Post Hybrid Cochlear Implant Hearing Loss and Endolymphatic Hydrops.
Post Hybrid Cochlear Implant Hearing Loss and Endolymphatic Hydrops.
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DOI：
10.1097/mao.0000000000001199
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发表时间：
2016-12
期刊：
影响因子：
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通讯作者：
Linthicum FH
中科院分区：
文献类型：
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作者：
Ishiyama A;Doherty J;Ishiyama G;Quesnel AM;Lopez I;Linthicum FH
目的：探讨混合型人工耳蜗植入后残余听力迟发性丧失的潜在原因。人工耳蜗植入人颞骨29例的组织病理学评价。加州大学洛杉矶分校（House-UCLA）神经病学和House HTB实验室。来自House-UCLA HTB实验室人工耳蜗植入患者的HTB （n = 28）和马萨诸塞州眼耳医院（MEEI）提供的HTB。组织病理学分析以确定耳蜗造口，前庭阶梯和鼓室纤维化和骨形成的位置，以及内淋巴积液。螺旋神经节神经元计数。统计分析比较耳蜗造口术的存在和位置与组织病理学结果。在29块阶梯前庭（SV）和鼓室纤维化的骨头中，有17块有耳蜗造瘘的证据，包括含有导管团聚的SV，所有这些都有积水。11块骨头中有10块没有SV纤维化，耳蜗造口术仅限于鼓室，所有的都没有积水。1例HTB有中度SV纤维化，不累及导管团聚，无水肿。1例HTB有SV耳蜗造口术，但电极破裂雷氏膜，无积水。耳蜗造瘘与SV纤维化及积水有显著相关性（p<0.01），无积水者无SV萎缩（p<0.01）。圆窗置入与无纤维化和无水肿相关。我们推测，涉及前庭鳞片的耳蜗造口术会刺激纤维化，损害耳蜗管，导致积液，这可能导致人工耳蜗残余低频听力的延迟丧失。
To evaluate for potential causes of delayed loss of residual hearing that variably occurs with hybrid cochlear implants. Histopathological evaluation of 29 human temporal bone (HTB) with cochlear implant. The Neurotology and House HTB Laboratory of UCLA (House-UCLA). HTB from cochlear implant patients from the House-UCLA HTB Laboratory (n = 28) and one courtesy of Massachusetts Eye and Ear Infirmary (MEEI). Histopathological analysis to identify the location of cochleostomy, fibrosis and bone formation in the scala vestibuli and tympani, and endolymphatic hydrops. Spiral ganglion neuron counts were obtained. Statistical analysis compared presence of cochleostomy and location with the histopathological findings. Seventeen of 29 bones with fibrosis in the scala vestibule (SV) and tympani had evidence of a cochleostomy involving the SV containing the ductus reunions, all of which had hydrops. Ten of eleven bones had no SV fibrosis, and a cochleostomy limited to the scala tympani, of which all had no hydrops. One HTB had moderate SV fibrosis not involving the ductus reuniens, and was without hydrops. One HTB had a SV cochleostomy but the electrode ruptured Reissner’s membrane, and was without hydrops. Cochleostomy was significantly associated with SV fibrosis and hydrops (p<0.01), those without hydrops had no SV atrophy (p<0.01). Round window insertion was associated with no fibrosis and no hydrops. We hypothesize that cochleostomies involving scala vestibuli incite fibrosis, compromising the ductus reuniens, causing hydrops which may cause the delayed loss of residual low frequency hearing in cochlear implant.