Vashishth Ashish, Fulcheri Andrea, Guida Maurizio, Caruso Antonio, Sanna Mario
Department of Otology and Skull Base Surgery, Gruppo Otologico, Piacenza, Rome, Italy.
Eur Arch Otorhinolaryngol. 2018 May;275(5):1059-1068. doi: 10.1007/s00405-018-4924-5. Epub 2018 Mar 5.
To evaluate incidence, demographics, surgical, and radiological correlates of incomplete and false tract electrode array insertions during cochlear implantation (CI). To evaluate outcomes in patients with incomplete electrode insertion (IEI).
Retrospective analysis.
Otology and skull base center.
Charts of 18 patients (19 ears) with incomplete or false tract insertions of the electrode array were evaluated who underwent CI, with at least 1 year follow-up (from 470 cases). Demographic findings, etiologies, pre-operative radiologic findings, operative records, post-operative plain radiographic assessment for extent of electrode insertion, and switch-on mapping were evaluated. Audiological outcomes were evaluated using maximum and last recorded vowel, word, sentence, and comprehension scores for patients with IEI.
Incidence of insertional abnormalities was 4.25% with 17 instances of incomplete and 2 cases of insertion into superior semicircular canal. Mean age and duration of deafness were 55.18 ± 4.62 and 22.12 ± 5.71 years. Etiologies in the IEI group were idiopathic, otosclerosis, meningitis, chronic otitis media (COM), temporal bone fractures, and Neurofibromatosis-2. 29.4% cases had cochlear luminal obstruction. Mean radiological and active electrophysiological length of insertion was 20.49 ± 0.66 and 19.49 ± 0.88 mm, respectively. No significant correlation was observed between audiological outcomes and insertional length except in time to achieve maximum word scores (p = 0.04). Age at implantation had significant correlations with last recorded word and comprehension scores at mean follow-up of 42.9 months, and with time to achieve maximum auditory scores.
IEI during cochlear implantation using straight electrodes can occur with or without cochlear luminal obstruction. Age plays an important role in the auditory rehabilitation in this patient subset.
评估人工耳蜗植入（CI）过程中不完全和错误通道电极阵列插入的发生率、人口统计学特征、手术及影像学相关因素。评估不完全电极插入（IEI）患者的预后。
回顾性分析。
耳科学与颅底中心。
对18例（19耳）电极阵列不完全或错误通道插入且接受CI的患者病历进行评估，随访至少1年（共470例）。评估人口统计学结果、病因、术前影像学结果、手术记录、术后电极插入范围的平片评估以及开机图谱。使用IEI患者的最大和最后记录的元音、单词、句子及理解分数评估听力结果。
插入异常的发生率为4.25%，其中17例不完全插入，2例插入上半规管。平均年龄和耳聋持续时间分别为55.18±4.62岁和22.12±5.71年。IEI组的病因包括特发性、耳硬化症、脑膜炎、慢性中耳炎（COM）、颞骨骨折和神经纤维瘤病2型。29.4%的病例存在耳蜗管腔阻塞。平均影像学和主动电生理插入长度分别为20.49±0.66毫米和19.49±0.88毫米。除达到最大单词分数的时间外（p = 0.04），未观察到听力结果与插入长度之间存在显著相关性。植入时的年龄与平均随访42.9个月时最后记录的单词和理解分数以及达到最大听觉分数的时间显著相关。
使用直电极进行人工耳蜗植入时，IEI可伴有或不伴有耳蜗管腔阻塞。年龄在该患者亚组的听觉康复中起重要作用。
