Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan.
Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto, Japan.
Anat Rec (Hoboken). 2020 Mar;303(3):563-593. doi: 10.1002/ar.24360. Epub 2020 Feb 6.
While cochlear implantation (CI) technology has greatly improved over the past 40 years, one aspect of CI that continues to pose difficulties is the variability of outcomes due to numerous factors involved in postimplantation performance. The electric acoustic stimulation (EAS) system has expanded indications for CI to include patients with residual hearing, and is currently becoming a standard therapy for these patients. Genetic disorders are known to be the most common cause of congenital/early-onset sensorineural hearing loss, and are also involved in a considerable proportion of cases of late-onset hearing loss. There has been a great deal of progress in the identification of deafness genes over the last two decades. Currently, more than 100 genes have been reported to be associated with non-syndromic hearing loss. Patients possessing a variety of deafness gene mutations have achieved satisfactory auditory performance after CI/EAS, suggesting that identification of the genetic background facilitates prediction of post-CI/EAS performance. When the intra-cochlear etiology is associated with a specific genetic background, there is a potential for good CI performance. Thus, it is essential to determine which region of the cochlea is affected by identifying the responsible genes. This review summarizes the genetic background of the patients receiving CI/EAS, and introduces detailed clinical data and CI/EAS outcomes in representative examples. Anat Rec, 303:563-593, 2020. © 2020 The Authors. The Anatomical Record published by Wiley Periodicals, Inc. on behalf of American Association of Anatomists.
虽然耳蜗植入 (CI) 技术在过去 40 年中得到了极大的改善,但由于植入后表现涉及许多因素,CI 的一个方面仍然存在困难,即结果的可变性。电声刺激 (EAS) 系统已经将 CI 的适应证扩展到包括残余听力的患者,并且目前正在成为这些患者的标准治疗方法。遗传疾病是先天性/早发性感觉神经性听力损失的最常见原因,也涉及相当一部分迟发性听力损失病例。在过去的二十年中,在鉴定耳聋基因方面取得了很大进展。目前,已有 100 多个基因被报道与非综合征性听力损失有关。许多耳聋基因突变的患者在接受 CI/EAS 后获得了满意的听觉效果,这表明鉴定遗传背景有助于预测 CI/EAS 后的表现。当耳蜗内病因与特定的遗传背景相关时,CI 表现良好的可能性较大。因此,必须通过确定相关基因来确定受影响的耳蜗区域。这篇综述总结了接受 CI/EAS 的患者的遗传背景,并介绍了有代表性的详细临床数据和 CI/EAS 结果。解剖记录,303:563-593,2020。©2020 作者。解剖学记录由 Wiley 期刊出版公司代表美国解剖学家协会出版。