Wang B, Cao K L, Wang Y, Li H
Department of Otolaryngology, Peking Union Medical College Hospital, Beijing, 100730, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Feb 20;31(4):284-289. doi: 10.13201/j.issn.1001-1781.2017.04.009.
To investigate the feasibility of cochlear implantation with contour electrode in patients with Mondini malformation and analysis of hearing rehabilitation after operation.Collection of 9 cases of straight electrode cochlear implantation patients with Mondini malformation, according to the age of deafness and the condition of rehabilitation, 9 patients with curved electrode implanted were matched and grouped.Retrospectively analysis of audiology characteristics, surgical technique, postoperative NRT results and map results, and evaluating the hearing and speech rehabilitation ability by CAP and SIR scores. The test parameters and rehabilitation effect of two groups' patients were compared according to different implant electrode.Eighteen cases of patients with Mondini malformation are severe sensory neural hearing loss according to preoperative hearing test, 6 cases without residual hearing. By preoperative EABR test, all patients were implanted with different types of electrode. There were 4 cases of gush in operation, 2 cases of facial spasm in straight electrode group, no complications postoperative cerebrospinal fluid leakage, no facial paralysis, no meningitis and other surgical complication after operation. Detecting NRT, the inducing rate of NRT was 77.78% in contour electrode group and 55.56% in straight electrode group; 6 month after operation, the average T value was (145.11±10.88)CL in contour electrode group and (168.44±22.45)CL in straight electrode group (< 0.05); the average C value was (182.67±14.65)CL in contour electrode group and (213.00±19.27)CL in straight electrode group (< 0.05). Dynamic range:(37.56±6.75)CL in contour electrode group and (44.56±18.06)CL in straight electrode group (> 0.05). Postoperative follow-ups were performed from 6 months to 4 years, the average score of CAP was 7.28±0.62 in contour electrode group and 7.22±0.79 in straight electrode group (> 0.05); the average score of SIR was 4.17±0.56 in contour electrode group and 4.00±0.71 in straight electrode group (> 0.05).Contour electrode can be chosen for bilateral serious hearing loss patients with Mondini malformation assisted by EABR, there is no significant difference compared with straight electrode in postoperative hearing and speech rehabilitation ability. The advantages are that the stimulation quantity is small, the NRT extraction rate is high, and the complication rate is low.
探讨蒙迪尼畸形患者植入轮廓电极人工耳蜗的可行性及术后听力康复分析。收集9例蒙迪尼畸形患者行直电极人工耳蜗植入病例,根据耳聋年龄及康复情况,匹配9例植入弯电极患者并分组。回顾性分析听力学特征、手术技巧、术后NRT结果及图谱结果,采用CAP和SIR评分评估听力及言语康复能力。比较两组患者不同植入电极的测试参数及康复效果。18例蒙迪尼畸形患者术前听力检查均为重度感音神经性聋,6例无残余听力。术前经EABR测试,均植入不同类型电极。术中4例出现鼓室出血,直电极组2例出现面部痉挛,术后无脑脊液漏、面瘫、脑膜炎等手术并发症。检测NRT,轮廓电极组NRT引出率为77.78%,直电极组为55.56%;术后6个月,轮廓电极组平均T值为(145.11±10.88)CL,直电极组为(168.44±22.45)CL(<0.05);轮廓电极组平均C值为(182.67±14.65)CL,直电极组为(213.00±19.27)CL(<0.05)。动态范围:轮廓电极组为(37.56±6.75)CL,直电极组为(44.56±18.06)CL(>0.05)。术后随访6个月至4年,轮廓电极组CAP平均评分为7.28±0.62,直电极组为7.22±0.79(>0.05);轮廓电极组SIR平均评分为4.17±0.56,直电极组为4.00±0.71(>0.05)。对于双侧重度听力损失的蒙迪尼畸形患者,在EABR辅助下可选择轮廓电极,术后听力及言语康复能力与直电极相比无显著差异。优势在于刺激量小、NRT引出率高、并发症发生率低。