梅尼埃病患者的人工耳蜗植入：一项系统综述。
Cochlear implantation in patients with Meniere's disease: A systematic review.
作者信息
Desiato Vincent M, Patel Jaimin J, Nguyen Shaun A, Meyer Ted A, Lambert Paul R
机构信息
Department of Otolaryngology- Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
出版信息
World J Otorhinolaryngol Head Neck Surg. 2020 Apr 23;7(4):303-311. doi: 10.1016/j.wjorl.2020.03.004. eCollection 2021 Oct.
BACKGROUND
Meniere's disease (MD) is an idiopathic disorder of the inner ear, which manifests as cochleo-vestibular dysfunction. Hearing loss will progress to a profound levelin a subset of patients with MD, and vestibular interventions can independently cause loss of hearing. The aim of this study was to systematically review the published literature describing the safety and efficacy of CI in patients with MD.
MATERIALS AND METHODS
A systematic literature review was conducted in accordance PRISMA guidelines to identify articles that assessed at least one functional outcome in patients with MD who underwent CI. Demographic information, disease history, MD symptoms, outcomes measures, and complications related to CI were extracted from included studies.
RESULTS
In total, 17 studies were included, and 182 patients with MD underwent CI. The weighted-mean age was 61.9 years (range 27-85). Study objective and methodology varied, and there was significant heterogeneity in CI outcome measures reported. In total, 179 (98.3%) of 182 patients reported objective improvements in at least one hearing metric after CI. A total of 69 patients (37.9%) reported vertigo or severe dizziness prior to CI, compared to 22 patients (15.4%) postoperatively. Two studies reported significant reductions in postoperative Tinnitus Handicap Inventory score (THI). Quality of life assessments varied between studies. Complications rates were low with only nine patients (4.9%) reporting a serious CI-related complication.
CONCLUSIONS
This systematic review evaluated 17 studies describing the safety and efficacy of CI in patients with MD and encountered many challenges due to small sample sizes, and heterogeneity in study design and outcomes measured. Despite these limitations, this study of 182 patients is to the best of our knowledge the largest systematic review evaluating the safety and efficacy of CI in MD. The results of this study support the need for a standardized approach to evaluating outcomes of CI in patients with MD in future studies.
背景
梅尼埃病（MD）是一种特发性内耳疾病，表现为耳蜗 - 前庭功能障碍。在一部分梅尼埃病患者中，听力损失会进展到重度水平，并且前庭干预可能会独立导致听力丧失。本研究的目的是系统回顾已发表的文献，描述人工耳蜗（CI）在梅尼埃病患者中的安全性和有效性。
材料与方法
根据PRISMA指南进行系统的文献综述，以识别评估接受人工耳蜗植入的梅尼埃病患者至少一项功能结局的文章。从纳入的研究中提取人口统计学信息、疾病史、梅尼埃病症状、结局指标以及与人工耳蜗相关的并发症。
结果
总共纳入了17项研究，182例梅尼埃病患者接受了人工耳蜗植入。加权平均年龄为61.9岁（范围27 - 85岁）。研究目的和方法各不相同，所报告的人工耳蜗结局指标存在显著异质性。182例患者中有179例（98.3%）报告人工耳蜗植入后至少一项听力指标有客观改善。共有69例患者（37.9%）在人工耳蜗植入术前报告有眩晕或严重头晕，而术后为22例患者（15.4%）。两项研究报告术后耳鸣障碍量表评分（THI）显著降低。不同研究之间生活质量评估各不相同。并发症发生率较低，只有9例患者（4.9%）报告了与人工耳蜗相关的严重并发症。
结论
本系统综述评估了17项描述人工耳蜗在梅尼埃病患者中的安全性和有效性的研究，由于样本量小以及研究设计和测量结局的异质性而遇到了许多挑战。尽管有这些局限性，但据我们所知，这项对182例患者的研究是评估人工耳蜗在梅尼埃病中的安全性和有效性的最大规模系统综述。本研究结果支持在未来研究中需要一种标准化方法来评估梅尼埃病患者人工耳蜗植入的结局。
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