Cochlear implantation and hearing preservation: Results in 21 consecutively operated patients using the round window approach
Cochlear implantation and hearing preservation: Results in 21 consecutively operated patients using the round window approach
复制标题
DOI：
10.3109/00016489.2012.680198
复制
发表时间：
2012-09-01
影响因子：
1.4
通讯作者：
Rask-Andersen, Helge
中科院分区：
文献类型：
--
作者：
Erixon, Elsa;Kobler, Susanne;Rask-Andersen, Helge
结论：如果考虑到圆窗（RW）解剖结构、地形和面神经位置的变化，使用柔软和灵活的电极阵列进行圆窗（RW）人工耳蜗植入后，可实现普遍的听力保护。最有利的电极插入深度仍有待确定。目的：我们评估了前21例连续手术患者在通过RW植入人工耳蜗（CI）电极后耳蜗功能的发生率，目的是保护听力。方法：11例患者术前低频听力适合电声刺激。另外9名患者应其要求保留了听力，并打算使用全频率CI刺激。解剖变异的RW仔细考虑使用我们的颞骨收集的微解剖耳朵。通过测量第一电极的插入角度和耳蜗内长度并与听力数据相关，在X线片上评估电极延伸。结果：所有患者均未发生残余听力完全丧失。一些患者的低频阈值出现轻微恶化。术后1个月时，125-500 Hz的平均听力损失为14.4 dB，1年后为15.6 dB。插入角度（300-540度）和深度（17.5-28.5 mm）与听力损失无统计学相关性。
Conclusion: Prevalent hearing conservation may be achieved after round window (RW) cochlear implantation using soft and flexible electrode arrays if variations of RW anatomy, topography, and facial nerve position are considered. The most favorable electrode insertion depth remains to be established. Objectives: We assessed the incidence of cochlear function after cochlear implant (CI) electrode insertion through the RW in our first 21 consecutively operated patients aimed at hearing conservation. Methods: Eleven patients had a preoperative low frequency hearing suitable for electro-acoustic stimulation. Hearing was preserved in an additional nine patients at their request with the intention to use full frequency CI stimulation. Anatomic variations of the RW were carefully considered using our temporal bone collection of micro-dissected ears. Electrode extension was assessed on X-ray by measuring the insertion angle of the first electrode and intra-cochlear length and correlated with audiometric data. Results: There was no incidence of total loss of residual hearing in any of the patients. A slight deterioration of low frequency thresholds occurred in some patients. Mean hearing loss at 125-500 Hz was 14.4 dB at 1 month following surgery and 15.6 dB after 1 year. Insertion angle (300-540 degrees) and depth (17.5-28.5 mm) were not statistically correlated to hearing loss.