Puram Sidharth V, Roberts Daniel S, Niesten Marlien E F, Dilger Amanda E, Lee Daniel J
Cochlear Implants Int. 2015 Jul;16(4):213-21. doi: 10.1179/1754762813Y.0000000044. Epub 2013 Nov 25.
To determine whether adult cochlear implant (CI) users with superior canal dehiscence syndrome (SCDS) or asymptomatic superior semicircular canal dehiscence (SCD) have different surgical, vestibular, and audiologic outcomes when compared to CI users with normal temporal bone anatomy.
A retrospective single institution review of CI users with either superior semicircular canal dehiscence syndrome or asymptomatic superior semicircular canal dehiscence identified eight post-lingually deafened adults with unilateral or bilateral cochlear implantation between 2006 and 2010. Preoperative and postoperative speech perception scores as well as medical and epidemiological data were recorded and analyzed.
One patient with superior canal dehiscence syndrome and seven patients with asymptomatic superior semicircular canal dehiscence were identified, representing 7% or 8/113 of CI patients that fulfilled selection criteria. Average dehiscence length was 3.3 mm ± 0.79 SEM. Three patients received bilateral implants and five patients received a unilateral implant. Among asymptomatic superior semicircular canal dehiscence patients, subjective rates of post-operative dizziness were similar to those seen in patients with normal temporal bone anatomy (12.5 % vs. 15.9%, respectively). Speech perception abilities after surgery were poorer in SCD patients compared to the non-SCD cohort (Consonant Nucleus Consonant 33.7 ± 7.78 SEM vs. 56.7 ± 2.15 SEM P = 0.011), although both groups improved substantially relative to pre-operative performance. We also completed detailed analyses of auditory and vestibular outcomes in one patient with SCDS who underwent CI surgery in the symptomatic ear, which demonstrated preservation of vestibular function post-operatively, improved quality-of-life measures, and reduced dizziness symptomatology.
Our data suggest that patients with asymptomatic superior canal dehiscence at the time of CI surgery have similar albeit decreased speech perception scores compared to non-SCD adult CI users. Subjective rate of dizziness or vertigo following CI surgery was similar in both asymptomatic SCD and non-SCD cohorts, with detailed analyses of a single symptomatic SCD patient revealing improved vestibular function and reduced SCD symptoms following CI.
确定与颞骨解剖结构正常的人工耳蜗（CI）使用者相比，患有上半规管裂综合征（SCDS）或无症状上半规管裂（SCD）的成年CI使用者在手术、前庭和听力方面是否有不同的结果。
对患有上半规管裂综合征或无症状上半规管裂的CI使用者进行单机构回顾性研究，确定了2006年至2010年间8名语后聋的成年人，他们接受了单侧或双侧人工耳蜗植入。记录并分析术前和术后的言语感知分数以及医学和流行病学数据。
确定了1例上半规管裂综合征患者和7例无症状上半规管裂患者，占符合选择标准的CI患者的7%或8/113。平均裂长为3.3 mm±0.79标准误。3例患者接受双侧植入，5例患者接受单侧植入。在无症状上半规管裂患者中，术后头晕的主观发生率与颞骨解剖结构正常的患者相似（分别为12.5%和15.9%）。与非SCD队列相比，SCD患者术后的言语感知能力较差（辅音-元音-辅音为33.7±7.78标准误对56.7±2.15标准误，P = 0.011），尽管两组相对于术前表现都有显著改善。我们还对1例在有症状耳接受CI手术的SCDS患者的听觉和前庭结果进行了详细分析，结果显示术后前庭功能得以保留，生活质量指标得到改善，头晕症状减轻。
我们的数据表明，与非SCD成年CI使用者相比，CI手术时无症状上半规管裂的患者言语感知分数虽有所下降但相似。无症状SCD和非SCD队列中CI手术后头晕或眩晕的主观发生率相似，对1例有症状SCD患者的详细分析显示，CI术后前庭功能改善，SCD症状减轻。
