Usami Shin-Ichi, Moteki Hideaki, Suzuki Nobuyoshi, Fukuoka Hisakuni, Miyagawa Maiko, Nishio Shin-Ya, Takumi Yutaka, Iwasaki Satoshi, Jolly Claude
Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan.
Acta Otolaryngol. 2011 Apr;131(4):405-12. doi: 10.3109/00016489.2010.539266. Epub 2011 Jan 5.
With full insertion with a long electrode, hearing preservation can be achieved even in the presence of a long electrode covering the residual hearing region.
Advances in developing new atraumatic concepts of electrode design as well as surgical technique have enabled hearing preservation after cochlear implantation surgery, and EAS (electric acoustic stimulation) accompanied with hearing preservation is a new trend for patients with residual hearing at the lower frequencies. However, full insertion with a long/medium electrode and hearing preservation is still a challenging field that calls for discussion.
In this study, round window insertion, an atraumatic electrode, and dexamethasone administration were used and atraumaticity (hearing preservation and conservation of vestibular function) was evaluated with full insertion of the electrode.
Postoperative evaluation after full insertion of the electrodes showed that hearing at low frequencies was well preserved in all five cases. Combined postoperative imaging with the referential tonotopic map confirmed achievement of full insertion and indicated the corresponding frequencies and the depth of the electrode. Achievement of atraumaticity of round window insertion in the present cases was confirmed from the viewpoint of the minimal drilling time as well as the preserved vestibular function.
使用长电极完全插入时,即使存在覆盖残余听力区域的长电极,也可实现听力保留。
电极设计及手术技术方面新的无创理念的发展进步,使得人工耳蜗植入术后能够保留听力,而伴有听力保留的电声刺激(EAS)是低频有残余听力患者的新趋势。然而,使用长/中电极完全插入并保留听力仍是一个具有挑战性的领域,值得探讨。
在本研究中,采用圆窗插入、无创电极及给予地塞米松,并在电极完全插入时评估无创性(听力保留及前庭功能保护)。
电极完全插入后的术后评估显示,所有5例患者的低频听力均得到良好保留。术后影像学与参考音调定位图相结合,证实了电极完全插入,并显示了相应的频率及电极深度。从最短钻孔时间及保留的前庭功能角度证实了本研究中圆窗插入的无创性。