Cardiff and Vale University Health Board.
Department of Ear, Nose and Throat Surgery, University Hospitals Birmingham NHS Foundation Trust, UK.
Otol Neurotol. 2022 Aug 1;43(7):734-741. doi: 10.1097/MAO.0000000000003574. Epub 2022 Jul 19.
This study aimed to establish hearing outcomes after cochlear implantation in patients with otosclerosis.
We conducted a systematic review and narrative synthesis. Databases searched were as follows: MEDLINE, PubMed, Embase, Web of Science, Cochrane Collection, and ClinicalTrials.gov . No limits were placed on language or year of publication. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.
Searches identified 474 abstracts and 180 full texts, with 68 studies meeting the inclusion criteria and reporting outcomes in a minimum of 481 patients with at least 516 implants. Patient-reported outcome measures (PROMs) were reported in five studies involving 51 patients. Intraoperative adverse events/surgical approach details and preoperative radiological assessment were reported in 46 and 38 studies, respectively. The methodological quality of included studies was modest, predominantly consisting of case reports and noncontrolled case series with small numbers of patients. Most studies were Oxford Centre for Evidence Based Medicine grade IV.
Access to good rehabilitation support is essential to achieving the good hearing outcomes and PROMs that can be expected by 12 months after implantation in most cases. There was a significant association between the radiological severity of otosclerosis and an increase in surgical and postoperative complications. Postoperative facial nerve stimulation can occur and may require deactivation of electrodes and subsequent hearing detriment.
Hearing outcomes are typically good, but patients should be counseled on associated surgical complications that may compromise hearing. Modern diagnostic techniques may help to identify potentially difficult cases to aid operative planning and patient counseling. Further work is needed to characterize PROMs in this population.
本研究旨在建立耳硬化症患者人工耳蜗植入后的听力结果。
我们进行了系统评价和叙述性综合。检索的数据库如下：MEDLINE、PubMed、Embase、Web of Science、Cochrane 集合和 ClinicalTrials.gov。未对语言或出版年份设置限制。该综述符合系统评价和荟萃分析报告的首选报告项目。
搜索共确定了 474 篇摘要和 180 篇全文，其中 68 项研究符合纳入标准，并报告了至少 481 例患者（至少 516 例植入物）的结果。五项研究报告了患者报告的结果测量（PROMs），涉及 51 例患者。46 项研究报告了术中不良事件/手术方法细节，38 项研究报告了术前影像学评估。纳入研究的方法学质量中等，主要由病例报告和非对照病例系列组成，患者数量较少。大多数研究为牛津循证医学中心四级。
获得良好的康复支持对于实现大多数情况下植入后 12 个月可预期的良好听力结果和 PROMs 至关重要。耳硬化症的影像学严重程度与手术和术后并发症的增加之间存在显著关联。术后面神经刺激可能发生，可能需要停用电极并随后导致听力下降。
听力结果通常良好，但应告知患者相关的手术并发症可能会损害听力。现代诊断技术可能有助于识别潜在困难的病例，以辅助手术计划和患者咨询。需要进一步研究来描述该人群中的 PROMs。
