耳蜗植入电极类型和位置与持续听力保护的关系。

The Relation of Cochlear Implant Electrode Array Type and Position on Continued Hearing Preservation.

机构信息

Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.

Department of Otolarynology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.

出版信息

Otol Neurotol. 2022 Jul 1;43(6):e634-e640. doi: 10.1097/MAO.0000000000003547. Epub 2022 Jun 17.

DOI:10.1097/MAO.0000000000003547

PMID:35709407

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9824900/

Abstract

OBJECTIVE

To analyze the relationship of electrode array (EA) type and position on hearing preservation longevity following cochlear implantation.

STUDY DESIGN

Retrospective chart review.

SETTING

Tertiary referral center.

PATIENTS

Adult cochlear implant recipients between 2013 and 2019 with hearing preserved postoperatively and postoperative CT scans.

INTERVENTIONS

CT scan analysis of EA position. Stepwise regression to determine influence of EA position, EA type, and patient demographics on postoperative low frequency hearing.

MAIN OUTCOME MEASURES

Low frequency pure tone average (LFPTA), LFPTA shift, angular insertion depth, base insertion depth, scalar position, mean perimodiolar distance.

RESULTS

Of 792 cochlear implant recipients, 121 had preoperative LFPTA <80 dB HL with 60 of the 121 (49.6%) implanted with straight, 32 (26.4%) with precurved, styletted, and 29 (24.0%) implanted precurved, nonstyletted EA. Mean follow up was 28.6 months (range 1-103). There was no statistically significant difference in activation, 6- and 12-month, and last follow-up LFPTA (125, 250, and 500 Hz) shift based on EA type (straight p = 0.302, precurved, styletted p = 0.52, precurved, nonstyletted p = 0.77). Preoperative LFPTA and age of implantation were significant predictors of LFPTA shift at activation, accounting for 30.8% of variance ( F [2, 113] = 26.603, p < 0.0001). LFPTA shift at activation, scalar position, and base insertion depth were significant predictors of variability and accounted for 39.1% of variance in LFPTA shift at 6 months ( F [3, 87] = 20.269, p < 0.0001). Only LFPTA shift at 12 months was found to be a significant predictor of LFPTA shift at last follow up, accounting for 41.0% of variance ( F [1, 48] = 32.653, p < 0.0001).

CONCLUSIONS

Patients had excellent long-term residual hearing regardless of EA type. Age, preoperative acoustic hearing, and base insertion depth may predict short term preservation, while 12-month outcomes significantly predicted long-term hearing preservation.

摘要

目的

分析人工耳蜗植入术后电极阵列（EA）类型和位置与听力保护寿命的关系。

研究设计

回顾性图表审查。

设置

三级转诊中心。

患者

2013 年至 2019 年间行人工耳蜗植入术且术后保留听力的成年患者，术后有 CT 扫描。

干预措施

对 EA 位置进行 CT 扫描分析。逐步回归分析以确定 EA 位置、EA 类型和患者人口统计学因素对术后低频听力的影响。

主要观察指标

低频纯音平均（LFPTA）、LFPTA 变化、角插入深度、基底插入深度、标度位置、平均围柱距离。

结果

792 例人工耳蜗植入患者中，121 例术前 LFPTA＜80dB HL，其中 60 例（49.6%）植入直形、32 例（26.4%）植入预弯、带导丝、29 例（24.0%）植入预弯、无导丝 EA。平均随访时间为 28.6 个月（范围 1-103）。基于 EA 类型，激活时、6 个月和 12 个月以及最后一次随访时的 LFPTA（125、250 和 500Hz）变化无统计学差异（直形 p=0.302，预弯、带导丝 p=0.52，预弯、无导丝 p=0.77）。术前 LFPTA 和植入年龄是激活时 LFPTA 变化的显著预测因素，占方差的 30.8%（ F [2,113]=26.603，p＜0.0001）。激活时的 LFPTA 变化、标度位置和基底插入深度是 6 个月时 LFPTA 变化的显著预测因素，占方差的 39.1%（ F [3,87]=20.269，p＜0.0001）。只有 12 个月时的 LFPTA 变化被发现是最后一次随访时 LFPTA 变化的显著预测因素，占方差的 41.0%（ F [1,48]=32.653，p＜0.0001）。