Vashishth Ashish, Fulcheri Andrea, Rossi Gianluca, Prasad Sampath Chandra, Caruso Antonio, Sanna Mario
Department of Otology and Skull Base Surgery, Gruppo Otologico, Piacenza, Rome, Italy.
Otol Neurotol. 2017 Oct;38(9):e345-e353. doi: 10.1097/MAO.0000000000001552.
Retrospective study.
Quaternary Otology and Skull base surgery center.
Charts of 36 patients (38 ears) with otosclerosis undergoing cochlear implantation were reviewed from the cochlear implant database. Demographic features, operative findings, auditory outcomes, and postimplantation FNS were analyzed. Operative findings included extent of cochlear ossification, approach (posterior tympantomy/subtotal petrosectomy), electrode insertion (partial/complete, scala tympani/vestibuli), and complications. All the patients underwent implantation using straight electrodes. Auditory outcomes were assessed over a 4-year follow-up period using vowel, word, sentence, and comprehension scores. Patients were divided into two groups (with and without cochlear ossification) for comparison of auditory outcomes.
The mean age and duration of deafness of patients was 59.72 and 28.9 years respectively. Twenty-three of 38 ears had cochlear ossification, with exclusive round window involvement in 60% of the patients, with the rest having partial or complete basal turn ossification. 36.8% ears underwent subtotal petrosectomy for cochlear ossification. One patient underwent scala vestibuli insertion and two had incomplete electrode insertion. Patients with no ossification had no intra or postoperative complications. One patient had bilateral FNS managed by alterations in programming strategy. Auditory outcomes in patients without any ossification were better than in patients with ossification, though statistically insignificant in most parameters.
Cochlear implantation in otosclerosis provides good auditory outcomes, despite high incidence of cochlear ossification. Patients of FNS can be managed by alterations in programming strategy, without affecting auditory outcomes.
1）回顾耳硬化症患者人工耳蜗植入的手术及听觉结果。2）回顾并发症及植入后面神经刺激（FNS）情况。3）比较有耳蜗骨化的患者与无骨化患者的听觉结果。
回顾性研究。
四级耳科学与颅底外科中心。
从人工耳蜗植入数据库中回顾了36例（38耳）接受人工耳蜗植入的耳硬化症患者的病历。分析了人口统计学特征、手术结果、听觉结果及植入后FNS情况。手术结果包括耳蜗骨化程度、手术入路（后鼓室切开术/部分岩骨切除术）、电极插入情况（部分/完全插入、鼓阶/前庭阶）及并发症。所有患者均使用直电极进行植入。在4年的随访期内，使用元音、单词、句子及理解得分评估听觉结果。将患者分为两组（有和无耳蜗骨化）以比较听觉结果。
患者的平均年龄和耳聋持续时间分别为59.72岁和28.9年。38耳中有23耳存在耳蜗骨化，60%的患者仅圆窗受累，其余患者有部分或完全的基底转骨化。36.8%的耳因耳蜗骨化接受了部分岩骨切除术。1例患者电极插入前庭阶，2例电极插入不完全。无骨化的患者无术中或术后并发症。1例患者出现双侧FNS，通过调整编程策略进行处理。无任何骨化的患者的听觉结果优于有骨化的患者，尽管在大多数参数上无统计学意义。
尽管耳蜗骨化发生率较高，但耳硬化症患者人工耳蜗植入仍可提供良好的听觉结果。FNS患者可通过调整编程策略进行处理，而不影响听觉结果。
