O'Connell Brendan P, Hunter Jacob B, Wanna George B
Department of Otolaryngology-Head and Neck Surgery Vanderbilt University Medical Center Nashville Tennessee U.S.A.
Laryngoscope Investig Otolaryngol. 2016 Nov 29;1(6):169-174. doi: 10.1002/lio2.42. eCollection 2016 Dec.
As indications for cochlear implantation have expanded to include patients with more residual hearing, increasing emphasis has been placed on minimally traumatic electrode insertion. Histopathologic evaluation remains the gold standard for evaluation of cochlear trauma, but advances in imaging techniques have allowed clinicians to determine scalar electrode location . This review will examine the relationship between scalar location of electrode arrays and audiologic outcomes. In addition, the impact that surgical approach, electrode design, and insertion depth have on scalar location will be evaluated. : PubMed literature review : A review of the current literature was conducted to analyze the relationship between scalar location of cochlear implant electrode arrays and speech perception outcomes. Further, data were reviewed to determine the impact that surgical variables have on scalar electrode location.
Electrode insertions into the scala tympani are associated with superior speech perception and higher rates of hearing preservation. Lateral wall electrodes, and round window/extended round window approaches appear to maximize the likelihood of a scala tympani insertion. It does not appear that deeper insertions are associated with higher rates of scalar translocation.
Superior audiologic outcomes are observed for electrode arrays inserted entirely within the scala tympani. The majority of clinical data demonstrate that lateral wall design and a round window approach increase the likelihood of a scala tympani insertion.
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随着人工耳蜗植入的适应症已扩大到包括更多有残余听力的患者，人们越来越重视微创电极插入。组织病理学评估仍然是评估耳蜗创伤的金标准，但成像技术的进步使临床医生能够确定电极在蜗管中的位置。本综述将研究电极阵列在蜗管中的位置与听力学结果之间的关系。此外，还将评估手术方式、电极设计和插入深度对蜗管位置的影响。：PubMed文献综述：对当前文献进行综述，以分析人工耳蜗植入电极阵列在蜗管中的位置与言语感知结果之间的关系。此外，还对数据进行了回顾，以确定手术变量对蜗管电极位置的影响。
电极插入鼓阶与更好的言语感知和更高的听力保留率相关。侧壁电极以及圆窗/扩展圆窗入路似乎能最大程度地增加电极插入鼓阶的可能性。似乎更深的插入与更高的蜗管移位率无关。
对于完全插入鼓阶内的电极阵列，观察到更好的听力学结果。大多数临床数据表明，侧壁设计和圆窗入路增加了电极插入鼓阶的可能性。
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