Lalwani A K, Larky J B, Wareing M J, Kwast K, Schindler R A
The Douglas Grant Cochlear Implant Center, Department of Otolaryngology-Head & Neck Surgery, University of California San Francisco, 94143-0342, USA.
Am J Otol. 1998 Jan;19(1):66-70.
This study aimed to review a single institution's experience with Clarion Multi-Strategy Cochlear Implant with respect to surgical technique, surgical complications, and rehabilitative outcome.
This study was a review of patients implanted with the Clarion Multi-Strategy Cochlear Implant.
The setting was a tertiary referral center with care delivered in the inpatient and outpatient environment.
The first 37 patients were implanted under an Investigational Device Exemption as part of the Food and Drug Administration (FDA) clinical trial of the Clarion implant. Subsequent patients were implanted after the device received FDA approval. Patients met the following criteria for implantation: 18 years of age or older, psychological and emotional stability, profound postlingual deafness without evidence of middle ear disease, one cochlea at least partially patent, and marginal or no benefit from conventional hearing aids.
Patients received implantation with the Clarion Multi-Strategy Cochlear Implant.
Measured were presence or absence of surgical complications and auditory performance with open- and closed-set word and sentence recognition testing.
A total of 47 patients have been implanted. Three patients have suffered complications: two cases of delayed-onset facial palsy both resolved with steroid therapy and one case of internal cochlear stimulator migration required refixation. Significant improvement in speech understanding has been seen in the majority of patients who were implanted within the first 6 months of device use. Specifically, at 6 months, scores on CID (Central Institute for the Deaf) sentences (implant alone) improved from a preoperative mean of 9% to a mean of 72%, and scores on the NU-6 (Northwestern University) monosyllabic word test increased from a preoperative mean of 3% (range, 0-20%) to a mean of 32% (range, 0-70%). More than two thirds (68%) of the adults were able to understand at least 50% of sentences over the telephone, and half were able to understand at least 75% of the sentence material.
The authors' institutional experience with the Clarion Multi-Strategy Cochlear Implant shows minimal surgical morbidity and significant improvement on all open-set test measures of sentence and word recognition.
本研究旨在回顾一家机构在使用Clarion多策略人工耳蜗方面的经验,内容涉及手术技术、手术并发症及康复效果。
本研究是对接受Clarion多策略人工耳蜗植入患者的回顾性研究。
研究地点为一家三级转诊中心,在住院及门诊环境中提供医疗服务。
首批37名患者是在研究器械豁免(Investigational Device Exemption)条件下植入的,这是美国食品药品监督管理局(FDA)对Clarion人工耳蜗进行临床试验的一部分。后续患者是在该器械获得FDA批准后植入的。患者符合以下植入标准:年龄18岁及以上,心理和情绪稳定,语后重度耳聋且无中耳疾病证据,至少一侧耳蜗部分通畅,使用传统助听器效果不佳或无效果。
患者接受Clarion多策略人工耳蜗植入。
观察手术并发症情况以及通过开放词表和封闭词表单词及句子识别测试评估听觉表现。
共有47名患者接受了植入手术。3名患者出现并发症:2例迟发性面神经麻痹经类固醇治疗后均痊愈,1例人工耳蜗内部刺激器移位需重新固定。大多数在器械使用的前6个月内植入人工耳蜗的患者在言语理解方面有显著改善。具体而言,在6个月时,聋人中央研究所(Central Institute for the Deaf,CID)句子测试(仅人工耳蜗)得分从术前平均9%提高到平均72%,西北大学(Northwestern University)NU - 6单音节单词测试得分从术前平均3%(范围0 - 20%)提高到平均32%(范围0 - 70%)。超过三分之二(68%)的成年人能够在电话中理解至少50%的句子,一半成年人能够理解至少75%的句子内容。
作者所在机构使用Clarion多策略人工耳蜗的经验表明,手术发病率极低,并且在所有开放词表句子和单词识别测试指标上均有显著改善。