经迷路前庭神经鞘瘤切除与人工耳蜗植入：无线连接语音测试的评估

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology Pub Date : 2025-07-23 DOI:10.1002/lio2.70197

Michelle Kwon, Guhan Kumarasamy, In Seok Moon

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引用次数: 0

摘要

目的经迷路入路（TLA）和人工耳蜗植入（CI）同时切除前庭神经鞘瘤（VS），可以实现手术视野重叠，改善术后听力效果，并最大限度地减少多种手术干预相关的并发症。然而，这种手术方法的有效性仍然是一个有争议的话题。为了解决这个问题，我们的目标是使用客观的无线连接语音测试来评估手术结果，以确保准确的听觉表现。方法对2020年至2024年6例同时行TLA和CI手术的患者进行分析。所有患者均表现为单侧耳聋或不对称听力损失，前庭神经鞘瘤分级为Koos I级或II级，局限于内耳道。术前和术后听力结果通过纯音测听阈值、单词识别评分、视觉模拟量表（VAS）和助听器受益调查简表（APHAB）进行评估。磁共振成像（MRI）证实肿瘤完全或几乎完全切除。术后听力结果还通过声场（拔掉）测试、闭塞封堵测试和iPad语音测试（将录制的声音直接无线传输到CI的语音处理器）进行评估。结果纯音听力学阈值和单词识别评分从术前到术后均有改善（p = 0.0002和p = 0.03）。在5名术后进行iPad语音测试的患者中，单音节和双音节得分始终低于插电和不插电测试的结果。值得注意的是，两名患者报告说，尽管在插入测试中表现可测，但没有可测的基于ipad的语音识别。此外，所有患者的APHAB评分均有显著改善。结论TLA联合CI是小前庭神经鞘瘤患者恢复听力的有效方法，可使双耳听力恢复。证据级别4

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Simultaneous Translabyrinthine Vestibular Schwannoma Removal and Cochlear Implantation: Assessment of Wireless Connection Speech Test

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Simultaneous Translabyrinthine Vestibular Schwannoma Removal and Cochlear Implantation: Assessment of Wireless Connection Speech Test

Objective

Simultaneous vestibular schwannoma (VS) removal via the translabyrinthine approach (TLA) and cochlear implantation (CI) allows for overlapping surgical fields, improving postoperative hearing outcomes, and minimizing complications associated with multiple surgical interventions. However, the effectiveness of this surgical approach remains a topic of debate. To address this, we aim to evaluate surgical outcomes using an objective wireless connection speech test to ensure accurate auditory performance.

Methods

We describe six patients with simultaneous TLA and CI surgery from 2020 to 2024. All patients presented with single-sided deafness or asymmetric hearing loss due to vestibular schwannomas classified as Koos grade I or II, confined to the internal auditory canal. Preoperative and postoperative hearing outcomes were assessed through pure-tone audiometry thresholds, word recognition scores, Visual Analog Scale (VAS), and Abbreviated Profile of Hearing Aid Benefit survey (APHAB). Magnetic resonance imaging (MRI) confirmed that tumors were either completely or nearly completely excised. Postoperative hearing outcomes were also evaluated through Sound Field (unplugging) tests, occlusion plugging tests, and the iPad speech test—a wireless transmission of recorded sound directly to the CI's speech processor.

Results

The pure-tone audiometry thresholds and word recognition scores improved from preoperative to postoperative assessments (p = 0.0002 and p = 0.03, respectively). Of the five patients who performed the postoperative iPad speech test, monosyllabic and disyllabic scores were consistently lower than the outcomes from the plugged and unplugged tests. Notably, two patients reported no measurable iPad-based speech recognition despite measurable performance on the plugged test. Additionally, APHAB scores showed significant improvement across all patients.

Conclusion

Simultaneous TLA and CI emerges as an effective procedure for restoring hearing in patients with small vestibular schwannomas, allowing the recovery of binaural hearing.