比较 100 例散发性前庭许旺瘤患者通过观察、放射外科手术或显微外科手术治疗后的人工耳蜗植入效果:多机构回顾

IF 1.9 3区 医学 Q3 CLINICAL NEUROLOGY
James R Dornhoffer, John P Marinelli, Christine M Lohse, Justin Cottrell, Sean O McMenomey, J Thomas Roland, Nicholas J Thompson, Kevin D Brown, Jacob C Lucas, Seilesh C Babu, Nathan R Lindquist, Elizabeth L Perkins, Torsten Rahne, Stefan K Plontke, Donald Tan, Jacob B Hunter, Erin Harvey, Nicholas L Deep, Samantha Y Cerasiello, Matthew L Kircher, Mana Espahbodi, Evan L Tooker, Simon K W Lloyd, Matthew L Carlson
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引用次数: 0

摘要

研究目的比较通过观察、放射外科手术或显微外科手术治疗的散发性前庭分裂瘤(VS)患者的人工耳蜗(CI)言语感知效果:研究设计:回顾性研究:11 家三级学术医疗中心:100 名接受同侧人工耳蜗植入的散发性 VS 患者:干预措施:同侧人工耳蜗植入:纯音阈值、单音节言语感知测试评分和开放式言语习得率:在接受研究的 100 名患者中,54 人接受了显微手术,26 人接受了放射手术,19 人继续观察,1 人接受了多模式治疗。在所有患者中,植入术后纯音平均值的中位数为 31 dB(四分位间距 [IQR] 25-39 dB),单音节言语感知得分的中位数为 30%(IQR 0-60%),植入术后的中位数为 12 个月(IQR 5-25 个月)。与采用观察法(中位数言语感知分数为 52%,IQR 为 40-72%)或放射外科法(中位数言语感知分数为 30%,IQR 为 16-60%)治疗的患者相比,采用显微手术治疗的患者(中位数言语感知分数为 11%,IQR 为 0-52%)的植入效果较差。采用显微手术治疗的患者中有 61% 达到开放式言语感知,采用观察治疗的患者达到 100%,采用放射手术治疗的患者达到 80%。在多变量设置中,与接受显微手术的患者相比,接受观察(p = 0.02)或放射外科手术(p = 0.04)的患者更有可能获得开放式言语感知:结论:人工耳蜗可为特定的散发性 VS 患者带来益处。尽管半数以上的患者在接受显微手术后能获得开放式言语感知,但与显微手术切除相比,接受观察或放射外科手术治疗的患者能更可靠地获得开放式言语感知。这些数据可为患者咨询和VS肿瘤管理提供参考,这些患者可能会从植入手术中获益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparing Cochlear Implant Outcomes in 100 Patients With Sporadic Vestibular Schwannoma Managed With Observation, Radiosurgery, or Microsurgery: A Multi-Institutional Review.

Objective: To compare cochlear implant (CI) speech perception outcomes in patients with sporadic vestibular schwannoma (VS) managed with observation, radiosurgery, or microsurgery.

Study design: Retrospective review.

Setting: Eleven tertiary academic medical centers.

Patients: One hundred patients with sporadic VS who received an ipsilateral CI.

Interventions: Ipsilateral cochlear implantation.

Main outcome measures: Pure-tone thresholds, monosyllabic speech perception testing scores, and rates of open-set speech acquisition.

Results: Of the 100 patients studied, 54 underwent microsurgery, 26 underwent radiosurgery, 19 continued observation, and 1 underwent multimodal therapy. Among all patients, the median post-implantation pure-tone average was 31 dB (interquartile range [IQR] 25-39 dB) and the median monosyllabic speech perception score was 30% (IQR 0-60%) at a median of 12 months (IQR 5-25 months) post-implantation. Patients who were managed with microsurgery (median speech perception score 11%, IQR 0-52%) exhibited poorer implant outcomes overall compared with those managed with observation (median speech perception score 52%, IQR 40-72%) or radiosurgery (median speech perception score 30%, IQR 16-60%). Open-set speech perception was achieved in 61% of patients managed with microsurgery, 100% with observation, and 80% with radiosurgery. In a multivariable setting, those managed with observation (p = 0.02) or who underwent radiosurgery (p = 0.04) were significantly more likely to achieve open-set speech perception compared with patients who underwent microsurgery.

Conclusions: Cochlear implants offer benefit in selected patients with sporadic VS. Although achieved in over half of people after microsurgery, open-set speech perception is more reliably attained in patients who are treated with observation or radiosurgery compared with microsurgical resection. These data may inform patient counseling and VS tumor management in people who may benefit from implantation.

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来源期刊
Otology & Neurotology
Otology & Neurotology 医学-耳鼻喉科学
CiteScore
3.80
自引率
14.30%
发文量
509
审稿时长
3-6 weeks
期刊介绍: ​​​​​Otology & Neurotology publishes original articles relating to both clinical and basic science aspects of otology, neurotology, and cranial base surgery. As the foremost journal in its field, it has become the favored place for publishing the best of new science relating to the human ear and its diseases. The broadly international character of its contributing authors, editorial board, and readership provides the Journal its decidedly global perspective.
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