Varadarajan Varun V, Sydlowski Sarah A, Li Michael M, Anne Samantha, Adunka Oliver F
Department of Otolaryngology-Head and Neck Surgery, 2647The Ohio State University, Columbus, OH, USA.
Head and Neck Institute, 443553Cleveland Clinic, Cleveland, OH, USA.
Ear Nose Throat J. 2021 Jan;100(1):31-37. doi: 10.1177/0145561320947258. Epub 2020 Aug 17.
The indications for cochlear implantation have gradually expanded as advancements in technology have evolved, resulting in improved audiologic outcomes for both adult and children. There remains a significant underutilization of cochlear implant technology in the United States, and recognition of the potential benefits of cochlear implantation for non-traditional indications is critical for encouraging the evolution of candidacy criteria. Adult cochlear implantation candidacy has progressed from patients with bilateral profound sensorineural hearing loss (SNHL) to include patients with greater degrees of residual hearing, single-sided deafness and asymmetric hearing, and atypical etiologies of hearing loss (eg, vestibular schwannoma, Ménière's disease, and otosclerosis). Indications for pediatric cochlear implantation have similarly evolved from children with bilateral severe to profound SNHL to implanting children at a younger age, including those with residual hearing, asymmetric hearing loss, inner ear malformations, as well as cochlear nerve deficiency. In this editorial, the literature investigating cochlear implantation for nontraditional indications is reviewed with an aim to use the best available evidence to encourage the evolution of candidacy criteria.
随着技术的进步，人工耳蜗植入的适应证逐渐扩大，这使得成人和儿童的听力结果都得到了改善。在美国，人工耳蜗植入技术的利用率仍然很低，认识到人工耳蜗植入在非传统适应证方面的潜在益处对于推动候选标准的发展至关重要。成人人工耳蜗植入的候选范围已从双侧极重度感音神经性听力损失（SNHL）患者扩大到包括残余听力程度更高、单侧耳聋和不对称听力以及非典型听力损失病因（如前庭神经鞘瘤、梅尼埃病和耳硬化症）的患者。小儿人工耳蜗植入的适应证也同样从双侧重度至极重度SNHL的儿童发展到在更年幼的儿童中进行植入，包括那些有残余听力、不对称听力损失、内耳畸形以及蜗神经缺损的儿童。在这篇社论中，对研究非传统适应证人工耳蜗植入的文献进行了综述，目的是利用现有最佳证据来推动候选标准的发展。
