Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea.
Sci Rep. 2019 Feb 4;9(1):1154. doi: 10.1038/s41598-018-37014-7.
The outcome of cochlear implantation (CI) in patients with cochlear nerve deficiency (CND) is variable, resulting in a wide range of speech perception performance, from degrees of environmental sound perception to conversation without lip-reading. Twenty-five cochlear implantees with CND were enrolled retrospectively to determine the factors correlated with CI outcome in patients with CND and to develop a predictive model for CI outcome. CI outcome was evaluated using the Categories of Auditory Performance (CAP) score at 2 years after CI. Patients with negative auditory brainstem response (ABR) showed a significantly lower CAP score than those with positive ABR (2.5 ± 1.7, 4.8 ± 0.7; p = 0.001). The area ratio of vestibulocochlear nerve (VCN) to facial nerve (FN) at the cerebellopontine angle on magnetic resonance images was positively correlated with CI outcome (p < 0.001). With multiple regression analysis, a predictive equation accounting for 66% of variance of CAP score at 2 years after CI was [Formula: see text]. We found that preoperative ABR and area ratio of VCN to FN at the cerebellopontine angle could predict CI outcome in patients with CND. Preoperative counselling based on our predictive model might be helpful to determine treatment modality for auditory rehabilitation and which ear to implant.
耳蜗神经缺如（CND）患者的人工耳蜗植入（CI）结果具有变异性，导致言语感知能力的范围很广，从环境声音感知程度到无需唇读的会话。本研究回顾性纳入 25 例 CND 患者，旨在确定与 CND 患者 CI 结果相关的因素，并建立 CI 结果的预测模型。使用人工耳蜗植入后 2 年的听觉绩效分类（CAP）评分评估 CI 结果。具有负听觉脑干反应（ABR）的患者的 CAP 评分明显低于具有正 ABR 的患者（2.5±1.7，4.8±0.7；p=0.001）。磁共振成像上小脑脑桥角前庭耳蜗神经（VCN）和面神经（FN）的面积比与 CI 结果呈正相关（p<0.001）。多元回归分析表明，解释人工耳蜗植入后 2 年 CAP 评分 66%变异的预测方程为 [公式：见文本]。我们发现术前 ABR 和小脑脑桥角 VCN 与 FN 的面积比可以预测 CND 患者的 CI 结果。基于我们的预测模型进行术前咨询可能有助于确定听觉康复的治疗方式和植入哪只耳朵。
