Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA.
Otolaryngol Head Neck Surg. 2020 May;162(5):731-736. doi: 10.1177/0194599820907336. Epub 2020 Mar 17.
To explore the immediate and 1-year outcomes of patients who underwent implantation with the slim modiolar electrode (SME).
Consecutive case series with chart review.
Tertiary referral academic center.
Between May 2016 and August 2018, a total of 326 cochlear implantations (CIs) were performed. Intraoperative x-rays were performed in all cases to identify tip rollovers. Scalar location was identified for 76 CIs that had postoperative computed tomography reconstructions. Speech outcomes were measured at 3, 6, and 12 months with consonant-nucleus-consonant word and AzBio sentences in quiet and noise (+10-dB signal-to-noise ratio). Preservation of hearing was defined as maintaining a low-frequency pure tone average ≤80 dB at 250 and 500 Hz.
Among 326 CIs, 23 (7%) had tip rollovers. Postoperative reconstructions revealed 5 of 76 (6.6%) scalar translocations. A subset of 177 cases met criteria for evaluation of speech perception scores. The marginal mean differences between presurgery and 12 months for speech tests were as follows: consonant-nucleus-consonant, 43.7 (95% CI, 39.8-47.6); AzBio in quiet, 49.7 (95% CI, 44.9-54.4); and AzBio in noise, 29.9 (95% CI, 25.2-34.7). Sixty-one patients were identified with preservable hearing (low-frequency pure tone average ≤80 dB), and 12 of 61 (20%) preserved hearing at 1 year.
CI with SME provides reliable scala tympani insertion in a consistent perimodiolar position. An initially increased tip rollover rate improved with case volume and sheath design improvement. For long-term outcomes, speech performance was comparable to that of other cochlear implants. While hearing preservation for the SME may be better than prior perimodiolar electrodes, consistent outcomes are unlikely.
探讨植入 slim modiolar 电极（SME）的患者的即刻和 1 年结果。
回顾性连续病例系列。
三级转诊学术中心。
2016 年 5 月至 2018 年 8 月，共进行了 326 例人工耳蜗植入术（CI）。所有病例均行术中 X 线检查以识别尖端翻转。对术后行 CT 重建的 76 例进行标量定位。术后 3、6 和 12 个月，在安静和噪声（+10dB 信噪比）下使用辅音-核-辅音词和 AzBio 句子测量言语结果。听力保存定义为低频纯音平均听力≤250 和 500 Hz 时 80 dB。
326 例 CI 中，23 例（7%）尖端翻转。术后重建显示 5/76（6.6%）标量移位。177 例符合言语感知评分评估标准。言语测试术前至 12 个月的边缘均值差异如下：辅音-核-辅音，43.7（95%CI，39.8-47.6）；安静时的 AzBio，49.7（95%CI，44.9-54.4）；噪声中的 AzBio，29.9（95%CI，25.2-34.7）。61 例患者听力可保存（低频纯音平均听力≤80 dB），其中 12 例（20%）1 年后听力可保存。
SME 的 CI 可提供可靠的 scala tympani 插入，并在一致的 peri-modiolar 位置。初始尖端翻转率增加随着病例量和鞘设计的改进而改善。对于长期结果，言语表现与其他人工耳蜗植入物相当。虽然 SME 的听力保存可能优于以前的 peri-modiolar 电极，但不太可能获得一致的结果。
