Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul.
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Eulji University, Daejeon, Korea.
Otol Neurotol. 2021 Jul 1;42(6):844-850. doi: 10.1097/MAO.0000000000003092.
To analyze the changes of cochlear nerve diameter and the presence of a cochlear nerve deficit at a high-frequency region and investigate their effects on cochlear implant (CI) performance in postlingual deaf adults.
Retrospective.
Tertiary care academic center.
Eighty-three postlingual deaf adults with no labyrinthine anomalies or cognitive deficits who received a CI with perimodiolar electrodes from a single manufacturer.
We evaluated the changes of cochlear nerve diameter and the presence of a "tail sign," defined as identifiable nerve fibers originating from the far basal turn of the cochlea, which represents the presence of cochlear nerve at a high-frequency region in magnetic resonance imaging, on monosyllabic word recognition scores.
The cochlear nerve diameter showed a positive correlation with word recognition scores (maximum diameter, R2 = 0.26, p < 0.01; minimum diameter, R2 = 0.26, p < 0.01), but a negative correlation with deaf duration. Recipients with a positive tail sign performed better (73 ± 19%) than those without (45 ± 24%, p < 0.01). A positive tail sign was more commonly found in good performers (52 of 62, 84%) than in poor performers (5 of 21, 24%, p < 0.01).
Favorable outcomes could be anticipated in postlingual deaf adults with a large cochlear nerve diameter and positive tail sign. A presence of cochlear nerve at a high-frequency region may be an imaging marker for predicting good CI performance.
分析高频区耳蜗神经直径的变化和耳蜗神经缺失的存在，并探讨其对语后聋成人人工耳蜗（CI）植入效果的影响。
回顾性研究。
三级学术中心。
83 例无迷路异常或认知障碍的语后聋成人，均由单一制造商植入了采用环绕式电极的 CI。
我们评估了磁共振成像中高频区耳蜗神经直径的变化和“尾巴征”（定义为可识别的神经纤维起源于耳蜗的远基底转，代表高频区存在耳蜗神经）的存在与单音节词识别得分的关系。
耳蜗神经直径与词识别得分呈正相关（最大直径，R2=0.26，p<0.01；最小直径，R2=0.26，p<0.01），但与耳聋持续时间呈负相关。出现阳性尾巴征的患者比未出现阳性尾巴征的患者（73±19%比 45±24%，p<0.01）表现更好。在表现良好的患者（62 例中的 52 例，84%）中，阳性尾巴征更为常见，而在表现较差的患者（21 例中的 5 例，24%）中则较少见（p<0.01）。
耳蜗神经直径较大且出现阳性尾巴征的语后聋成人可能会有较好的预后。高频区存在耳蜗神经可能是预测 CI 效果良好的影像学标志物。
