Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA.
Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA; Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA; Department of Surgery, Division of Otolaryngology, Texas Children's Hospital, Houston, TX, USA.
Am J Otolaryngol. 2020 Jul-Aug;41(4):102512. doi: 10.1016/j.amjoto.2020.102512. Epub 2020 Apr 30.
The aim of this study was to report a case of cochlear implantation (CI) for a patient with an otic capsule-sparing traumatic brain injury (TBI) and to review the relevant literature.
A patient with history of TBI received a CI for bilateral profound hearing loss. A systematic review of the literature was performed to identify and compare similar cases.
A 36-year-old male with a history of hearing loss from right acute labyrinthitis was referred for bilateral profound sensorineural hearing loss (SNHL) after a fall with associated injury to the central auditory nervous system (CANS) including the brainstem. On the right, behavioral acoustic threshold measurements were in the profound range with absent OAEs. On the left, testing revealed no measurable behavioral acoustic thresholds and variable physiologic measures. A right unilateral cochlear implant was performed with most recent follow-up demonstrating speech awareness thresholds of 25 dB HL with excellent detection of all 6 Ling sounds. However, the patient also continues to suffer from other neurologic sequelae related to his TBI, which challenge his ability to demonstrate objective and subjective benefit. A systematic review of the literature demonstrates variable outcomes for patients with TBI and SNHL.
Patients with profound SNHL and TBI present a distinct rehabilitative challenge for clinicians. CI may provide meaningful benefit in this population, though care should be taken in patient selection and counseling.
本研究旨在报告一例伴有耳蜗囊保留性创伤性脑损伤（TBI）的患者行人工耳蜗植入（CI）的病例，并复习相关文献。
一名 TBI 病史患者因双侧极重度感音神经性听力损失接受 CI。对文献进行系统回顾，以确定并比较类似病例。
一名 36 岁男性，右侧因急性迷路炎致听力丧失，在中枢听觉神经系统（CANS）包括脑干受伤后，因跌倒导致双侧极重度感音神经性听力损失（SNHL）而就诊。右侧行为听阈测试在极重度范围内，无 OAE。左侧测试显示无可测量的行为听阈，且生理测量值变化不定。行右侧单侧人工耳蜗植入术，最近的随访显示言语识别阈为 25dBHL，所有 6 个 Ling 声音均可被极好地探测到。然而，患者仍患有其他与 TBI 相关的神经系统后遗症，这对其展示客观和主观获益的能力构成挑战。文献的系统回顾显示 TBI 和 SNHL 患者的结果存在差异。
双侧极重度 SNHL 和 TBI 的患者对临床医生提出了明显的康复挑战。CI 可能为该人群提供有意义的获益，但在患者选择和咨询时应慎重。
