Torres Renato, Daoudi Hannah, Lahlou Ghizlene, Sterkers Olivier, Ferrary Evelyne, Mosnier Isabelle, Nguyen Yann
Unité Fonctionnelle Implants Auditifs, Service Oto-Rhino-Laryngologie, AP-HP/Sorbonne Université, Paris, France.
Centre de Recherche en Audiologie Adulte, GHU Pitié-Salpêtrière/Fondation Pour l'Audition, AP-HP, Paris, France.
Front Surg. 2021 Sep 10;8:729736. doi: 10.3389/fsurg.2021.729736. eCollection 2021.
Robot-assisted cochlear implantation has recently been implemented in clinical practice; however, its effect on hearing outcomes is unknown. The aim of this preliminary study was to evaluate hearing performance 1 year post-implantation whether the electrode array was inserted manually or assisted by a robot. Forty-two profoundly deaf adults were implanted either manually ( = 21) or assisted by a robot (RobOtol®, Collin, Bagneux, France) with three different electrode array types. Participants were paired by age, and electrode array type. The scalar position of the electrode array in the cochlea was assessed by 3D reconstruction from the pre- and post-implantation computed tomography. Pure-tone audiometry and speech perception in silence (percentage of disyllabic words at 60 dB) were tested on the implanted ear 1 year post-implantation in free-field conditions. The pure-tone average was calculated at 250-500-750 Hz, 500-1,000-2,000-3,000 Hz, and 3,000-4,000-8,000 Hz for low, mid, and high frequencies, respectively. One year after cochlear implantation, restoration of the high-frequency thresholds was associated with better speech perception in silence, but not with low or mid frequencies ( < 0.0001; Adjusted = 0.64, polynomial non-linear regression). Although array translocation was similar using either technique, the number of translocated electrodes was lower when the electrode arrays had been inserted with the assistance of the robot compared with manual insertion ( = 0.018; Fisher's exact test). The restoration of high-frequency thresholds (3,000-4,000-8,000 Hz) by cochlear implantation was associated with good speech perception in silence. The numbers of translocated electrodes were reduced after a robot-assisted insertion.
机器人辅助人工耳蜗植入术最近已应用于临床实践；然而，其对听力结果的影响尚不清楚。这项初步研究的目的是评估植入后1年时，无论电极阵列是手动插入还是由机器人辅助插入，患者的听力表现。42名极重度聋成年人分别接受了手动植入（n = 21）或由机器人（RobOtol®，法国科兰公司，巴涅区）辅助植入三种不同类型的电极阵列。参与者按年龄和电极阵列类型进行配对。通过植入前后计算机断层扫描的三维重建来评估电极阵列在耳蜗中的蜗管位置。在植入后1年，于自由声场条件下对植入耳进行纯音听力测定和安静环境下的言语感知测试（60分贝时双音节词的百分比）。分别计算250 - 500 - 750赫兹、500 - 1000 - 2000 - 3000赫兹和3000 - 4000 - 8000赫兹的低频、中频和高频纯音平均听阈。人工耳蜗植入术后1年，高频听阈的恢复与安静环境下更好的言语感知相关，但与低频或中频无关（P < 0.0001；校正R² = 0.64，多项式非线性回归）。尽管两种技术下电极阵列的移位情况相似，但与手动插入相比，在机器人辅助下插入电极阵列时，移位电极的数量更少（P = 0.018；Fisher精确检验）。人工耳蜗植入术使高频听阈（3000 - 4000 - 8000赫兹）恢复，这与安静环境下良好的言语感知相关。机器人辅助插入后，移位电极的数量减少。
