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圆窗龛内薄型电极在人工耳蜗植入术后保留残余听力。

Preservation of residual hearing after cochlear implant surgery with slim modiolar electrode.

机构信息

University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland.

Kuopio University Hospital, Ear, Nose and Throat Diseases, KNK-klinikka, Puijonlaaksontie 2, 70210, Kuopio, Finland.

出版信息

Eur Arch Otorhinolaryngol. 2020 Feb;277(2):367-375. doi: 10.1007/s00405-019-05708-x. Epub 2019 Oct 31.

Abstract

PURPOSE

To evaluate the insertion results and hearing preservation of a novel slim modiolar electrode (SME) in patients with residual hearing.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c0a/6981311/a9f1d74b9c0c/405_2019_5708_Fig1_HTML.jpg

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