Neural Responsiveness to Electrical Stimulation in Children With Common Cavity Deformity

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology Pub Date : 2025-06-10 DOI:10.1002/lio2.70176

Xiuhua Chao, Jinye Li, Jianfen Luo, Xianqi Liu, Zhaomin Fan, Haibo Wang, Lei Xu

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Abstract

Objectives

To investigate neural responsiveness to electrical stimulation in children with common cavity deformity (CCD) after cochlear implantation (CI), compare these responses to those in children with normal cochlea, and analyze the influence of cavity volume and electrode position on these responses.

Methods

This is a case–control study. Participant included nine children with CCD and 11 children with normal cochlea. For each participant, electrically evoked compound action potentials (ECAPs) were measured, and input/output (I/O) functions were analyzed. The volume of the CCD, electrode to the fundus of the internal auditory canal (E-IAC) distance, and inner wall (E-IW) distance were measured on preoperative and postoperative imaging for children with CCD. Linear mixed-effects models (LMM) explored group differences and the influences of volume, E-IAC distance, and E-IW distance on ECAP responses for children with CCD.

Results

Children with CCD exhibited significantly higher ECAP thresholds and lower amplitudes than those with normal cochlea. The E-IAC distance has a significant influence on the ECAP threshold and maximum amplitude (p_s < 0.05), but no significant effect on the I/O function slopes (p > 0.05). Neither cavity volume nor E-IW distance had a significant effect on ECAP responses (p_s > 0.05). Most children in the CCD group achieved open-set speech perception, but their word and sentence recognition rates were significantly lower than those in the Control group (p_s < 0.01).

Conclusion

Our findings demonstrated that there were a certain number of residual CNs in children with CCD; however, these nerves exhibited poorer responsiveness to electrical stimulation compared to children with a normal cochlea. Electrodes placed closer to the IAC fundus elicited stronger ECAP responses for children with CCD, which emphasized the importance of surgical strategies that minimize the distance between electrode contacts and residual cochlear nerve structures.

Level of Evidence: 3

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常见腔畸形儿童对电刺激的神经反应

目的观察人工耳蜗植入术后常见腔畸形（CCD）患儿对电刺激的神经反应，并与正常耳蜗患儿进行比较，分析腔体积和电极位置对电刺激神经反应的影响。方法采用病例-对照研究。参与者包括9名患有CCD的儿童和11名耳蜗正常的儿童。对每个参与者进行电诱发复合动作电位（ecap）测量，并分析输入/输出（I/O）功能。术前、术后影像学测量CCD的体积、电极到内耳道底（E-IAC）的距离、内耳道内壁（E-IW）的距离。线性混合效应模型（LMM）探讨组间差异及体积、E-IAC距离、E-IW距离对CCD患儿ECAP反应的影响。结果CCD患儿的ECAP阈值明显高于正常耳蜗患儿，振幅明显低于正常耳蜗患儿。E-IAC距离对ECAP阈值和最大振幅有显著影响（p < 0.05），但对I/O函数斜率无显著影响（p > 0.05）。空腔体积和E-IW距离对ECAP反应均无显著影响（ps > 0.05）。CCD组患儿大部分实现了开放集语音感知，但单词和句子识别率显著低于对照组（ps < 0.01）。结论CCD患儿体内存在一定数量的残余中枢神经系统；然而，与耳蜗正常的儿童相比，这些神经对电刺激的反应较差。对于患有CCD的儿童，靠近IAC眼底的电极引起更强的ECAP反应，这强调了手术策略的重要性，即尽量减少电极接触与残余耳蜗神经结构之间的距离。证据等级：3

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