Human Otopathologic Findings in Cases of Folded Cochlear Implant Electrodes.
Human Otopathologic Findings in Cases of Folded Cochlear Implant Electrodes.
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折叠人工耳蜗植入电极病例中的人类耳病理学发现。
DOI：
10.1097/mao.0000000000001886
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Remenschneider,AaronK
中科院分区：
文献类型：
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作者：
Trakimas,DanielleR;Kozin,ElliottD;Ghanad,Iman;NadolJr,JosephB;Remenschneider,AaronK
背景：CI电极阵列折叠（例如近端阵列折叠）是一种相对常见的手术并发症，可能在用力插入电极时发生，可能是影响植入结局的重要且可避免的因素。然而，耳病理学的发现和听力学的结果，其中折叠的植入物电极阵列观察人类的情况下仍然undefined.Methods：从人的颞骨库标本经历CI在生活中进行了评价。组织学分析中电极阵列折叠的样本构成研究病例。无阵列折叠的电极匹配标本构成对照。所有标本均进行光镜检查和组织病理学描述。测量颅内纤维化和骨组织，以及SGN计数。术前和术后单词识别scores.Results：折叠电极的情况下，表现出更大的体积比对照组，这是最突出的阵列折叠附近的地区的颅内骨组织。病例和对照组均显示出相似数量的纤维组织。与对侧耳相比，折叠病例显示SGN减少，而对照组显示两耳之间SGN群体稳定。在这个小的队列，术后听力的结果是相似的groups.Conclusion：不典型的纤维-骨质变化和较低的SGN计数的情况下观察CI电极折叠。未来的研究是必要的，以确定是否识别和纠正折叠可以防止长期的脑内变化。
Background:CI electrode array folding, such folding of the proximal array, is a relatively common surgical complication that can occur with forceful electrode insertion and may be an important and avoidable factor affecting implant outcomes. However, otopathologic findings and audiologic outcomes of human cases where folding of the implant electrode array is observed remain undefined.Methods:Specimens from a human temporal bone repository having undergone CI during life were evaluated. Specimens with folding of the electrode array on histological analysis constituted study cases. Electrode-matched specimens without array folding constituted controls. All specimens were examined by light microscopy and histopathologically described. Intracochlear fibrosis and osseous tissue, and SGN counts were measured. Pre-and postoperative word recognition scores were also compared.Results:Cases with folded electrodes showed greater volumes of intracochlear osseous tissue than controls, which was most prominent in areas adjacent to array folding. Both cases and controls demonstrated similar amounts of fibrous tissue. Folded cases showed decreased SGNs when compared with the contralateral ear, whereas controls showed stable SGN populations between ears. In this small cohort, postoperative hearing outcomes were similar between groups.Conclusion:Atypical fibro-osseous changes and lower SGN counts are observed in cases of CI electrode folding. Future studies are necessary to determine if recognition and correction of folding can prevent long-term intracochlear changes.