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老年人工耳蜗植入患者的听力保护。

Hearing Preservation in Elderly Cochlear Implant Recipients.

机构信息

Ear & Hearing | Center for Neurosciences, Tucson, Arizona.

出版信息

Otol Neurotol. 2020 Jun;41(5):618-624. doi: 10.1097/MAO.0000000000002596.

Abstract

OBJECTIVE

Examine hearing preservation rates in cochlear implant recipients 72 years and older.

STUDY DESIGN

Retrospective case series.

SETTING

Tertiary otology/neurotology practice.

PATIENTS

Cochlear implant recipients 72 years and older who are candidates for hearing preservation and were implanted between April 2017 and June 2018 INTERVENTION:: Surgical/rehabilitative.

MAIN OUTCOME MEASURES

Hearing was measured preoperatively and 6 months after cochlear implantation.

RESULTS

Between April 2017 and June 2018, 125 cochlear implant operations were performed by the senior author (A.J.). Of these patients, 62 were over age 72 and comprehensive pre- and postoperative residual hearing data were available on 24 patients. Although several methods for calculating hearing preservation are evaluated, our practice has found that hearing preservation techniques should be used in all patients having even a single frequency ≤85 dB HL between 125 and 2000 Hz before surgery. Using this method, 60% of recipients had at least one postoperative threshold ≤85 dB HL, and more importantly, over 80% of these patients subsequently used an electroacoustic MAP.

CONCLUSION

Despite concerns about cochlear fragility in elderly patients, preservation of residual hearing is feasible in cochlear implant recipients 72 years and older. This suggests that the vast majority of patients, including an elderly cohort, can benefit from soft surgery techniques.

摘要

目的

研究 72 岁及以上人工耳蜗植入患者的听力保护率。

研究设计

回顾性病例系列。

设置

三级耳科学/神经耳科学实践。

患者

72 岁及以上符合听力保护条件并于 2017 年 4 月至 2018 年 6 月期间植入人工耳蜗的患者。

干预措施

手术/康复。

主要观察指标

术前和人工耳蜗植入后 6 个月的听力。

结果

2017 年 4 月至 2018 年 6 月期间,高级作者(A.J.)进行了 125 例人工耳蜗手术。在这些患者中,有 62 例年龄超过 72 岁,有 24 例患者有完整的术前和术后残余听力数据。尽管评估了几种计算听力保护的方法,但我们的实践发现,即使在术前 125 至 2000Hz 之间有一个或多个频率≤85dBHL 的患者,也应使用听力保护技术。使用这种方法,60%的患者术后至少有一个阈值≤85dBHL,更重要的是,超过 80%的患者随后使用电声 MAP。

结论

尽管对老年患者耳蜗脆弱性存在担忧,但在 72 岁及以上的人工耳蜗植入患者中保留残余听力是可行的。这表明,包括老年患者在内的绝大多数患者都可以从软手术技术中受益。

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