Behr Robert, Colletti Vittorio, Matthies Cordula, Morita Akio, Nakatomi Hirofumi, Dominique Liguoro, Darrouzet Vincent, Brill Stefan, Shehata-Dieler W, Lorens Artur, Skarzynski Henryk
*Klinikum Fulda gAG, Academic Hospital of the University of Marburg, Fulda, Germany; †University of Verona, Verona, Italy; ‡University of Wuerzburg, Wuerzburg, Germany; §NTT Medical Center Tokyo, Tokyo, Japan; ∥University of Tokyo, Tokyo, Japan; ¶University of Bordeaux, Bordeaux, France; and #Institute of Physiology and Pathology of Hearing, Warsaw, Poland.
Otol Neurotol. 2014 Dec;35(10):1844-51. doi: 10.1097/MAO.0000000000000584.
To determine factors related to high levels of speech recognition in patients with the auditory brainstem implant (ABI).
Retrospective case review.
International multicenter data from hospitals and tertiary referral facilities.
Patients with neurofibromatosis type 2 (NF2) and bilateral vestibular schwannomas.
ABIs were placed after the removal of vestibular schwannomas.
Demographic and surgical data were collected from 26 patients with ABIs who achieved scores of better than 30% correct identification of sentences presented in quiet listening conditions and without lipreading cues.
Scores better than 30% speech recognition of standard sentence test materials (HINT or equivalent) in quiet listening conditions were obtained in 26 of the 84 NF2 patients (31%). ABI speech recognition was correlated with surgical position, length of deafness, the number of distinct pitch electrodes, perceptual levels, and ABI stimulation rate, but not correlated with tumor size, tumor stage, the number of electrodes used, or electrophysiological recordings. This paper presents the consensus opinion from a meeting of surgeons to compare outcomes across ABI surgical centers.
The consensus opinion was that brainstem trauma is a primary factor in the variability of outcomes in NF2 patients. The significant co-factors in outcomes implied that ABI surgery should be accomplished with great care to minimize physical and venous trauma to the brainstem. It is clear that high levels of speech recognition, including high levels of open-set speech recognition, are possible with the ABI even in patients with NF2 and large tumors.
确定与听觉脑干植入（ABI）患者高水平言语识别相关的因素。
回顾性病例分析。
来自医院和三级转诊机构的国际多中心数据。
2型神经纤维瘤病（NF2）和双侧前庭神经鞘瘤患者。
在切除前庭神经鞘瘤后植入ABI。
收集了26例ABI患者的人口统计学和手术数据，这些患者在安静聆听条件下且无唇读线索时，对呈现句子的正确识别得分超过30%。
84例NF2患者中有26例（31%）在安静聆听条件下对标准句子测试材料（HINT或等效材料）的言语识别得分超过30%。ABI言语识别与手术位置、耳聋时长、不同音调电极数量、感知水平和ABI刺激率相关，但与肿瘤大小、肿瘤分期、使用的电极数量或电生理记录无关。本文呈现了外科医生会议的共识意见，以比较各ABI手术中心的结果。
共识意见是脑干损伤是NF2患者手术结果差异的主要因素。结果中的重要协同因素表明，ABI手术应格外小心进行，以尽量减少对脑干的物理和静脉损伤。很明显，即使是患有NF2和大肿瘤的患者，使用ABI也有可能实现高水平言语识别，包括高水平的开放式言语识别。
