Department of Head and Neck Surgery.
Department of Neurology, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, California.
Otol Neurotol. 2021 Aug 1;42(7):e942-e948. doi: 10.1097/MAO.0000000000003106.
Years of implantation, surgical insertion approach, and electrode length will impact the volume of new tissue formation secondary to cochlear implantation.
New tissue formation, fibrosis, and osteoneogenesis after cochlear implantation have been implicated in increasing impedance and affecting performance of the cochlear implant.
3-D reconstructions of 15 archival human temporal bones from patients with a history of cochlear implantation (CI) were generated from H&E histopathologic slides to study factors which affect volume of tissue formation.
Years of implantation was a predictor of osteoneogenesis (r = 0.638, p-value = 0.011) and total new tissue formation (r = 0.588, p-value = 0.021), however not of fibrosis (r = 0.235, p-value = 0.399). Median total tissue formation differed between cochleostomy and round window insertions, 25.98 and 10.34%, respectively (Mann-Whitney U = 7, p = 0.018). No correlations were found between electrode length or angular insertion depth and total new tissue (p = 0.192, p = 0.35), osteoneogenesis (p = 0.193, p = 0.27), and fibrosis (p = 0.498, p = 0.83), respectively. However, the type II error for electrode length and angular insertion depth ranged from 0.73 to 0.90, largely due to small numbers of the shorter electrodes.
With numbers of cochlear implant recipients increasing worldwide, an understanding of how to minimize intracochlear changes from implantation is important. The present study demonstrates that increasing years of implantation and inserting electrodes via a cochleostomy compared with a round window approach are associated with significantly greater degree of new tissue volume formation. While previous studies have demonstrated increased intracochlear damage in the setting of translocation with longer electrodes, length, and angular insertion depth of CI electrodes were not associated with increased tissue formation.
植入年限、手术入路和电极长度会影响耳蜗植入后的新生组织量。
耳蜗植入后的新生组织形成、纤维化和骨生成已被认为会增加阻抗并影响耳蜗植入的性能。
对 15 例有耳蜗植入史的患者的 archival 人颞骨 H&E 组织病理学切片进行 3D 重建，以研究影响组织形成量的因素。
植入年限是骨生成（r=0.638，p 值=0.011）和总新生组织形成（r=0.588，p 值=0.021）的预测因子，但不是纤维化的预测因子（r=0.235，p 值=0.399）。耳蜗造口术和圆窗植入的总组织形成中位数分别为 25.98%和 10.34%（Mann-Whitney U=7，p=0.018）。未发现电极长度或角插入深度与总新生组织（p=0.192，p=0.35）、骨生成（p=0.193，p=0.27）和纤维化（p=0.498，p=0.83）之间存在相关性。然而，电极长度和角插入深度的 II 类错误范围为 0.73 至 0.90，主要是由于较短电极的数量较少。
随着全球耳蜗植入接受者数量的增加，了解如何最大限度地减少植入引起的耳蜗内变化非常重要。本研究表明，与圆窗入路相比，增加植入年限和经耳蜗造口术插入电极与新生组织体积形成的程度显著增加有关。虽然先前的研究表明，在使用较长电极的情况下，转位会导致耳蜗内损伤增加，但 CI 电极的长度和角插入深度与组织形成增加无关。
