Anne K Maxwell, Jacob B Kahane, Rahul Mehta, Moises A Arriaga
{"title":"耳蜗内纤维化人工耳蜗植入术:手术技术的比较。","authors":"Anne K Maxwell, Jacob B Kahane, Rahul Mehta, Moises A Arriaga","doi":"10.1080/14670100.2022.2153968","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>While the implications of ossification on cochlear implantation (CI) have been extensively described, there is a paucity of data regarding the fibrotic stage. We examined the outcomes of different insertion techniques for managing intracochlear fibrosis.</p><p><strong>Study design: </strong>Retrospective review of case series with case-control comparison.</p><p><strong>Setting: </strong>University-based tertiary-referral otology-neurotology practice.</p><p><strong>Patients: </strong>Between 2009 to 2020, 384 patients underwent CI. Of those, 7 patients (8 ears) demonstrated intracochlear fibrosis.</p><p><strong>Interventions: </strong>CI performed 1-4 months following meningitis/labyrinthitis and 12-24 months after idiopathic sudden SNHL. Fibrosis removal (38%) or dilation (63%) permitted implantation. A styleted-electrode was used in 63% due to dense fibrosis.</p><p><strong>Main outcome measures: </strong>Postoperative audiometry with CI in place, additional comparisons with audiometric outcomes in age-matched controls.</p><p><strong>Results: </strong>Full insertion achieved in all except one ear with partial ossification. Mean ipsilateral pure tone average (PTA) improved to 29 ± 15 dB and speech discrimination to 72 ± 28%. Fibrosis removal vs. dilation resulted in no PTA differences (<i>p</i> = 0.76). Poorest outcomes occurred with the longest time to surgery.</p><p><strong>Conclusions: </strong>Good CI audiologic outcomes in the setting of cochlear fibrosis can be achieved and are independent of technique. Instead, they vary with time to implantation. Every attempt should be made to intervene as early as possible.</p>","PeriodicalId":53553,"journal":{"name":"COCHLEAR IMPLANTS INTERNATIONAL","volume":"24 2","pages":"73-82"},"PeriodicalIF":1.4000,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":"{\"title\":\"Cochlear implantation through intracochlear fibrosis: A comparison of surgical techniques.\",\"authors\":\"Anne K Maxwell, Jacob B Kahane, Rahul Mehta, Moises A Arriaga\",\"doi\":\"10.1080/14670100.2022.2153968\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>While the implications of ossification on cochlear implantation (CI) have been extensively described, there is a paucity of data regarding the fibrotic stage. We examined the outcomes of different insertion techniques for managing intracochlear fibrosis.</p><p><strong>Study design: </strong>Retrospective review of case series with case-control comparison.</p><p><strong>Setting: </strong>University-based tertiary-referral otology-neurotology practice.</p><p><strong>Patients: </strong>Between 2009 to 2020, 384 patients underwent CI. Of those, 7 patients (8 ears) demonstrated intracochlear fibrosis.</p><p><strong>Interventions: </strong>CI performed 1-4 months following meningitis/labyrinthitis and 12-24 months after idiopathic sudden SNHL. Fibrosis removal (38%) or dilation (63%) permitted implantation. A styleted-electrode was used in 63% due to dense fibrosis.</p><p><strong>Main outcome measures: </strong>Postoperative audiometry with CI in place, additional comparisons with audiometric outcomes in age-matched controls.</p><p><strong>Results: </strong>Full insertion achieved in all except one ear with partial ossification. Mean ipsilateral pure tone average (PTA) improved to 29 ± 15 dB and speech discrimination to 72 ± 28%. Fibrosis removal vs. dilation resulted in no PTA differences (<i>p</i> = 0.76). Poorest outcomes occurred with the longest time to surgery.</p><p><strong>Conclusions: </strong>Good CI audiologic outcomes in the setting of cochlear fibrosis can be achieved and are independent of technique. Instead, they vary with time to implantation. 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Cochlear implantation through intracochlear fibrosis: A comparison of surgical techniques.
Objective: While the implications of ossification on cochlear implantation (CI) have been extensively described, there is a paucity of data regarding the fibrotic stage. We examined the outcomes of different insertion techniques for managing intracochlear fibrosis.
Study design: Retrospective review of case series with case-control comparison.
Patients: Between 2009 to 2020, 384 patients underwent CI. Of those, 7 patients (8 ears) demonstrated intracochlear fibrosis.
Interventions: CI performed 1-4 months following meningitis/labyrinthitis and 12-24 months after idiopathic sudden SNHL. Fibrosis removal (38%) or dilation (63%) permitted implantation. A styleted-electrode was used in 63% due to dense fibrosis.
Main outcome measures: Postoperative audiometry with CI in place, additional comparisons with audiometric outcomes in age-matched controls.
Results: Full insertion achieved in all except one ear with partial ossification. Mean ipsilateral pure tone average (PTA) improved to 29 ± 15 dB and speech discrimination to 72 ± 28%. Fibrosis removal vs. dilation resulted in no PTA differences (p = 0.76). Poorest outcomes occurred with the longest time to surgery.
Conclusions: Good CI audiologic outcomes in the setting of cochlear fibrosis can be achieved and are independent of technique. Instead, they vary with time to implantation. Every attempt should be made to intervene as early as possible.
期刊介绍：
Cochlear Implants International was founded as an interdisciplinary, peer-reviewed journal in response to the growing number of publications in the field of cochlear implants. It was designed to meet a need to include scientific contributions from all the disciplines that are represented in cochlear implant teams: audiology, medicine and surgery, speech therapy and speech pathology, psychology, hearing therapy, radiology, pathology, engineering and acoustics, teaching, and communication. The aim was to found a truly interdisciplinary journal, representing the full breadth of the field of cochlear implantation.
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