Predictors of Fibrotic and Bone Tissue Formation With 3-D Reconstructions of Post-implantation Human Temporal Bones.
Predictors of Fibrotic and Bone Tissue Formation With 3-D Reconstructions of Post-implantation Human Temporal Bones.
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DOI：
10.1097/mao.0000000000003106
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发表时间：
2021-08-01
期刊：
影响因子：
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通讯作者：
Ishiyama A
中科院分区：
文献类型：
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作者：
Danielian A;Ishiyama G;Lopez IA;Ishiyama A
植入年数、手术插入方法和电极长度将影响继发于人工耳蜗植入的新组织形成的体积。人工耳蜗植入后新组织的形成、纤维化和骨新生与阻抗的增加和人工耳蜗植入性能的影响有关。通过 H&E 组织病理学切片对 15 块有人工耳蜗植入 (CI) 史的患者存档的人类颞骨进行 3D 重建，以研究影响组织形成体积的因素。植入年数是骨新生（r=0.638，p 值=0.011）和总新组织形成（r=0.588，p 值=0.021）的预测因子，但不是纤维化（r=0.235，p 值=0.399）的预测因子。耳蜗造口术和圆窗插入术之间的中位总组织形成差异，分别为 25.98% 和 10.34%（Mann-Whitney U=7，p=0.018）。电极长度或角度插入深度分别与新组织总数（p=0.192，p=0.35）、骨新生（p=0.193，p=0.27）和纤维化（p=0.498，p=0.83）之间没有相关性。然而，电极长度和角度插入深度的 II 类误差范围为 0.73 至 0.90，这主要是由于较短电极的数量较少。随着全球人工耳蜗植入者数量的增加，了解如何最大限度地减少植入引起的耳蜗内变化非常重要。本研究表明，与圆窗方法相比，通过耳蜗造口术植入和插入电极的年数增加与新组织体积形成程度显着增加相关。虽然先前的研究表明，在使用较长电极的易位情况下，耳蜗内损伤会增加，但 CI 电极的长度和角度插入深度与组织形成的增加无关。
Years of implantation, surgical insertion approach, and electrode length will impact the volume of new tissue formation secondary to cochlear implantation. New tissue formation, fibrosis and osteoneogenesis after cochlear implantation have been implicated in increasing impedance and affecting performance of the cochlear implant. 3-D reconstructions of 15 archival human temporal bones from patients with a history of cochlear implantation (CI) were generated from H&E histopathologic slides to study factors which affect volume of tissue formation. Years of implantation was a predictor of osteoneogenesis (r=0.638, p-value=0.011) and total new tissue formation (r=0.588, p-value=0.021), however not of fibrosis (r=0.235, p-value=0.399). Median total tissue formation differed between cochleostomy and round window insertions, 25.98% and 10.34%, respectively (Mann-Whitney U=7, p=0.018). No correlations were found between electrode length or angular insertion depth and total new tissue (p=0.192, p=0.35), osteoneogenesis (p=0.193, p=0.27), and fibrosis (p=0.498, p=0.83), respectively. However, the type II error for electrode length and angular insertion depth ranged from 0.73 to 0.90, largely due to small numbers of the shorter electrodes. With numbers of cochlear implant recipients increasing worldwide, an understanding of how to minimize intracochlear changes from implantation is important. The present study demonstrates that increasing years of implantation and inserting electrodes via a cochleostomy compared to a round window approach are associated with significantly greater degree of new tissue volume formation. While prior studies have demonstrated increased intracochlear damage in the setting of translocation with longer electrodes, length and angular insertion depth of CI electrodes were not associated with increased tissue formation.