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- 郑军主任医师 教授
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医院:
首都医科大学附属北京同仁医院
科室:
耳鼻咽喉科
- 人工耳蜗长电极全植入后的残余听力保存情况
- 作者:郑军|发布时间:2012-03-27|浏览量:1391次
Usami SI, Moteki H, Suzuki N, Fukuoka H, Miyagawa M, Nishio SY, Takumi Y, Iwasaki S, Jolly C (2011)Achievement of hearing preservation in the presence of an electrode covering the residual hearing region.Acta Otolaryngol, 131(4): 405-12.
人工耳蜗长电极全植入后的残余听力保存情况
摘要:
结论:
在应用长电极全部植入耳蜗,使长电极插入至耳蜗的残余听力区域之后,依然能很好地保留患者的残余听力。
目的:
新的电极设计的无创理念和无创手术技术已经可以实现保留人工耳蜗植入者的残余听力,而且EAS(声电联合刺激)和残余听力保护已经成为低频有残余听力的患者人工耳蜗植入的新趋势。然而,长电极或中长电极的全植入对于残余听力的保存仍然是一个亟待商榷的挑战领域。
方法:
本研究采用了圆窗入路、一种无创设计的电极以及地塞米松处理。并对电极全植入的无创性(残余听力的保存、前庭功能的保护)进行了评估。
结果:
电极全植入术后的评估显示:所有的5例患者低频区的残余听力都得到了很好的保护。术后的影像检查和参考的音调拓扑图确定了电极的全植入并显示电极植入深度所对应的频率。根据本研究现有病例的分析,圆窗入路的无创性关键在于它最短的钻磨时间和前庭功能的保护。
Abstract:
CONCLUSIONS: With full insertion with a long electrode, hearing preservation can be achieved even in the presence of a long electrode covering the residual hearing region.
OBJECTIVES:Advances in developing new atraumatic concepts of electrode design as well as surgical technique have enabled hearing preservation after cochlear implantation surgery, and EAS (electric acoustic stimulation) accompanied with hearing preservation is a new trend for patients with residual hearing at the lower frequencies. However, full insertion with a long/medium electrode and hearing preservation is still a challenging field that calls for discussion.
METHOD:In this study, round window insertion, an atraumatic electrode, and dexamethasone administration were used and atraumaticity (hearing preservation and conservation of vestibular function) was evaluated with full insertion of the electrode.
RESULTS:Postoperative evaluation after full insertion of the electrodes showed that hearing at low frequencies was well preserved in all five cases. Combined postoperative imaging with the referential tonotopic map confirmed achievement of full insertion and indicated the corresponding frequencies and the depth of the electrode. Achievement of atraumaticity of round window insertion in the present cases was confirmed from the viewpoint of the minimal drilling time as well as the preserved vestibular function.