人工耳蜗植入电极插入前后的圆窗电耳蜗图
Round window electrocochleography before and after cochlear implant electrode insertion.
作者信息
Adunka Oliver F, Giardina Christopher K, Formeister Eric J, Choudhury Baishakhi, Buchman Craig A, Fitzpatrick Douglas C
机构信息
Department of Otolaryngology-Head & Neck Surgery, the Ohio State University, Columbus, Ohio, U.S.A.
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.
出版信息
Laryngoscope. 2016 May;126(5):1193-200. doi: 10.1002/lary.25602. Epub 2015 Sep 11.
OBJECTIVE/HYPOTHESIS: Previous reports have documented the feasibility of utilizing electrocochleographic (ECoG) responses to acoustic signals to assess trauma caused during cochlear implantation. The hypothesis is that intraoperative round window ECoG before and after electrode insertion will help predict postoperative hearing preservation outcomes in cochlear implant recipients.
STUDY DESIGN
Prospective cohort study.
METHODS
Intraoperative round window ECoG responses were collected from 31 cochlear implant recipients (14 children and 17 adults) immediately prior to and just after electrode insertion. Hearing preservation was determined by postoperative changes in behavioral thresholds.
RESULTS
On average, the postinsertion response was smaller than the preinsertion response by an average of 4 dB across frequencies. However, in some cases (12 of 31) the response increased after insertion. The subsequent hearing loss was greater than the acute loss in the ECoG, averaging 22 dB across the same frequency range (250-1,000 Hz). There was no correlation between the change in the ECoG response and the corresponding change in audiometric threshold.
CONCLUSIONS
Intraoperative ECoG is a sensitive method for detecting electrophysiologic changes during implantation but had limited prognostic value regarding hearing preservation in the current conventional cochlear implant patient population where hearing preservation was not intended.
LEVEL OF EVIDENCE
2b Laryngoscope, 126:1193-1200, 2016.
目的/假设：既往报道已证明利用耳蜗电图（ECoG）对声音信号的反应来评估人工耳蜗植入过程中造成的创伤具有可行性。假设是电极插入前后的术中圆窗ECoG将有助于预测人工耳蜗植入受者术后听力保留结果。
研究设计
前瞻性队列研究。
方法
从31例人工耳蜗植入受者（14名儿童和17名成人）在电极插入前和刚插入后立即采集术中圆窗ECoG反应。通过术后行为阈值的变化来确定听力保留情况。
结果
平均而言，插入后反应在各频率上比插入前反应平均小4 dB。然而，在某些情况下（31例中的12例），插入后反应增加。随后的听力损失大于ECoG中的急性损失，在相同频率范围（250 - 1000 Hz）内平均为22 dB。ECoG反应的变化与听力阈值的相应变化之间没有相关性。
结论
术中ECoG是检测植入过程中电生理变化的一种敏感方法，但对于当前无意保留听力的传统人工耳蜗植入患者群体，其在听力保留方面的预后价值有限。
证据水平
2b 《喉镜》，126:1193 - 1200，2016年。
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