Simultaneous Labyrinthectomy and Cochlear Implantation in Patients With Refractory Ménière's Disease.

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

Annals of Otology Rhinology and Laryngology Pub Date : 2025-05-14 DOI:10.1177/00034894251322623

Robert J Macielak, Markus E Harrigan, Vivian F Kaul, Meghan M Hiss, Aaron C Moberly, Edward E Dodson, Oliver F Adunka, Yin Ren

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引用次数: 0

Abstract

Objective: To assess the efficacy and safety of simultaneous labyrinthectomy and cochlear implantation (CI) in patients with refractory Ménière's disease (MD).

Methods: A retrospective review of patients with definite refractory MD per American Academy of Otolaryngology-Head and Neck Surgery treated via simultaneous transmastoid labyrinthectomy and CI was performed at a tertiary referral center. Patients' clinical and audiometric outcomes were assessed and analyzed.

Results: Twenty-four patients underwent simultaneous transmastoid labyrinthectomy and CI between 7/2015 and 9/2023 (median age = 58 years [interquartile range (IQR) = 43.5-64.5], 54% female). Complete resolution of vertigo occurred in 23 patients (96%). Evaluating available data at ≥6 months postoperatively, both CNC (n = 9; 36% vs 40%, P = .76) and AzBio scores (n = 13; 40% vs 62%, P = .15) improved after surgery. When performing a sound localization task with the CI on, the median score in identifying the noise was 32% (IQR = 22%-56%) with a median degree error of 27.9 (IQR = 15.8-38.0) versus a median score with the CI off of 20% (IQR = 14%-42%) with a median degree error of 43.8 (IQR = 21.9-73.5) at a median of 9.8 months (IQR = 6.7-14.6) from surgery.

Conclusions: The present study represents one of the largest cohorts of refractory MD patients undergoing simultaneous labyrinthectomy and CI. Combining these procedures appears safe, enables excellent control of vertigo, and expedites aural rehabilitation in appropriately selected candidates, but future study is warranted to continue to evaluate this treatment paradigm.

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难治性梅氏病同时行迷路切除术和人工耳蜗植入术。

目的：评价难治性mims患者行迷路切除联合人工耳蜗植入术（CI）的疗效和安全性。方法：回顾性分析美国耳鼻喉头颈外科学会（American Academy of耳鼻喉科-头颈外科）对在三级转诊中心同时进行经乳突迷路切除术和CI治疗的明确难治性MD患者。对患者的临床和听力结果进行评估和分析。结果：2015年7月至2023年9月期间，24例患者同时接受了经乳突迷路切除术和CI（中位年龄= 58岁[四分位间距(IQR) = 43.5-64.5]，其中54%为女性）。23例患者（96%）眩晕完全消失。评估术后≥6个月的可用数据，两名CNC (n = 9；36% vs 40%, P = 0.76)和AzBio评分(n = 13；40% vs 62%, P = 0.15)术后改善。在CI开启的情况下执行声音定位任务时，识别噪声的中位数得分为32% (IQR = 22%-56%)，中位数度误差为27.9 (IQR = 15.8-38.0)，而CI关闭时的中位数得分为20% (IQR = 14%-42%)，中位数度误差为43.8 (IQR = 21.9-73.5)，手术后中位数为9.8个月（IQR = 6.7-14.6）。结论：本研究是同时行迷路切除术和CI的难治性MD患者中最大的队列之一。结合这些方法似乎是安全的，能够很好地控制眩晕，并在适当选择的候选人中加速听力康复，但未来的研究需要继续评估这种治疗模式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Otology Rhinology and Laryngology 医学-耳鼻喉科学

CiteScore

3.10

自引率

7.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： The Annals of Otology, Rhinology & Laryngology publishes original manuscripts of clinical and research importance in otolaryngology–head and neck medicine and surgery, otology, neurotology, bronchoesophagology, laryngology, rhinology, head and neck oncology and surgery, plastic and reconstructive surgery, pediatric otolaryngology, audiology, and speech pathology. In-depth studies (supplements), papers of historical interest, and reviews of computer software and applications in otolaryngology are also published, as well as imaging, pathology, and clinicopathology studies, book reviews, and letters to the editor. AOR is the official journal of the American Broncho-Esophagological Association.