Amin Nikul, Sethukumar Priya, Pai Irumee, Rajput Kaukab, Nash Robert
a Department of Paediatric Otolaryngology , Great Ormond Street Hospital , London , UK.
b Hearing Implant Team, Guy's and St Thomas' NHS Foundation Trust , London , UK.
Cochlear Implants Int. 2019 Sep;20(5):266-280. doi: 10.1080/14670100.2019.1634857. Epub 2019 Jul 7.
CHARGE syndrome presents with a collection of congenital anomalies affecting multiple organs. Ear and temporal bone anomalies, including hearing loss are highly prevalent. We present an aid to management of this challenging condition and report the strategies and outcomes of cochlear implantation. Systematic review of Medline, EMBASE, Web of Science, CENTRAL and clinicaltrials.gov was performed up to 21/10/2018 The review and meta-analysis of studies were performed according to the PRISMA statement. Patient demographics, comorbidity, anatomical factors, details of cochlear implantation and audiological outcome were extracted and summarized. Anatomical and surgical factors were evaluated by meta-analysis. Audiological outcomes reported were too heterogeneous for meta-analysis. All statistics were calculated with SPSS v23.0 (IBM, New York, USA). Thirty-one studies reported 165 cochlear implants in 156 patients with CHARGE syndrome. Temporal bone and facial nerve anomalies were common. The assessment and management of patients with CHARGE syndrome undergoing cochlear implantation is challenging. Outcomes may be affected by cochlear nerve deficiency, inner ear anomalies, and developmental delay. Surgery is almost invariably complicated by abnormal anatomy, and increased incidence of complications. A careful, case-by-case assessment of an individual's requirements within a multi-disciplinary setup is essential for achieving the best possible outcome.
CHARGE综合征表现为一系列影响多个器官的先天性异常。耳部和颞骨异常,包括听力损失非常普遍。我们提供了一种有助于管理这种具有挑战性疾病的方法,并报告了人工耳蜗植入的策略和结果。截至2018年10月21日,对Medline、EMBASE、科学网、CENTRAL和clinicaltrials.gov进行了系统综述。根据PRISMA声明对研究进行综述和荟萃分析。提取并总结了患者的人口统计学特征、合并症、解剖学因素、人工耳蜗植入细节和听力学结果。通过荟萃分析评估解剖学和手术因素。所报告的听力学结果因过于异质而无法进行荟萃分析。所有统计数据均使用SPSS v23.0(美国纽约IBM公司)计算。31项研究报告了156例CHARGE综合征患者中的165例人工耳蜗植入情况。颞骨和面神经异常很常见。对接受人工耳蜗植入的CHARGE综合征患者进行评估和管理具有挑战性。结果可能会受到蜗神经缺陷、内耳异常和发育迟缓的影响。手术几乎总是因解剖结构异常和并发症发生率增加而变得复杂。在多学科环境中对个体需求进行仔细的逐案评估对于取得最佳可能结果至关重要。