人工耳蜗植入失败与再次植入：30 年分析与文献回顾。
Cochlear implant failures and reimplantation: A 30-year analysis and literature review.
机构信息
Department of Otolaryngology-Head and Neck Surgery, University of Manitoba, Max Rady College of Medicine, Winnipeg, Manitoba, Canada.
Cochlear Implant Program, London Health Sciences Centre, London, Ontario, Canada.
出版信息
Laryngoscope. 2020 Mar;130(3):782-789. doi: 10.1002/lary.28071. Epub 2019 May 21.
OBJECTIVES/HYPOTHESIS: The objectives of the study were to present an institutional experience with device failures and cochlear reimplantation rates over a 30-year period and to perform a detailed literature review.
STUDY DESIGN
Retrospective institutional experience and literature review.
METHODS
A review of cochlear implant failures over a period of 30 years, between January 1988 and March 2017, at a single institution was conducted. Cochlear implant failures were calculated based on manufacturer, type of failure, and overall failure rate. Survival analysis was performed using Kaplan-Meier curves. An electronic search of the PubMed, Web of Science, and EMBASE databases revealed 24 articles on the topic of cochlear device failure. Data on reimplantation and device failure rates were extracted from this literature review and analyzed.
RESULTS
A total of 804 cochlear implantations were reviewed from three manufacturers. The institutional reimplantation rate was 2.9% compared to the pooled rate of 6.0% calculated from the literature review. Medical failures accounted for 0.5% of the overall failures, device failures accounted for 1.6%, and inconclusive failures account for 0.7%. Survival analysis revealed a significant difference among manufacturers. An improved device failure rate was noted in the adult population (0.8%) as compared to the pediatric population (2.8%).
CONCLUSIONS
This 30-year review represents one of the longest series in the literature examining reimplantation, device failure, and medical failure rates. Cochlear implant survival varied by manufacturer and was significantly better in adult compared to pediatric patients.
LEVEL OF EVIDENCE
NA Laryngoscope, 130:782-789, 2020.
目的/假设：本研究的目的是展示一个机构在 30 年期间的设备故障和人工耳蜗再植入率的经验，并进行详细的文献回顾。
研究设计
回顾性机构经验和文献回顾。
方法
对 1988 年 1 月至 2017 年 3 月期间在一家机构发生的人工耳蜗植入失败进行了为期 30 年的回顾。根据制造商、故障类型和总故障率计算人工耳蜗植入失败。使用 Kaplan-Meier 曲线进行生存分析。对 PubMed、Web of Science 和 EMBASE 数据库进行电子搜索，共检索到 24 篇关于人工耳蜗设备故障的文章。从文献回顾中提取了关于再植入和设备故障率的数据，并进行了分析。
结果
共对来自三个制造商的 804 例人工耳蜗植入进行了回顾。机构再植入率为 2.9%，而从文献回顾中计算出的汇总再植入率为 6.0%。医疗故障占总故障的 0.5%，设备故障占 1.6%，不确定故障占 0.7%。生存分析显示制造商之间存在显著差异。与儿科人群（2.8%）相比，成人人群（0.8%）的设备故障发生率有所改善。
结论
这项 30 年的回顾是文献中检查再植入、设备故障和医疗故障率的最长系列之一。人工耳蜗的存活率因制造商而异，成人明显优于儿科患者。
证据水平
无。喉镜，130：782-789，2020 年。
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