Gärtner Lutz, Klötzer Katharina, Lenarz Thomas, Scheper Verena
Department of Otolaryngology, Hannover Medical School, 30625 Hannover, Germany.
Cluster of Excellence "Hearing4All", 30625 Hannover, Germany.
Life (Basel). 2021 Mar 5;11(3):203. doi: 10.3390/life11030203.
Cochlear implants (CI) are the treatment of choice in profoundly deaf patients. Measuring the electrically evoked compound action potential (ECAP) has become an important tool for verifying the function of the spiral ganglion neurons (SGN), which are the target cells of the CI stimulation. ECAP measurement is only possible after electrode insertion. No information about the neuronal health status is available before cochlear implantation. We investigated possible correlations between the ECAP amplitude growth function (AGF) slope and anamnestic parameters to identify possible predictors for SGN health status and therefore for CI outcome. The study included patients being implanted with various electrode array lengths. Correlation analysis was performed for the mean AGF slope of the whole array, for separate electrodes as well as for grouped electrodes of the apical, medial, and basal region, with duration of deafness, age at implantation, residual hearing (grouped for electrode length), and etiology. The mean ECAP AGF slopes decreased from apical to basal. They were not correlated to the length of the electrode array or any etiology. For the mean of the full array or when grouped for the apical, middle, and basal part, the ECAP AGF slope was negatively correlated to the duration of hearing loss and the age at implantation. Since a significant negative correlation of the ECAP AGF slope and age at cochlear implantation and duration of deafness was observed, this study supports the statement that early implantation of a CI is recommended for sensorineural hearing loss. Additional factors such as the cochlear coverage and insertion angle influence the ECAP AGF slope and performance of the patient and should be included in future multifactorial analysis to study predictive parameters for the CI outcome.
人工耳蜗（CI）是极重度聋患者的首选治疗方法。测量电诱发复合动作电位（ECAP）已成为验证螺旋神经节神经元（SGN）功能的重要工具，螺旋神经节神经元是人工耳蜗刺激的靶细胞。只有在电极插入后才能进行ECAP测量。在人工耳蜗植入前无法获得有关神经元健康状况的信息。我们研究了ECAP振幅增长函数（AGF）斜率与既往病史参数之间的可能相关性，以确定SGN健康状况以及人工耳蜗植入结果的可能预测指标。该研究纳入了植入不同电极阵列长度的患者。对整个阵列、单独电极以及顶端、中间和基底区域的分组电极的平均AGF斜率与耳聋持续时间、植入时年龄、残余听力（按电极长度分组）和病因进行了相关性分析。平均ECAP AGF斜率从顶端到基底逐渐降低。它们与电极阵列长度或任何病因均无相关性。对于整个阵列的平均值或按顶端、中间和基底部分分组时，ECAP AGF斜率与听力损失持续时间和植入时年龄呈负相关。由于观察到ECAP AGF斜率与人工耳蜗植入时年龄和耳聋持续时间之间存在显著负相关，本研究支持对于感音神经性听力损失建议尽早植入人工耳蜗这一观点。其他因素如耳蜗覆盖范围和插入角度会影响ECAP AGF斜率和患者表现，未来的多因素分析应纳入这些因素以研究人工耳蜗植入结果的预测参数。
