Hearing Preservation Cochlear Implantation in Adolescents
Hearing Preservation Cochlear Implantation in Adolescents
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DOI：
10.1097/mao.0000000000000542
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发表时间：
2014-10-01
影响因子：
2.1
通讯作者：
Green, Kevin M. J.
中科院分区：
文献类型：
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作者：
Bruce, Iain A.;Felton, Mark;Green, Kevin M. J.
目的：本研究描述了我们在青少年中进行人工耳蜗植入 (CI) 并保留听力的经验。我们的目的是确定该人群的听力保留是否成功，是否能够维持保留的听力，以及保留该人群的听力的潜在益处是什么。 患者： 14 名保留低频听力（125、250 和 500 Hz）的重度聋青少年。 干预： 12 名青少年患有单侧 CI，两名青少年患有双侧 CI。均为首次植入，所有患者均接受听力保留手术（软手术）。主要指标：通过术前和术后纯音听力图测量听力保留情况。在植入前和随后的随访预约时进行言语听力测试。结果：14 名患者中有 13 名实现了听力保留（可测量的听力阈值）。平均随访时间为 2 年 10 个月（范围：4 个月至 4 年 9 个月）。 13 名最初成功保留听力的患者中有 3 名在随后的随访中听力恶化。与单独使用植入物相比，在人工耳蜗植入物中添加自然保留的听力可提高言语听力测试分数。结论：本研究表明，使用软手术技术插入标准长度电极，可以在短期/中期持续保留和维持青少年的残余听力。保留残余低频听力的潜在好处似乎是在具有挑战性的听力条件下改善言语辨别能力，尽管还需要进行更大规模的研究。
Objective: This study describes our experience of cochlear implantation (CI) with hearing preservation in adolescents. Our aim was to determine if hearing preservation is successful in this population, if the preserved hearing is maintained, and what the potential benefit of preserving hearing in this population is.Patients: Fourteen profoundly deaf adolescents with preservation of low-frequency hearing (125, 250, and 500 Hz).Intervention: Twelve adolescents had a single-sided CI, and two had bilateral CI. All were having their first implantation, and all patients had hearing preservation surgery (soft surgery).Main Outcome Measures: Hearing preservation was measured with preoperative and postoperative pure-tone audiograms. Speech audiometry was performed before implantation and at subsequent follow-up appointments.Results: Hearing preservation (measurable hearing thresholds) was achieved in 13 of 14 patients. Average follow-up was 2 years 10 months (range, 4 mo-4 yr 9 mo). Three of 13 patients with initial successful hearing preservation had deterioration of their hearing at subsequent follow-up. The addition of naturally preserved hearing to the cochlear implant improved speech audiometry scores compared with using the implants in isolation.Conclusion: This study demonstrates that residual hearing can be consistently preserved and maintained in adolescents during the short-/medium-term using a soft surgical technique to insert standard-length electrodes. The potential benefit of preserving residual low-frequency hearing seems to be improvement in speech discrimination in challenging hearing conditions, although larger studies are required.