Spiegel Jennifer L, Mueller Joachim, Boehnlein Rebecca, Hempel John-Martin, Spiro Judith E, Weiss Bernhard G, Bertlich Mattis, Canis Martin, Rader Tobias
Department for Otorhinolaryngology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany.
Department of Radiology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, Munich, Germany.
Eur Arch Otorhinolaryngol. 2025 Apr;282(4):1853-1863. doi: 10.1007/s00405-024-09086-x. Epub 2024 Dec 17.
PURPOSE: Individualized cochlear implantation (CI) is essential to facilitate optimal hearing results for patients. Influence of cochlear coverage (CC) has been studied, however without consideration of different CI-categories, like single sided deafness (SSD), bimodal, and bilateral separately. METHODS: Retrospective analysis of preoperative CT scans was performed at a tertiary center. For each patient their individual CC with the selected electrode array was calculated off the complete CDL. Patients were categorized into SSD (n = 30), bimodal (n = 72), and bilateral CI patients (n = 29). Speech perception within the first 12 months post-implantation was compared between patient groups with shorter and longer CC. For subgroup analysis the cutoff between a shorter or longer CC was identified by the median. RESULTS: Cutoff between a shorter or longer CC was identified at 65% off the complete CDL for SSD and bimodal patients, and at 70% for bilateral patients. In SSD-patients longer CC was associated with better performance at activation (CC 20.0 ± 28.9% vs. CC 31.5 ± 24.7%; p = 0.04) and no benefit was found with deeper insertion at 12 months. No significant benefit was found for deeper insertion in bimodal and bilateral patients. CONCLUSIONS: Capacities of hearing performance seem to differ between SSD, bimodal and bilateral patients within the first year after implantation with regards to cochlear coverage. SSD-patients appear to benefit from deeper insertion than 65% up to 12 months after implantation. However, these results should be interpreted with caution, hence development of speech perception with CI is influenced by a whole range of factors, and bimodal and bilateral treated patients are extremely heterogenous patient groups.
目的:个性化人工耳蜗植入(CI)对于促进患者获得最佳听力结果至关重要。虽然已经研究了耳蜗覆盖范围(CC)的影响,但未分别考虑不同的CI类别,如单侧耳聋(SSD)、双耳双模和双侧植入。 方法:在一家三级中心对术前CT扫描进行回顾性分析。根据完整的耳蜗长度(CDL)计算每位患者所选电极阵列的个体CC。患者分为SSD组(n = 30)、双耳双模组(n = 72)和双侧CI患者组(n = 29)。比较CC较短和较长的患者组在植入后前12个月内的言语感知情况。对于亚组分析,通过中位数确定CC较短或较长的临界值。 结果:SSD和双耳双模患者CC较短或较长的临界值确定为完整CDL的65%,双侧患者为70%。在SSD患者中,较长的CC与开机时更好的表现相关(CC 20.0 ± 28.9% vs. CC 31.5 ± 24.7%;p = 0.04),且在12个月时更深插入未发现益处。在双耳双模和双侧患者中,更深插入未发现显著益处。 结论:在植入后的第一年内,就耳蜗覆盖范围而言,SSD、双耳双模和双侧患者的听力表现能力似乎有所不同。SSD患者在植入后长达12个月似乎受益于超过65%的更深插入。然而,这些结果应谨慎解释。因此,CI言语感知的发展受一系列因素影响,且双耳双模和双侧治疗患者是极其异质的患者群体。
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