Verhaert Nicolas, Borgers Charlotte, De Voecht Katleen, Boon Ellen, Desloovere Christian
Department of Otolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven - University of Leuven, Leuven, Belgium.
Audiol Neurootol. 2018;23(2):89-97. doi: 10.1159/000491990. Epub 2018 Aug 21.
Recent findings support the efficacy of the direct acoustic cochlear implant (DACI) in patients with advanced otosclerosis whose rehabilitation is very challenging. Standard treatment consists of stapes surgery combined with hearing aids or a cochlear implant (CI). CI surgery, however, is often challenging depending on the grade of otosclerosis. This study aims to compare speech perception scores in quiet and noise of 6 DACI and 12 CI patients with advanced otosclerosis at 3 and 12 months after fitting. Preoperative computed tomographic scans of all patients were scored by experts using an existing otosclerosis grading system (stages 1-3). Speech perception in quiet was significantly better for DACI compared to CI users at 3 months after fitting. At 12 months, no difference was found between DACI and CI patients. Speech perception scores in noise were significantly better in the DACI group. In summary, a DACI system seems to provide an effective treatment option as the acoustic component can be preserved in patients with advanced otosclerosis.
近期研究结果支持了直接声学人工耳蜗（DACI）对重度耳硬化症患者的疗效，这类患者的康复治疗极具挑战性。标准治疗方法包括镫骨手术联合助听器或人工耳蜗（CI）。然而，CI手术往往因耳硬化症的严重程度而具有挑战性。本研究旨在比较6名接受DACI治疗和12名接受CI治疗的重度耳硬化症患者在佩戴后3个月和12个月时在安静环境和噪声环境下的言语感知得分。所有患者术前的计算机断层扫描由专家使用现有的耳硬化症分级系统（1 - 3期）进行评分。佩戴后3个月时，DACI使用者在安静环境下的言语感知明显优于CI使用者。在12个月时，DACI和CI患者之间未发现差异。DACI组在噪声环境下的言语感知得分明显更高。总之，DACI系统似乎提供了一种有效的治疗选择，因为在重度耳硬化症患者中可以保留声学成分。
