Department of Otolaryngology-Head and Neck Surgery, University Hospitals Case, Medical Center, Cleveland, OH, USA.
Am J Otolaryngol. 2012 Sep-Oct;33(5):608-14. doi: 10.1016/j.amjoto.2012.05.001. Epub 2012 Jul 2.
To compare hearing outcomes in patients with far advanced otosclerosis (FAO) undergoing cochlear implantation to an age-matched group of controls, to describe the effects of cochlear ossification on hearing, and to review the adverse effects of implantation in patients with FAO.
Hearing performance in patients with FAO after cochlear implantation is comparable to similarly treated postlingually deafened adults without FAO. Ossification or retrofenestral otosclerosis does not predict poor hearing outcomes. Modiolar-hugging technology reduces postoperative facial nerve stimulation.
Retrospective chart review.
Academic neurotologic tertiary referral center.
Thirty patients with FAO, who metaudiological criteria for cochlear implantation, were compared to 30 age-matched controls, postlingually deafened by non-otosclerotic causes.
Audiometric pre- and postoperative speech reception threshold, word, and sentence scores were analyzed. The presence of retrofenestral findings on computed tomography or intraoperative cochlear ossification were noted.
In the FAO group, radiographic abnormalities were noted in 26.4% of patients. Intraoperative ossification requiring drillout was seen in 29.4% of patients. None developed postoperative facial nerve stimulation. There was no difference between the FAO and control groups in the mean short-term and long-term postoperative speech reception threshold, word, and sentence scores (P = .77). The presence of radiographic abnormalities did not predict hearing outcome. Intraoperative cochlear ossification was not associated with worse short-term word and sentence scores (P = .58 and 0.79, respectively), and for the long-term hearing outcome (P = .24).
In patients with FAO, effective and safe hearing rehabilitation can be accomplished with cochlear implantation.
比较晚期耳硬化症（FAO）患者与年龄匹配的对照组患者行耳蜗植入术后的听力结果，描述耳蜗骨化对听力的影响，并回顾 FAO 患者植入的不良反应。
FAO 患者行耳蜗植入术后的听力表现与无 FAO 的类似治疗的后天性聋患者相当。骨化或后窗耳硬化症并不能预测听力结果不良。紧贴蜗轴技术减少术后面神经刺激。
回顾性图表分析。
学术神经耳科三级转诊中心。
30 例符合耳蜗植入标准的 FAO 患者与 30 例年龄匹配的、因非耳硬化症导致后天性聋的对照组患者进行比较。
分析术前和术后听力言语接受阈、言语、句子得分。注意 CT 上的后窗发现或术中耳蜗骨化。
在 FAO 组中，26.4%的患者有放射影像学异常。29.4%的患者术中发现需要钻孔的骨化。无患者发生术后面神经刺激。FAO 组和对照组在平均短期和长期术后言语接受阈、言语和句子得分方面无差异（P =.77）。放射影像学异常的存在并不能预测听力结果。术中耳蜗骨化与短期言语和句子得分较差无关（P =.58 和 0.79），与长期听力结果无关（P =.24）。
在 FAO 患者中，耳蜗植入可实现有效且安全的听力康复。
