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电-声刺激(EAS)治疗部分聋对人工耳蜗植入患者前庭功能的影响。

Effect on vestibular function of cochlear implantation by partial deafness treatment-electro acoustic stimulation (PDT-EAS).

机构信息

Otorhinolaryngosurgery Clinic, Institute of Physiology and Pathology of Hearing, Warsaw, Poland.

Department of Otoneurology, Institute of Physiology and Pathology of Hearing, Warsaw, Poland.

出版信息

Eur Arch Otorhinolaryngol. 2019 Jul;276(7):1951-1959. doi: 10.1007/s00405-019-05425-5. Epub 2019 May 3.

Abstract

PURPOSE

Although the cochlear implantation procedure does not interfere with vestibular structures directly, both the vestibulum and the cochlea share the same inner ear fluid space, and this fluid may be responsible for transferring possibly damaging forces from one to the other. The purpose of the study is to assess postoperative vestibular function after partial deafness treatment-electro-acoustic stimulation (PDT-EAS) cochlear implantation.

METHODS

Fifty-five patients were included in the study (30 females, 25 males, age 11-80, mean 41.8 ± 19.35). cVEMP and oVEMP were performed preoperatively and 1-3 months after cochlear implantation. Caloric and vHIT tests were conducted preoperatively and 4-6 months after cochlear implantation.

RESULTS

Our study shows that, based on a wide range of electrodes, use of PDT-EAS is protective in terms of preserving vestibular function. It gives a rate of saccular damage of 15.79%, utricular damage of 19.04%, and a horizontal semicircular canal response reduction of 15.79%.

CONCLUSIONS

PDT-EAS is protective in terms of preserving vestibular function. Nevertheless, it should be emphasized that the risk of vestibular damage cannot be totally eliminated even when hearing preservation techniques are adopted.

摘要

目的

尽管耳蜗植入手术不会直接干扰前庭结构,但前庭和耳蜗共享相同的内耳液空间,而这种液 体可能会将可能的损伤力从一个结构传递到另一个结构。本研究旨在评估部分聋治疗-电声刺激(PDT-EAS)耳蜗植入术后的术后前庭功能。

方法

本研究纳入了 55 例患者(30 名女性,25 名男性,年龄 11-80 岁,平均 41.8±19.35 岁)。在耳蜗植入术前和术后 1-3 个月进行 cVEMP 和 oVEMP 检查。在耳蜗植入术前和术后 4-6 个月进行冷热试验和 vHIT 检查。

结果

我们的研究表明,基于广泛的电极,PDT-EAS 的使用在保护前庭功能方面是有保护作用的。它导致囊状损害的发生率为 15.79%,壶腹损害的发生率为 19.04%,水平半规管反应减少的发生率为 15.79%。

结论

PDT-EAS 在保护前庭功能方面是有保护作用的。然而,应该强调的是,即使采用听力保护技术,也不能完全消除前庭损伤的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85ad/6581932/24b6e76709e6/405_2019_5425_Fig1_HTML.jpg

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