Luetje Charles M, Thedinger Bradley S, Buckler Lisa R, Dawson Kristin L, Lisbona Kristin L
Midwest Ear Institute, Kansas City, Missouri, USA.
Otol Neurotol. 2007 Jun;28(4):473-8. doi: 10.1097/RMR.0b013e3180423aed.
To substantiate the benefits of hybrid cochlear implantation (CI) in patients with residual low-frequency hearing.
Prospective study of patients in a manufacturer-sponsored clinical trial.
Independent referral center for CI.
Thirteen patients who met candidacy criteria for a hybrid CI. The 10 women and 3 men had a mean age of 51 years.
Preoperative evaluation, CI with a Nucleus Hybrid cochlear implant, subsequent programming, and diagnostic testing.
Benefits of high-frequency electrical stimulation from the hybrid CI as measured by conventional audiometry, consonant-nucleus-consonant monosyllabic word and Bamford-Kowal-Bench sentence in noise testing at quarterly intervals per protocol.
Follow-up ranged from 3 to 24 months. All 13 patients had preserved hearing immediately postoperative. However, one lost residual hearing 7 days postoperatively, and 2 patients had delayed hearing losses at 2 and 24 months, the latter apparently due to barotrauma; however, this was not conclusive. Another had a bilateral symmetrically progressive hearing loss. Six patients showed changes in low-frequency hearing less than 10 dB; 2 showed changes in the range 11 to 20 dB; 2, 21 to 30 dB; and 3, more than 50 dB. Eleven of 13 had improved consonant-nucleus-consonant words ranging up to 83% when tested with hearing aid + CI in the operated ear. Four subjects exhibited improvement in Bamford-Kowal-Bench sentence in noise testing, although only one subject showed a significant decline associated with bilateral progression in hearing impairment.
Combined electrical and acoustical hearing can result in significant improvement in speech understanding. Only one patient lost residual hearing as a direct result of surgery. Two others had delayed losses. There are no absolute predictive factors as to success with hybrid CI, just as there are none for conventional CI. Similarly, wide variation in results may occur. Further studies may clarify factors involved in such variation.
证实混合式人工耳蜗植入（CI）对低频残余听力患者的益处。
对一项由制造商赞助的临床试验中的患者进行前瞻性研究。
人工耳蜗植入独立转诊中心。
13名符合混合式人工耳蜗植入候选标准的患者。其中10名女性和3名男性，平均年龄51岁。
术前评估、使用Nucleus Hybrid人工耳蜗进行植入、后续编程及诊断测试。
按照方案每季度通过传统听力测定、辅音-核-辅音单音节词以及噪声环境下的Bamford-Kowal-Bench句子测试来衡量混合式人工耳蜗高频电刺激的益处。
随访时间为3至24个月。所有13名患者术后听力立即得以保留。然而，1名患者术后7天丧失残余听力，2名患者分别在术后2个月和24个月出现迟发性听力损失，后者显然是由于气压伤所致，但尚无定论。另1名患者出现双侧对称性进行性听力损失。6名患者低频听力变化小于10分贝；2名患者变化范围在11至20分贝；2名患者在21至30分贝；3名患者变化超过50分贝。13名患者中有11名在患侧使用助听器+人工耳蜗测试时，辅音-核-辅音单词理解能力提高，最高可达83%。4名受试者在噪声环境下的Bamford-Kowal-Bench句子测试中有改善，尽管只有1名受试者因双侧听力障碍进展而出现显著下降。
电声联合听力可显著提高言语理解能力。仅1名患者因手术直接导致残余听力丧失。另外2名患者出现迟发性听力损失。对于混合式人工耳蜗植入成功与否，不存在绝对的预测因素，传统人工耳蜗植入亦是如此。同样，结果可能会有很大差异。进一步的研究可能会阐明这种差异所涉及的因素。
