Cochlear Implantation in Pediatric Cochlear Nerve Deficiency: A Systematic Review and Meta-Analysis.

IF 2.2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Laryngoscope Pub Date : 2024-11-09 DOI:10.1002/lary.31888
Susmita Chennareddy, Kalena H Liu, Maria A Mavrommatis, Derek D Kao, Aparna Govindan, Zachary G Schwam, Maura K Cosetti
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引用次数: 0

Abstract

Objective: Cochlear nerve deficiency (CND) is commonly implicated in moderate-to-profound pediatric sensorineural hearing loss (SNHL). Although cochlear implantation (CI) was previously contraindicated in CND patients, recent studies have demonstrated the potential for auditory response to CI in a subset of CND patients, though clinical outcomes remain variable. This study aims to evaluate pre- and postoperative speech and auditory outcomes of CI in pediatric patients with bilateral SNHL and radiographically confirmed CND.

Data sources: Embase and Ovid MEDLINE.

Review methods: A systematic review was conducted to identify studies reporting pre- and postoperative outcomes of children with CND confirmed by magnetic resonance imaging who underwent CI. A random-effects model was used to account for within- and between-study variance in speech and auditory outcomes.

Results: After abstract screening of 818 distinct articles, 16 studies were selected for final inclusion, consisting of 248 patients with cochlear nerve hypoplasia or aplasia who underwent CI. Various speech perception and language development tests were investigated across studies (Speech Intelligibility Rating, Speech Perception Category, Speech Awareness Thresholds, Meaningful Auditory Integration Scale, Meaningful Use of Speech Scale, Categories of Auditory Performance, and Auditory Level). Pooled outcomes demonstrated improvement in speech perception after CI in pediatric patients with CND (SMD 2.18, 95% CI 1.68-2.69).

Conclusion: Indications for CI are expanding as research demonstrates benefit in populations previously thought inappropriate. Our study demonstrates global postoperative improvement in speech and auditory outcomes in children with bilateral SNHL and CND after CI.

Level of evidence: NA Laryngoscope, 2024.

人工耳蜗植入治疗小儿耳蜗神经缺陷:系统回顾与元分析》。
目的:耳蜗神经缺损(CND)通常与中度至重度小儿感音神经性听力损失(SNHL)有关。虽然人工耳蜗植入术(CI)以前是 CND 患者的禁忌症,但最近的研究表明,部分 CND 患者有可能对 CI 产生听觉反应,尽管临床结果仍不尽相同。本研究旨在评估双侧 SNHL 和经放射学确诊的 CND 儿童患者术前和术后 CI 的语言和听觉效果:Embase和Ovid MEDLINE:进行了一项系统性综述,以确定对磁共振成像证实患有 CND 并接受 CI 的儿童的术前和术后效果进行报告的研究。采用随机效应模型来解释言语和听觉结果的研究内和研究间差异:经过对 818 篇不同文章的摘要筛选,最终选出了 16 项研究,其中包括 248 名接受 CI 的耳蜗神经发育不良或发育不全患者。各项研究对各种言语感知和语言发展测试(言语清晰度评级、言语感知类别、言语感知阈值、有意义听觉整合量表、有意义言语使用量表、听觉表现类别和听觉水平)进行了调查。汇总结果显示,CND儿科患者进行CI后,语言感知能力有所提高(SMD 2.18,95% CI 1.68-2.69):结论:随着研究证明CI对以前认为不适合的人群有益,CI的适应症也在不断扩大。我们的研究表明,双侧 SNHL 和 CND 患儿在接受 CI 治疗后,术后的言语和听觉效果得到了全面改善:NA 《喉镜》,2024 年。
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来源期刊
Laryngoscope
Laryngoscope 医学-耳鼻喉科学
CiteScore
6.50
自引率
7.70%
发文量
500
审稿时长
2-4 weeks
期刊介绍: The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects
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