Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, 250022, People's Republic of China.
Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China.
Eur Arch Otorhinolaryngol. 2024 Aug;281(8):4029-4038. doi: 10.1007/s00405-024-08504-4. Epub 2024 Feb 11.
This retrospective cohort study aimed to investigate the effect of minimally invasive cochlear implantation (CI) on the vestibular function (VF) and residual hearing (RH) as well as their relationship in pediatric recipients before and after surgery.
Twenty-four pediatric patients with preoperative low frequency residual hearing (LFRH) (250 or 500 Hz ≤ 80 dB HL) who underwent minimally invasive CI were enrolled. Pure-tone thresholds, the cervical/ocular vestibular-evoked myogenic potential (cVEMP/oVEMP), and video head impulse test (vHIT) were all evaluated in the 24 pediatric patients with preoperative normal VF before and at 1 and 12 months after surgery. The relationship between changes in hearing and VF was analyzed preoperatively and at 1 and 12 months postoperatively.
There were no significant differences on VF preservation and hearing preservation (HP) at both 1 and 12 months post-CI (p > 0.05). At 1 month post-CI, the correlations of the variations in vestibulo-ocular reflex (VOR) gains of horizontal semicircular canal (HSC) and posterior semicircular canal (PSC) and the shift in 250 Hz threshold were negatively correlated (r = - 0.41, p = 0.04 and r = - 0.43, p = 0.04, respectively). At 12 months post-CI, the shift in 250 Hz threshold negatively correlated to the variations in VOR gain of superior semicircular canal (SSC) (r = - 0.43, p = 0.04); the HP positively correlated to the variation in oVEMP-amplitude ratio (AR) (r = 0.41, p = 0.04).
Our study confirmed that there were partial correlations between VF preservation and HP both in the short- and long-terms after atraumatic CI surgery, especially with the 250 Hz threshold. Regarding the variation of PSC function, the correlation with hearing status was variable with time after atraumatic CI surgery. Minimally invasive techniques for HP are successful and effective for the preservation of VF in pediatric patients both in the short- and long-terms.
本回顾性队列研究旨在探讨微创人工耳蜗植入（CI）对术前低频残余听力（LFRH）患儿手术前后前庭功能（VF）和残余听力（RH）的影响及其相关性。
纳入 24 例术前低频残余听力（250 或 500 Hz≤80 dB HL）行微创 CI 的患儿。所有患儿术前及术后 1 个月和 12 个月时进行纯音听阈测试、颈肌/眼肌前庭诱发肌源性电位（cVEMP/oVEMP）和视频头脉冲试验（vHIT）检查。分析术前及术后 1 个月和 12 个月时听力和 VF 变化的相关性。
术后 1 个月和 12 个月时 VF 保存和听力保存（HP）均无显著差异（p>0.05）。术后 1 个月时，水平半规管（HSC）和后半规管（PSC）前庭眼反射（VOR）增益变化与 250 Hz 阈值改变的相关性呈负相关（r=-0.41，p=0.04 和 r=-0.43，p=0.04）。术后 12 个月时，250 Hz 阈值改变与上半规管（SSC）VOR 增益变化呈负相关（r=-0.43，p=0.04）；HP 与 oVEMP 幅度比（AR）变化呈正相关（r=0.41，p=0.04）。
本研究证实，微创 CI 术后短期内和长期内，VF 保存与 HP 之间存在部分相关性，尤其是与 250 Hz 阈值相关。关于 PSC 功能的变化，与听力状况的相关性随微创 CI 术后时间的变化而变化。微创技术对 HP 是成功有效的，可在短期内和长期内有效保护儿童患者的 VF。
