电极类型及其对人工耳蜗植入中阻抗波动和残余听力损失的影响。
Electrode Array Type and Its Impact on Impedance Fluctuations and Loss of Residual Hearing in Cochlear Implantation.
机构信息
Department of Otolaryngology/Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
出版信息
Otol Neurotol. 2020 Feb;41(2):186-191. doi: 10.1097/MAO.0000000000002457.
HYPOTHESIS/OBJECTIVE: Determine variables associated with electrode impedance fluctuations and loss of residual hearing in cochlear implant (CI) recipients.
BACKGROUND
CI recipients with postoperative hearing preservation demonstrate superior speech perception with an electric-acoustic stimulation (EAS) device as compared with a CI-alone device. Maintaining superior speech perception over time relies on long-term hearing preservation; therefore, understanding variables that may contribute to loss of residual hearing is needed. Recent reports suggest a relationship between changes in electrode impedance and loss of residual hearing. The variables influencing this relationship have yet to be determined.
METHODS
Review of pediatric and adult CI cases from 2013 to 2016 who presented with preoperative residual hearing. Regression analysis was performed to evaluate effects of array type (lateral wall vs. perimodiolar), manufacturer, age at implantation, and preoperative hearing on impedance. The correlation between peak impedance change and change in low-frequency hearing was determined.
RESULTS
One hundred forty-six CI recipients presented with preoperative residual hearing. A multivariate regression analysis demonstrated a statistically significant association between preoperative hearing thresholds (p = 0.017), device manufacturer (p = 0.011), and array type (p = 0.038) on postoperative impedance changes. Hearing preservation rates and change in impedance differed by electrode array type. The association between peak impedance changes and loss of residual hearing differed between manufacturers (R = 0.208, p = 0.029 vs. R = 0.016, p = 0.609).
CONCLUSION
Impedance fluctuation appears to be a marker for loss of residual hearing for specific electrode array types and manufacturers. Specific arrays may affect the cochlear microenvironment differently, with different effects on postoperative hearing preservation.
假设/目的：确定与耳蜗植入（CI）受者电极阻抗波动和残余听力损失相关的变量。
背景
与单独使用 CI 设备相比，术后保留听力的 CI 受者使用电-声刺激（EAS）设备表现出更好的言语感知能力。为了长期保持良好的言语感知能力，需要长期保留听力；因此，需要了解可能导致残余听力损失的变量。最近的报告表明，电极阻抗的变化与残余听力损失之间存在关系。影响这种关系的变量尚未确定。
方法
回顾 2013 年至 2016 年期间有术前残余听力的儿童和成人 CI 病例。进行回归分析以评估阵列类型（侧壁与 peri-modolar）、制造商、植入年龄和术前听力对阻抗的影响。确定峰值阻抗变化与低频听力变化之间的相关性。
结果
146 例 CI 受者术前有残余听力。多变量回归分析显示，术前听力阈值（p=0.017）、设备制造商（p=0.011）和阵列类型（p=0.038）与术后阻抗变化有统计学显著关联。不同电极阵列类型的听力保存率和阻抗变化不同。峰值阻抗变化与残余听力损失之间的关系因制造商而异（R=0.208，p=0.029 与 R=0.016，p=0.609）。
结论
阻抗波动似乎是特定电极阵列类型和制造商残余听力损失的标志物。特定的阵列可能会以不同的方式影响耳蜗微环境，对术后听力保护产生不同的影响。
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