Prentiss Sandra, Sykes Kevin, Staecker Hinrich
Department of Otolaryngology Head and Neck Surgery, University of Kansas School of Medicine, USA.
J Am Acad Audiol. 2010 Mar;21(3):197-203. doi: 10.3766/jaaa.21.3.8.
One of the most significant recent advances in cochlear implantation is the implantation of patients with residual hearing. These patients have a downsloping sensorineural hearing loss with poor speech discrimination and perform poorly with standard amplification. Studies using a variety of different electrode designs have demonstrated that it is possible to implant an inner ear and preserve residual hearing. Initial studies have demonstrated that a combination of residual acoustic hearing in the low frequencies with electrical stimulation in the mid- to high frequencies resulted in superior hearing performance in background noise.
The objective of this study was to determine the effect of electrode insertion depth on hearing preservation.
Eighteen patients with mild to severe hearing loss in the low frequencies combined with poor word recognition were recruited for the study.
Cochlear implantation.
Pre- and postoperative hearing test, Hearing in Noise Test, and consonant-nucleus-consonant testing. Data analysis was performed with Kruskal Wallis and Mann-Whitney testing.
In our study of 18 patients implanted with a Med-El PulsarCI100 we demonstrated the ability to preserve residual hearing with implant insertion depths ranging from 20 to 28 mm, giving us the possibility of near complete cochlear frequency coverage with an implant array while preserving residual hearing. These patients performed well both in quiet and in 10 dB signal-to-noise ratio conditions.
Hearing preservation was achievable even with deep implant insertion. Patients performed well in combined acoustic and electric conditions.
人工耳蜗植入术最近最重要的进展之一是对有残余听力的患者进行植入。这些患者患有低频下降型感音神经性听力损失,言语辨别能力差,使用标准放大装置效果不佳。使用各种不同电极设计的研究表明,有可能植入内耳并保留残余听力。初步研究表明,低频残余听觉与中高频电刺激相结合可在背景噪声中获得更好的听力表现。
本研究的目的是确定电极插入深度对听力保留的影响。
招募了18名低频轻度至重度听力损失且单词识别能力差的患者进行研究。
人工耳蜗植入。
术前和术后听力测试、噪声环境下听力测试以及辅音-元音-辅音测试。采用Kruskal Wallis检验和Mann-Whitney检验进行数据分析。
在我们对18例植入Med-El PulsarCI100的患者的研究中,我们证明了植入深度在20至28毫米范围内时能够保留残余听力,这使我们有可能在保留残余听力的同时,通过植入阵列实现近乎完整的耳蜗频率覆盖。这些患者在安静环境和10分贝信噪比条件下表现良好。
即使植入深度较深也能实现听力保留。患者在声学和电刺激联合条件下表现良好。