Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, U.S.A.
Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.
Laryngoscope. 2024 Apr;134(4):1913-1918. doi: 10.1002/lary.30978. Epub 2023 Aug 16.
Evaluate the rate of preserved vestibular function in pediatric cochlear implant surgery.
Retrospective case review.
Pre- and post-operative vestibular tests were compared in children who underwent cochlear implantation at a tertiary level pediatric hospital over a 4-year period.
Data from 59 implanted ears in 44 children was included. Median age was 2.8 years at initial testing (range 7 months - 21 years) with 1:1 male/female ratio. Implant surgeries were 26 unilateral, 13 bilateral simultaneous, and 5 bilateral sequential. The majority were implanted with slim, non-styletted electrodes (86.4%) via a round window approach (91.5%). Normal pre-operative results were preserved post-operatively on rotary chair testing in 75% (21/28) of patients, cervical vestibular evoked myogenic potential testing in (75%) 30/40 of ears tested, ocular vestibular evoked myogenic potential testing in 85.7% (6/7) of ears tested, video head impulse testing in 100% (9/9) of ears tested, and computerized dynamic posturography in 100% (5/5) of patients tested. Overall, 62.5% of patients had no new deficits on any vestibular test performed post-operatively.
Preservation rates of vestibular function following cochlear implant surgery were higher in this cohort than what has been reported in many earlier studies. Contemporary, less traumatic electrodes and insertion techniques may be a significant factor. The risk of causing a new, severe bilateral vestibular loss with long-term functional impacts appears to be low. Further study is warranted on the impacts of different cochlear implant electrode designs and insertion approaches on post-operative vestibular preservation.
4, Case Series Laryngoscope, 134:1913-1918, 2024.
评估儿童人工耳蜗植入术中前庭功能保留率。
回顾性病例分析。
对在一家三级儿科医院接受人工耳蜗植入术的儿童进行为期 4 年的术前和术后前庭测试比较。
共纳入 44 名儿童的 59 个植入耳数据。初次测试时的中位年龄为 2.8 岁（范围为 7 个月至 21 岁），男女比例为 1:1。植入手术为 26 例单侧、13 例双侧同时、5 例双侧序贯。大多数采用 slim、非 styletted 电极（86.4%），通过圆窗入路（91.5%）。在旋转椅测试中，75%（21/28）的患者术后保留了正常的术前结果，40 个测试耳中有 75%（30/40）的颈性前庭诱发肌源性电位测试结果正常，6 个测试耳中有 85.7%（6/7）的眼性前庭诱发肌源性电位测试结果正常，9 个测试耳中有 100%（9/9）的视频头脉冲测试结果正常，5 个测试患者中有 100%（5/5）的计算机动态姿势描记术结果正常。总的来说，62.5%的患者术后在任何一项前庭测试中均无新的缺陷。
与许多早期研究相比，本队列中人工耳蜗植入术后前庭功能保留率更高。现代的、创伤较小的电极和插入技术可能是一个重要因素。长期功能影响下造成新的、严重双侧前庭损失的风险似乎较低。需要进一步研究不同的人工耳蜗电极设计和插入方法对术后前庭保护的影响。
4，病例系列研究，喉镜，134:1913-1918，2024。
