Diong Huey Ting, Wong Yuhan, Png Shermaine, Raymond Ngo Yeow Seng
Department of Audiology, Ng Teng Fong General Hospital, 1 Jurong East Street 21, Singapore, 609606, Singapore.
Manchester Centre for Audiology and Deafness, Division of Psychology, Communication and Human Neuroscience, The University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom.
J Otol. 2024 Oct;19(4):241-246. doi: 10.1016/j.joto.2024.03.003. Epub 2024 Oct 29.
To report a case of cochlear implantation with a misplaced electrode array in the vestibule and the causes for the delay in identification. A 23-year-old male with left single-sided deafness underwent cochlear implantation. The intraoperative assessment did not reveal any major red flags of electrode array misplacement. He did not display any vestibular symptoms postoperatively but showed poor speech performance, even though the aided tone audiometry revealed good sound detection thresholds. High-resolution computed tomography (HRCT) showed that the entire perimodiolar electrode array was situated within the vestibule, and a revision surgery was conducted. Retrospective analysis of the neural response telemetry (NRT) revealed subtle differences in responses between the misplaced and correctly placed electrode arrays. Unlike previously reported cases, the patient did not display vestibular symptoms despite the misplacement of the electrode in the vestibule due to existing weakness in otolithic function. Further investigation is warranted when a motivated patient with normal inner ear anatomy does not show benefit with the cochlear implant post-operatively.
报告一例电极阵列误置于前庭的人工耳蜗植入病例及识别延迟的原因。一名23岁的左侧单侧耳聋男性接受了人工耳蜗植入。术中评估未发现电极阵列误置的任何重大警示信号。术后他未表现出任何前庭症状，但言语表现不佳，尽管助听听阈测试显示声音检测阈值良好。高分辨率计算机断层扫描（HRCT）显示整个蜗周电极阵列位于前庭内，遂进行了翻修手术。对神经反应遥测（NRT）的回顾性分析显示，误置和正确放置的电极阵列之间的反应存在细微差异。与先前报道的病例不同，尽管电极误置于前庭，但由于耳石功能存在缺陷，该患者未表现出前庭症状。对于内耳解剖结构正常但术后人工耳蜗未显示获益的积极患者，有必要进行进一步调查。
