How well do cochlear implant intraoperative impedance measures predict postoperative electrode function?
How well do cochlear implant intraoperative impedance measures predict postoperative electrode function?
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DOI：
10.1097/mao.0b013e31827c9d71
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发表时间：
2013-02
期刊：
影响因子：
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通讯作者：
Lusk RP
中科院分区：
文献类型：
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作者：
Goehring JL;Hughes ML;Baudhuin JL;Lusk RP
目标是：1）评价术中和初始激活时人工耳蜗植入电极阻抗异常的发生率，2）确定初始激活时解决的异常百分比，以及3）确定初始激活时异常的正常术中阻抗的发生率。术中和术后人工耳蜗植入电极阻抗的回顾性记录审查。三级转诊中心。检查了165名儿童和成人患者植入的194件器械的记录。结果表明，12.4%（24/194）的器械在术中至少发生1次开路（OC）或短路（SC），术后降至8.2%（16/194）。在术中（92% vs. 8%）和术后（94% vs. 6%）间期，OC比SC更普遍。在3430个电极中，78个在术中出现阻抗异常。其中64例（82%）在术后间期消退（62例OC，2例SC），而14/78例（18%）在术后仍异常（12例OC，2例SC）。3430个电极中有6个（0.17%）术中阻抗正常，但术后异常。由于单极耦合检测SC的灵敏度较差，本研究中的SC发生率可能被低估。术中OC通过初始激活解决的可能性很高，特别是当相邻电极受到影响时，并且表明在这些情况下使用备用器械的需求有限。手术技术和/或并发症（如取出/重新植入或外淋巴涌出）可能导致耳蜗内气泡发生率增加，并可能在异常术中阻抗结果中发挥作用。
Objectives were to: 1) evaluate the incidence of abnormal cochlear implant electrode impedance intraoperatively and at the initial activation, 2) identify the percentage of abnormalities that resolve by the initial activation, and 3) determine the incidence of normal intraoperative impedances that present as abnormal at the initial activation. Retrospective records review of intraoperative and postoperative cochlear implant electrode impedances. Tertiary referral center. Records were examined for 194 devices implanted in 165 pediatric and adult patients. Results indicate at least 1 open (OC) or short circuit (SC) in 12.4% (24/194) of devices intraoperatively, decreasing to 8.2% (16/194) postoperatively. OCs were more prevalent than SCs for intraoperative (92% vs. 8%) and postoperative (94% vs. 6%) intervals. Of the 3430 total electrodes, 78 had abnormal impedance intraoperatively. Sixty-four of those (82%) resolved by the postoperative interval (62 OC, 2 SC) while 14/78 (18%) remained abnormal postoperatively (12 OC, 2 SC). Six of 3430 (0.17%) electrodes had normal impedance intraoperatively but were abnormal postoperatively. The incidence of SCs in the present study is likely underestimated due to poor sensitivity of monopolar coupling for detecting SCs. Intraoperative OCs have a high probability of resolving by the initial activation, particularly when contiguous electrodes are affected, and suggests limited need for the use of a backup device in these cases. Surgical technique and/or complications such as explant/reimplant or perilymphatic gushers may result in increased incidence of bubbles in the cochlea, and may play a role in abnormal intraoperative impedance results.