Johns Hopkins University School of Medicine.
Department of Otolaryngology-Head and Neck Surgery and Cochlear Implant Center, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Otol Neurotol. 2024 Feb 1;45(2):136-142. doi: 10.1097/MAO.0000000000004083. Epub 2023 Dec 23.
Cochlear implant electrode arrays are categorized based on their design as lateral wall (LW) and perimodiolar (PM) electrode arrays. The objective of this study was to investigate the effect of LW versus PM designs on postoperative speech perception across multiple manufacturers and over long follow-up durations.
Retrospective cohort study.
Single academic medical center.
A total of 478 adult cochlear implant recipients, implanted between the years 1992 and 2017.
PM versus LW cochlear implants.
Postoperative Consonant-Nucleus-Consonant Word (CNC-w) and Hearing in Noise Test (HINT) scores between 6 months and 5 years.
Across 478 patients, approximately one-third received LW (n = 176, 36.8%), whereas 302 patients received a PM array (63.2%). The PM group had higher CNC-w scores from 6 months to 2 years (52 [interquartile range, 38-68] versus 48 [31-62], p = 0.036) and from 2 to 5 years (58 [43-72] versus 48 [33-66], p < 0.001). Multivariable analysis of patient-averaged scores indicated that the PM group had greater improvement from preoperative scores at all time points after the initial 6 months for both CNC-w ( β = 4.4 [95% confidence interval, 0.6-8.3], p = 0.023) and HINT testing ( β = 4.5 [95% confidence interval, 0.3-8.7], p = 0.038).
This study indicates that PM electrode arrays are associated with small increases in postoperative speech perception scores, relative to LW arrays, when assessed across manufacturers, over long time durations, and using multiple outcome instruments. These findings may help guide surgeon selection and patient counseling of cochlear implant arrays.
根据设计，人工耳蜗电极阵列可分为侧墙 (LW) 和环绕式 (PM) 电极阵列。本研究旨在调查 LW 与 PM 设计对多个制造商和长期随访期间术后言语感知的影响。
回顾性队列研究。
单家学术医疗中心。
共纳入 478 名成人耳蜗植入患者，植入时间为 1992 年至 2017 年。
PM 与 LW 耳蜗植入。
术后辅音-核-辅音词 (CNC-w) 和噪声下听力测试 (HINT) 得分在 6 个月至 5 年内的情况。
在 478 名患者中，约有 1/3 患者接受了 LW （n = 176，36.8%），而 302 名患者接受了 PM 阵列（63.2%）。PM 组在 6 个月至 2 年（52 [四分位距，38-68] 比 48 [31-62]，p = 0.036）和 2 年至 5 年（58 [43-72] 比 48 [33-66]，p < 0.001）时的 CNC-w 得分更高。对患者平均得分的多变量分析表明，在初始 6 个月后，PM 组在所有时间点的 CNC-w （β=4.4 [95%置信区间，0.6-8.3]，p = 0.023）和 HINT 测试（β=4.5 [95%置信区间，0.3-8.7]，p = 0.038）中的术前得分均有更大改善。
本研究表明，与 LW 阵列相比，当在多个制造商、长时间和使用多种结果工具进行评估时，PM 电极阵列与术后言语感知得分的小幅度增加相关。这些发现可能有助于指导耳蜗植入物阵列的外科医生选择和患者咨询。
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