Department of Otolaryngology-Head and Neck Surgery, CHA University, Seongnam, Republic of Korea.
Otol Neurotol. 2013 Apr;34(3):549-53. doi: 10.1097/MAO.0b013e31828399da.
OBJECTIVES/HYPOTHESIS: To review our experiences with revision cochlear implantation (CI), to assess revision CI efficacy, and to find factors that cause incomplete electrode insertion.
Retrospective chart review of revision CI from 2004 to 2011.
Academic tertiary referral center.
Twenty-two patients who underwent revision CI.
INTERVENTIONS(S): Revision cochlear implant surgery, explanted device analysis, electrode analysis for a newly implanted device, measurement of electrode insertion depth on postoperative radiographic evaluation, and postoperative speech perception test by open-set testing.
MAIN OUTCOME MEASURE(S): Surgical outcomes, postoperative performance, and analysis of used electrodes.
Approximately 2.7% (22/816) of CI recipients underwent revision surgery. The reasons for revision surgery were device failure (n = 14) and medical reason (n = 8). Cochlear implantation was performed at an average of 4.7 years after initial operation. Seventeen patients underwent revision CI with an electrode that was the same as or similar to the initial one, and all electrodes were fully inserted. Different electrode types were used in the remaining 5 patients. Interestingly, 4 of the 5 had incomplete electrode insertion. Among the 4 patients, 2 had poorer open set sentence scores after revision than after initial surgery.
In this study, full electrode insertion was achieved in all cases where the same type of electrode was used during initial and revision CI. In contrast, we noticed incomplete insertion in 4 of 5 patients who had revision electrodes that differed from initial electrodes. While incomplete electrode insertion does not necessitate poor speech performance, some patients with incomplete electrode insertion certainly experience it. Therefore, electrode selection requires circumspection in revision CI. Choosing a thinner electrode for revision CI may reduce the possibility of incomplete electrode insertion.
目的/假设：回顾我们在修正人工耳蜗植入（CI）方面的经验，评估修正 CI 的疗效，并找到导致电极不完全插入的因素。
对 2004 年至 2011 年期间进行的修正 CI 的回顾性图表审查。
学术三级转诊中心。
22 例接受修正 CI 的患者。
修正人工耳蜗植入手术、取出设备分析、新植入设备的电极分析、术后放射评估测量电极插入深度以及开放式测试的术后言语感知测试。
手术结果、术后表现和使用电极的分析。
大约 2.7%（22/816）的 CI 接受者进行了修正手术。修正手术的原因是设备故障（n=14）和医疗原因（n=8）。初次手术后平均 4.7 年进行了人工耳蜗植入。17 例患者接受了与初次手术相同或相似的修正 CI 电极，所有电极均完全插入。其余 5 例患者使用了不同类型的电极。有趣的是，5 例中有 4 例电极不完全插入。在这 4 名患者中，有 2 名患者在修正后比初次手术后的开放式句子得分更差。
在本研究中，在初次和修正 CI 中使用相同类型电极的所有情况下均实现了完全电极插入。相比之下，我们注意到在 5 例中有修正电极与初次电极不同的患者中有 4 例电极不完全插入。虽然不完全电极插入不一定导致言语表现不佳，但一些不完全电极插入的患者肯定会经历这种情况。因此，在修正 CI 中，电极选择需要慎重。选择更细的电极进行修正 CI 可能会减少不完全电极插入的可能性。
