University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland.
Kuopio University Hospital, Ear, Nose and Throat Diseases, KNK-klinikka, Puijonlaaksontie 2, 70210, Kuopio, Finland.
Eur Arch Otorhinolaryngol. 2020 Feb;277(2):367-375. doi: 10.1007/s00405-019-05708-x. Epub 2019 Oct 31.
To evaluate the insertion results and hearing preservation of a novel slim modiolar electrode (SME) in patients with residual hearing.
We retrospectively collected the data from the medical files of 17 patients (18 ears) implanted with a SME. All patients had functional low frequency hearing (PTA ≤ 80 dB HL). The insertion results were re-examined from the postoperative cone-beam computed tomography scans. Postoperative thresholds were obtained at the time of switch-on of the sound processors (mean 43 days) and at latest follow-up (mean 582 days). The speech recognition in noise was measured with the Finnish matrix sentence test preoperatively and at follow-up.
The mean insertion depth angle (IDA) was 395°. Neither scala dislocations nor tip fold over were detected. There were no total hearing losses. Functional low-frequency hearing was preserved in 15/18 (83%) ears at switch-on and in 14/17 (82%) ears at follow-up. According to HEARRING classification, 55% (10/18) had complete HP at switch-on and 41% (7/17) still at follow-up. Thirteen patients (14 ears) were initially fitted with electric-acoustic stimulation and seven patients (8 ears) continued to use it after follow-up.
The preliminary hearing preservation results with the SME were more favorable than reported for other perimodiolar electrodes. The results show that the array may also be feasible for electro-acoustic stimulation; it is beneficial in that it provides adequate cochlear coverage for pure electrical stimulation in the event of postoperative or progressive hearing loss.
评估新型细极耳蜗内植入电极（SME）在保留残余听力患者中的植入效果和听力保护。
我们回顾性地收集了 17 例（18 耳）植入 SME 的患者的病历数据。所有患者均有功能性低频听力（PTA≤80dB HL）。根据术后锥形束 CT 扫描对植入结果进行重新检查。在声音处理器开启时（平均 43 天）和随访时（平均 582 天）获得术后阈值。术前和随访时使用芬兰矩阵句子测试测量言语识别噪声。
平均插入深度角（IDA）为 395°。未发现 scala 移位或尖端折叠。无全聋。15/18（83%）耳在开启时和 14/17（82%）耳在随访时保留了功能性低频听力。根据 HEARRING 分类，10/18（55%）耳在开启时具有完全高频听力，7/17（41%）耳在随访时仍具有高频听力。13 例患者（14 耳）最初适配电声刺激，7 例患者（8 耳）在随访后继续使用。
与其他peri-modiolar 电极相比，SME 的初步听力保护结果更为有利。结果表明，该阵列对于电声刺激也可能是可行的；如果发生术后或渐进性听力损失，它提供了足够的耳蜗覆盖范围，有利于纯电刺激。
