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I型不完全分隔型儿童人工耳蜗植入后的手术效果:与内耳结构正常的聋儿比较

Surgical outcomes after cochlear implantation in children with incomplete partition type I: comparison with deaf children with a normal inner ear structure.

作者信息

Suk Yun, Lee Jeong Hyun, Lee Kwang-Sun

机构信息

*Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine; and †Departments of Radiology and ‡Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.

出版信息

Otol Neurotol. 2015 Jan;36(1):e11-7. doi: 10.1097/MAO.0000000000000606.

Abstract

OBJECTIVE

To compare audiologic performance after cochlear implantation (CI) in children with incomplete partition (IP) Type I and age-matched children with normal cochleae.

STUDY DESIGN

Retrospective chart review.

SETTING

Academic center.

PATIENTS

Twenty-three children (25 ears) with IP Type I and 230 age-matched deaf children (230 ears) with nonsyndromic normal inner ears who underwent CI between January 2000 and June 2013.

INTERVENTION CI MAIN OUTCOME MEASURE

The Categories of Auditory Performance (CAP) Scale score and the Meaningful Auditory Integration Scale (MAIS) score.

RESULTS

The mean age of IP Type I patients at the time of CI was 5.3 years (standard deviation, 5.4 yr; range, 0.9-17.7 yr). The mean duration of follow-up was 4.7 years (standard deviation, 3.5 yr; range, 1.1-11.2 yr). Fourteen of the 25 IP Type I ears (56%) had cerebrospinal fluid gusher during the cochleostomy. In the IP type ears, the number of inserted electrodes was 16.3 ± 3.2 (range, 11-22), and the insertion angle was 236.5 ± 41.2 degrees (range, 180-305 degrees). The cochlear nerve was assessed in 17 of the 25 IP type ears, and hypoplasia was present in nine (53%). Facial nerve stimulation occurred in 15 of the 25 IP type ears. IP Type I patients younger than 3 years at CI had significantly lower CAP Scale and MAIS scores than age-matched controls at 12 and 24 months after CI, but similar CAP Scale and MAIS scores as age-matched controls at 42 and 72 months after CI. IP Type I patients aged 3 to 18 years at CI had similar CAP Scale and MAIS scores as age-matched controls at all post-CI time points.

CONCLUSION

Children with IP Type I who underwent CI performed as well as children with normal cochlea in the long-term.

摘要

目的

比较I型不完全分隔(IP)患儿与年龄匹配的正常耳蜗患儿人工耳蜗植入(CI)后的听力学表现。

研究设计

回顾性病历审查。

研究地点

学术中心。

患者

2000年1月至2013年6月期间接受CI的23例I型IP患儿(25耳)和230例年龄匹配的非综合征性内耳正常的聋哑儿童(230耳)。

干预措施

CI

主要观察指标

听觉表现分类(CAP)量表评分和有意义听觉整合量表(MAIS)评分。

结果

I型IP患者CI时的平均年龄为5.3岁(标准差5.4岁;范围0.9 - 17.7岁)。平均随访时间为4.7年(标准差3.5年;范围1.1 - 11.2年)。25例I型IP耳中有14例(56%)在耳蜗造口时出现脑脊液喷射。在I型IP耳中,插入电极数量为16.3±3.2(范围11 - 22),插入角度为236.5±41.2度(范围180 - 305度)。25例I型IP耳中有17例评估了蜗神经,其中9例(53%)存在发育不全。25例I型IP耳中有15例发生面神经刺激。CI时年龄小于3岁的I型IP患者在CI后12个月和24个月时的CAP量表和MAIS评分显著低于年龄匹配的对照组,但在CI后42个月和72个月时的CAP量表和MAIS评分与年龄匹配的对照组相似。CI时年龄在3至18岁的I型IP患者在CI后的所有时间点的CAP量表和MAIS评分与年龄匹配的对照组相似。

结论

接受CI的I型IP患儿长期表现与正常耳蜗患儿相同。

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