Schraivogel Stephan, Aebischer Philipp, Weder Stefan, Caversaccio Marco, Wimmer Wilhelm
Hearing Research Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
Department of ENT-Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Front Neurol. 2023 May 23;14:1183116. doi: 10.3389/fneur.2023.1183116. eCollection 2023.
Maintaining the structural integrity of the cochlea and preserving residual hearing is crucial for patients, especially for those for whom electric acoustic stimulation is intended. Impedances could reflect trauma due to electrode array insertion and therefore could serve as a biomarker for residual hearing. The aim of this study is to evaluate the association between residual hearing and estimated impedance subcomponents in a known collective from an exploratory study.
A total of 42 patients with lateral wall electrode arrays from the same manufacturer were included in the study. For each patient, we used data from audiological measurements to compute residual hearing, impedance telemetry recordings to estimate near and far-field impedances using an approximation model, and computed tomography scans to extract anatomical information about the cochlea. We assessed the association between residual hearing and impedance subcomponent data using linear mixed-effects models.
The progression of impedance subcomponents showed that far-field impedance was stable over time compared to near-field impedance. Low-frequency residual hearing demonstrated the progressive nature of hearing loss, with 48% of patients showing full or partial hearing preservation after 6 months of follow-up. Analysis revealed a statistically significant negative effect of near-field impedance on residual hearing (-3.81 dB HL per kΩ; < 0.001). No significant effect of far-field impedance was found.
Our findings suggest that near-field impedance offers higher specificity for residual hearing monitoring, while far-field impedance was not significantly associated with residual hearing. These results highlight the potential of impedance subcomponents as objective biomarkers for outcome monitoring in cochlear implantation.
维持耳蜗的结构完整性并保留残余听力对患者至关重要,尤其是对于那些打算接受电声刺激的患者。阻抗可以反映电极阵列插入造成的损伤,因此可作为残余听力的生物标志物。本研究的目的是在一项探索性研究的已知群体中评估残余听力与估计的阻抗子成分之间的关联。
本研究共纳入42例使用同一制造商生产的侧壁电极阵列的患者。对于每位患者,我们使用听力测量数据计算残余听力,使用近似模型通过阻抗遥测记录估计近场和远场阻抗,并通过计算机断层扫描提取有关耳蜗的解剖信息。我们使用线性混合效应模型评估残余听力与阻抗子成分数据之间的关联。
阻抗子成分的变化表明,与近场阻抗相比,远场阻抗随时间保持稳定。低频残余听力显示出听力损失的渐进性,48%的患者在随访6个月后仍保留全部或部分听力。分析显示近场阻抗对残余听力有统计学意义的负面影响(每千欧-3.81 dB HL;<0.001)。未发现远场阻抗有显著影响。
我们的研究结果表明,近场阻抗对残余听力监测具有更高的特异性,而远场阻抗与残余听力无显著关联。这些结果突出了阻抗子成分作为人工耳蜗植入结局监测客观生物标志物的潜力。