儿童人工耳蜗植入术中的听力保护技术：系统综述和荟萃分析。

IF 2.6 3区医学 Q1 OTORHINOLARYNGOLOGY

Otolaryngology- Head and Neck Surgery Pub Date : 2025-05-01 Epub Date: 2025-03-07 DOI:10.1002/ohn.1180

Ory Madgar, Amber D Shaffer, Daniel Gerges, Dennis J Kitsko, David H Chi

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引用次数: 0

摘要

目的：保留人工耳蜗植入术（CI）后的残余听力可提高治疗效果，并使患者能够使用电刺激和声刺激。近年来，听力保护和尽量减少植入过程中的耳蜗内创伤已成为研究和设备开发的关键领域。这项荟萃分析评估了患者特征或手术方法是否会影响术后 CI 的听力保存：在 PubMed、Web of Science、Cochrane Library、PsycINFO 和 Cumulative Index to Nursing and Allied Health Literature 中进行了系统检索：根据《系统综述和元分析首选报告项目》（PRISMA）指南，在数据库中检索了 2024 年 8 月之前发表的英文研究。搜索关键词为 "听力保护"、"人工耳蜗植入"、"测听 "和 "儿科 "及其同义词。主要研究结果为植入人工耳蜗后听力保持率。研究提取了患者、听力学、设备和手术技术的特征。结果：结果：共纳入 24 项研究，患者总数为 567 人。男性患者占 50%（95% 置信区间 [CI]：45%-55%）。患者平均年龄为 9.68 岁（95% 置信区间：8.27-11.09 岁）。CI 前后的平均纯音平均值 (PTA) 分别为 60.48 dB (95% CI: 48.81-72.14 dB) 和 70.95 dB (95% CI: 56.75-85.15 dB)。78%的耳朵（95% CI：71%-85%）报告了听力保留，不同研究之间存在高度异质性（I2 = 79.96%）。性别、手术方式、电极阵列、局部皮质类固醇和初始 PTA 与听力保留无显著相关性：结论：78% 的小儿 CI 耳朵可保留听力。在这项荟萃分析中，没有任何患者特征或手术技术与听力保护有显著相关性。

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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Hearing Preservation Techniques in Pediatric Cochlear Implantation: A Systematic Review and Meta-Analysis.

Objective: Preserving residual hearing following cochlear implantation (CI) improves outcomes and allows patients to use electrical and acoustic stimulation. Hearing preservation and minimizing intracochlear trauma during implantation have become key areas of research and device development in recent years. This meta-analysis evaluated whether patient characteristics or surgical methodology impact hearing preservation postpediatric CI.

Data sources: A systematic search was performed in PubMed, Web of Science, Cochrane Library, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature.

Review methods: Per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the databases were searched for English studies published before August 2024. Search terms were "hearing preservation," "cochlear implant," "audiometry," and "pediatric" and their synonyms. The main outcome was the percentage of ears with hearing preservation after CI. Patient, audiological, device, and surgical technique characteristics were extracted. The impact of these factors on hearing preservation was evaluated.

Results: Twenty-four studies were included, with a total of 567 patients. Males comprised 50% of patients (95% confidence interval [CI]: 45%-55%). Mean patient age was 9.68 years (95% CI: 8.27-11.09 years). Mean pure tone averages (PTAs) before and after CI were 60.48 dB (95% CI: 48.81-72.14 dB) and 70.95 dB (95% CI: 56.75-85.15 dB), respectively. Hearing preservation was reported in 78% of ears (95% CI: 71%-85%), with high heterogeneity between studies (I² = 79.96%). Gender, surgical approach, electrode array, topical corticosteroids, and initial PTA were not significantly associated with hearing preservation.

Conclusions: Hearing preservation following pediatric CI occurred in 78% of ears. In this meta-analysis, no patient characteristic or surgical technique was significantly associated with hearing preservation.

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来源期刊

Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学

CiteScore

6.70

自引率

2.90%

发文量

250

审稿时长

2-4 weeks

期刊介绍： Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.