [6.6%], and Clarion 7 of 117 [6.0%]). The incidence of FNS in Nucleus perimodiolar electrodes (16 of 250 [6.4%]) was similar to straight electrodes (13 of 190 (6.8%]), as was the mean number of electrodes causing FNS per patient (11 vs. 12). However, straight electrodes caused stimulation at significantly softer perceived loudness levels than perimodiolar electrodes (P < .0001).
In this large series of CI FNS, the overall incidence of FNS is consistent with previous reports. All devices had a similar incidence of FNS, but perimodiolar electrodes produced FNS only at significantly higher loudness levels than straight electrodes, making them preferable for patients at risk for FNS receiving Nucleus devices.
本研究旨在比较接受科利耳公司、先进生物科技公司和梅德埃尔公司生产的人工耳蜗（CI）的患者中，面神经刺激（FNS）的发生率及性质。
在一家三级转诊中心进行回顾性病历审查。
回顾了1993年至2003年间接受CI且至少随访1年的600例患者的病历，以确定显著的FNS（在功能刺激水平下至少1个通道上出现FNS）。收集的数据包括年龄、性别、耳聋病因、设备类型、电极、初次刺激后FNS发作情况、引起FNS的电极触点数量和位置，以及FNS出现时的响度水平。还比较了Nucleus直电极和环模电极。
600例患者中有39例（6.5%）至少在一个通道上出现FNS（梅德埃尔公司43例中有3例[7.0%]，Nucleus公司440例中有29例[6.6%]，Clarion公司117例中有7例[6.0%]）。Nucleus环模电极的FNS发生率（250例中有16例[6.4%]）与直电极（190例中有13例[6.8%]）相似，每位患者引起FNS的电极平均数量也相似（分别为11个和12个）。然而，直电极引起刺激时的响度水平明显低于环模电极（P <.0001）。
在这一大型人工耳蜗FNS系列研究中，FNS的总体发生率与先前报告一致。所有设备的FNS发生率相似，但环模电极产生FNS时的响度水平明显高于直电极，这使得它们更适合有FNS风险且接受Nucleus设备的患者。
