Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center.
Department of Audiology, Vanderbilt University Medical Center.
Otol Neurotol. 2020 Jan;41(1):33-38. doi: 10.1097/MAO.0000000000002426.
Describe audiologic outcomes in hearing preservation cochlear implantation (CI) using a precurved electrode array inserted using an external sheath and evaluate association of electrode positioning and preservation of residual hearing.
Retrospective review.
Tertiary otologic center.
Twenty-four adult patients who underwent hearing preservation CI with precurved electrode array.
CI, intraoperative computed tomography (CT) OUTCOME MEASURES:: Audiologic measures (consonant-nucleus-consonant [CNC] words, AzBio sentences, low-frequency pure tone averages [LFPTA]) and electrode location (scalar location, electrode-to-modiolus distance ((Equation is included in full-text article.)), angular insertion depth).
Twenty-four adults with less than 80 dB LFPTA with a precurved electrode array inserted using an external sheath; 16 underwent intraoperative CT. LFPTA was 58.5 dB HL preoperatively, with a 17.3 dB threshold shift at CI activation (p = 0.005). CNC word scores improved from 6% preoperatively to 64% at 6 months postoperatively (p < 0.0001). There was one scalar translocation and no tip fold-overs. The average angular insertion depth was 388.2 degrees, and the average (Equation is included in full-text article.)across all electrodes was 0.36 mm. Multivariate regression revealed a significant correlation between CNC scores at 6 months and angular insertion depth (p = 0.0122; r = 0.45, adjusted r = 0.35). Change in LFPTA was not significantly associated with angular insertion depth or (Equation is included in full-text article.).
A low rate of translocation allows a precurved electrode array inserted using an external sheath to maintain hearing preservation rates comparable to straight electrode arrays. With scala tympani insertion, angular insertion depth is a positive marker of improved speech performance postoperatively but may be a confounder variable based on individual cochlear size.
描述使用外部鞘管插入的预弯电极阵列进行听力保护人工耳蜗植入 (CI) 的听力结果，并评估电极位置与残余听力保留之间的关系。
回顾性研究。
三级耳科中心。
24 名成人患者，接受了使用预弯电极阵列的听力保护 CI。
CI，术中计算机断层扫描 (CT)
听力测量（辅音-核-辅音 (CNC) 词、AzBio 句子、低频纯音平均值 (LFPTA)) 和电极位置（标度位置、电极-调制器距离（方程包含在全文中））、角插入深度）。
24 名成年人的 LFPTA 小于 80dB，使用外部鞘管插入预弯电极阵列；16 名患者接受了术中 CT。术前 LFPTA 为 58.5dB HL，CI 激活时阈值移位 17.3dB（p=0.005）。CNC 单词分数从术前的 6%提高到术后 6 个月的 64%（p<0.0001）。有 1 次标度移位，无尖端折叠。平均角插入深度为 388.2 度，所有电极的平均（方程包含在全文中）为 0.36mm。多变量回归显示 6 个月时 CNC 评分与角插入深度之间存在显著相关性（p=0.0122；r=0.45，调整 r=0.35）。LFPTA 的变化与角插入深度或（方程包含在全文中）无显著相关性。
低转位率允许使用外部鞘管插入的预弯电极阵列保持与直电极阵列相当的听力保护率。在鼓阶插入时，角插入深度是术后言语表现改善的一个积极指标，但可能是基于个体耳蜗大小的混杂变量。
