Quatre Raphaële, Eklöf Martin, Wales Jeremy, Bonnard Åsa
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital, Grenoble Alpes, France.
GeodAIsics, Biopolis, La Tronche, France.
Otolaryngol Head Neck Surg. 2025 Jun;172(6):2065-2071. doi: 10.1002/ohn.1224. Epub 2025 Mar 19.
This study aims to evaluate the long-term auditory performance at 5 years in patients with far advanced otosclerosis (FAO) after cochlear implantation compared to controls.
A retrospective cohort study.
This study was conducted at a single tertiary medical center.
Patients with FAO were compared to a control group of postlingually deafened patients, selected from the same cochlear implant database. The following data were collected from medical records: age, sex, etiology, duration of hearing deprivation, prior stapes surgery, age at implantation, side of implantation, computed tomography scan findings, surgery details, postoperative complications, and hearing test results.
A total of 41 patients with otosclerosis and 73 control cases were included in this study. The mean speech comprehension score at 5 years was 48.63% ± 24.66 in the otosclerosis group compared to 48.17% ± 23.08 in the control group (P = .76). Cochleostomy (P = .01), scala vestibuli insertion (P < .001), and postoperative dizziness (P < .01) were more common in the otosclerosis group. Facial nerve stimulation was observed in both groups: otosclerosis group 4 cases (9.8%) and control group 4 cases (5.48%) (P = .39). In the otosclerosis group, at 5 years, the average speech comprehension in patients with a previous stapedotomy was 39.3% ± 23.9 and 57.52% ± 22.45 in patients without a previous stapedotomy (P = .02).
Cochlear-implanted patients with otosclerosis achieve satisfactory long-term audiometric outcomes, although with higher surgical challenges and complication rates compared to other etiologies. Notably, we found that a history of stapedotomy can negatively impact long-term auditory outcomes after cochlear implantation.
本研究旨在评估极重度耳硬化症（FAO）患者人工耳蜗植入术后5年的长期听觉表现，并与对照组进行比较。
一项回顾性队列研究。
本研究在一家单一的三级医疗中心进行。
将FAO患者与从同一人工耳蜗植入数据库中选取的语后聋患者对照组进行比较。从病历中收集以下数据：年龄、性别、病因、听力剥夺持续时间、既往镫骨手术史、植入时年龄、植入侧、计算机断层扫描结果、手术细节、术后并发症及听力测试结果。
本研究共纳入41例耳硬化症患者和73例对照病例。耳硬化症组5年时的平均言语理解得分是48.63%±24.66，而对照组为48.17%±23.08（P = 0.76）。耳硬化症组中，耳蜗开窗术（P = 0.01）、前庭阶插入（P < 0.001）及术后头晕（P < 0.01）更为常见。两组均观察到面神经刺激：耳硬化症组4例（9.8%），对照组4例（5.48%）（P = 0.39）。在耳硬化症组中，5年时，既往有镫骨切除术的患者平均言语理解率为39.3%±23.9，无既往镫骨切除术的患者为57.52%±22.45（P = 0.02）。
人工耳蜗植入的耳硬化症患者可获得令人满意的长期听力测量结果，尽管与其他病因相比，手术挑战和并发症发生率更高。值得注意的是，我们发现镫骨切除术史会对人工耳蜗植入后的长期听觉结果产生负面影响。
