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单次静脉大剂量给予泼尼松龙对大多数人工耳蜗植入患者术后阻抗无影响。

Single Intravenous High Dose Administration of Prednisolone Has No Influence on Postoperative Impedances in the Majority of Cochlear Implant Patients.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School.

Cluster of Excellence "Hearing4all" of the German Research Foundation, Hannover, Germany.

出版信息

Otol Neurotol. 2018 Dec;39(10):e1002-e1009. doi: 10.1097/MAO.0000000000002033.

Abstract

OBJECTIVE

To evaluate effect of prednisolone on the impedances after cochlear implantation.

STUDY DESIGN

Retrospective case series.

SETTING

Tertiary referral center.

PATIENTS AND INTERVENTION

A total of 130 patients underwent cochlear implantation with a Med-El Flex28 synchrony device between 2012 and 2016 and met the inclusion criteria. Only patients with full datasets regarding impedance measurements perioperatively, at first fitting (before and after chronic electric stimulation) and at 3 and 12 months appointments afterward were included. Patients (n = 101) received a single intravenous administration of at least 200 mg prednisolone intraoperatively and control patients (n = 29) did not receive any steroids at all. Patients receiving low dose steroids during surgery were excluded.

MAIN OUTCOME MEASURES

Mean values for impedances were calculated over all electrode contacts and separately for basal, medial, and apical regions.

RESULTS

Impedances increased significantly from perioperative measures to first fitting in both groups. Mainly at the basal region of the electrode array, impedances were slightly lower in the steroid group compared with controls. However, the majority of the patients showed increased impedances whether they received steroid treatment or not.

CONCLUSION

The present study shows a slight but statistically significant reduction of the mean value of postoperative impedances at the basal electrode contacts in patients receiving a single systemic high dose application of prednisolone. Less than half of the patients showed a decrease in impedances and whether this decrease is clinically relevant remains to be elucidated.

摘要

目的

评估地塞米松对人工耳蜗植入后阻抗的影响。

研究设计

回顾性病例系列研究。

设置

三级转诊中心。

患者和干预措施

共有 130 例患者于 2012 年至 2016 年间接受 Med-El Flex28 同步装置人工耳蜗植入,符合纳入标准。仅纳入了围手术期、初次适配(慢性电刺激前后)以及之后 3 个月和 12 个月时具有完整阻抗测量数据集的患者。101 例患者术中接受至少 200mg 地塞米松单次静脉给药,对照组(n=29)患者未接受任何类固醇治疗。术中接受低剂量类固醇治疗的患者被排除在外。

主要观察指标

所有电极触点和基底、中间和顶端区域的平均阻抗值。

结果

两组患者的阻抗均从围手术期测量值显著增加到初次适配。在类固醇组中,电极阵列的基底区域的阻抗与对照组相比略低。然而,大多数患者无论是否接受类固醇治疗,阻抗都有所增加。

结论

本研究表明,接受单次全身高剂量地塞米松治疗的患者术后基底电极接触点的平均阻抗值略有降低,但具有统计学意义。不到一半的患者出现阻抗降低,而这种降低是否具有临床意义仍有待阐明。

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