Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center.
Case Western Reserve University School of Medicine.
Otol Neurotol. 2020 Oct;41(9):1296-1304. doi: 10.1097/MAO.0000000000002750.
Menière's disease (MD) is characterized by episodes of vertigo, tinnitus, and sensorineural hearing loss. In the setting of bilateral deafness due to MD alone or contralateral pathology, cochlear implantation (CI) improves hearing. Active MD is characterized by fluctuating auditory symptoms and vertigo; whereas remittance of vertiginous symptoms and severe, permanent sensorineural hearing loss characterizes the inactive disease state. This study evaluates outcomes for MD patients compared with the general CI population and assesses if disease activity affects implant outcomes.
Retrospective chart review.
Tertiary referral center.
Twenty-four patients with MD that received CI (7 active, 16 inactive, and 1 Probable Menière's), and 24 age-matched controls.
Cochlear implantation.
Word Recognition Score, Sentence Recognition Score (SRS), and Speech Reception Threshold.
Best-aided preoperative and postoperative audiometric data were compared per ear between MD patients and controls and stratified by disease status using descriptive statistics with mixed-effects modeling. Patients with MD derived significantly more benefit from CI than controls when comparing differences between preoperative and postoperative levels for Word Recognition Score (12.2%, p = 0.0236), SRS (12.8%, p = 0.0375), and Speech Reception Threshold (-14.4 dB, p = 0.0188). Active disease status does not negatively impact CI outcomes and patients with active MD may benefit from greater gains in SRS (23.5%, p = 0.0107).
CI provides greater gains in functional hearing for patients with MD compared with age-matched controls. Patients with active MD seem to perform better with respect to SRS following CI than patients with inactive status.
梅尼埃病（MD）的特征是眩晕、耳鸣和感音神经性听力损失发作。在因 MD 导致双侧耳聋或对侧病变的情况下，植入人工耳蜗（CI）可改善听力。活动性 MD 的特征是听觉症状和眩晕波动；而静止性疾病状态的特征是眩晕症状缓解和严重、永久性感音神经性听力损失。本研究评估了 MD 患者与一般 CI 人群的结果，并评估了疾病活动是否影响植入物的结果。
回顾性图表审查。
三级转诊中心。
24 名接受 CI 的 MD 患者（7 名活动性、16 名静止性和 1 名疑似梅尼埃病）和 24 名年龄匹配的对照者。
人工耳蜗植入。
言语识别得分、句子识别得分（SRS）和言语接受阈。
使用混合效应模型进行描述性统计分析，对 MD 患者和对照组的每只耳朵的最佳辅助术前和术后听力数据进行比较，并按疾病状态进行分层。与对照组相比，MD 患者在比较术前和术后言语识别得分（12.2%，p=0.0236）、SRS（12.8%，p=0.0375）和言语接受阈（-14.4dB，p=0.0188）的差异时，从 CI 中获得了显著更多的获益。活动性疾病状态不会对 CI 结果产生负面影响，活动性 MD 患者可能会从 SRS 中获得更大的收益（23.5%，p=0.0107）。
与年龄匹配的对照组相比，CI 为 MD 患者提供了更大的功能性听力增益。与静止性状态的患者相比，活动性 MD 患者在接受 CI 后 SRS 的表现似乎更好。
