Wolf-Magele A, Schnabl J, Edlinger S, Pok S M, Schoerg P, Sprinzl G M
Department of Otorhinolaryngology, Karl Landsteiner Private University, University Clinic, St.Poelten, Austria.
Department of Audiology, Karl Landsteiner Private University, University Clinic, St.Poelten, Austria.
Clin Otolaryngol. 2015 Dec;40(6):527-34. doi: 10.1111/coa.12391.
Cochlear implantation is a clinically routine treatment for patients with severe sensorineural hearing loss for over 20 years. Up to now, the general recommendation for speech processor activation was 4 weeks after cochlear implantation. The aim of this study was to determine whether activation is possible at <4 weeks postop and to show the postoperative change in telemetry over time.
The study was retrospectively carried out at the Karl Landsteiner University Hospital St. Pölten, Austria. Patients who routinely received a CI between January and August 2013 were included in this study. Two weeks after the surgery clinical complications, the ability to wear the audio processor and the impedance values were analysed.
Forty-five patients were included in this study. Forty patients were examined at the first postoperative visit, scheduled 2 weeks after the surgery. In nine cases, a mild wound-healing complication occurred; just in one patient, the activation could not carry out immediately. There were no statistically significant differences between the intraoperative, the 2- and 6-week postop impedance measurements for each channel.
We used the minimally invasive approach and soft implantation technique in all of our patients and believe this to have been a major reason that earlier activation was possible. With this technique, you can reduce the wound-healing process, which makes it possible for the wound to heal fully and for the patient to wear the sound processor over the wound without problems. We found out that telemetry is not a predictor for the time of activation.
Based on the results in this study, an earlier activation can be recommended. This will shorten the time the patient needs to wait following cochlear implantation, and rehabilitation can begin sooner.
人工耳蜗植入作为重度感音神经性听力损失患者的临床常规治疗方法已有20多年。到目前为止，关于言语处理器激活的一般建议是在人工耳蜗植入后4周。本研究的目的是确定术后<4周是否可以激活，并展示术后遥测随时间的变化。
本研究在奥地利圣珀尔滕的卡尔·兰德施泰纳大学医院进行回顾性研究。纳入2013年1月至8月期间常规接受人工耳蜗植入的患者。术后两周分析临床并发症、佩戴音频处理器的能力和阻抗值。
本研究纳入45例患者。40例患者在术后首次随访时接受检查，随访安排在术后2周。9例出现轻度伤口愈合并发症；仅1例患者无法立即进行激活。每个通道的术中、术后2周和6周阻抗测量之间无统计学显著差异。
我们在所有患者中均采用微创方法和软植入技术，认为这是能够更早激活的主要原因。采用这种技术，可以减少伤口愈合过程，使伤口能够完全愈合，患者能够毫无问题地在伤口上方佩戴声音处理器。我们发现遥测不是激活时间的预测指标。
基于本研究结果，可推荐更早激活。这将缩短患者人工耳蜗植入后需要等待的时间，康复可以更早开始。
