Article record

耳蜗微解剖结构对人工耳蜗植入者听力保留的影响

Influence of Cochlear Microanatomy on Hearing Preservation in Cochlear Implant Recipients.

临床研究耳科IF 1.9Q2

文献信息

PMID	42715295
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Elena Quinonez Del Cid 查看其他 6 位作者 Ashley Micuda；Margaret T Dillon；Saangyoung E Lee；Hanif M Ladak；Sumit Agrawal；Kevin D Brown
作者单位	School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC. 查看其他 5 条单位信息 Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC.；Department of Medical Biophysics, Western University, London, ON, Canada.；Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada.；School of Biomedical Engineering, Western University, London, ON, Canada.；Department of Electrical and Computer Engineering, Western University, London, ON, Canada.
期刊	Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
SCI 分区	Q2
IF	1.9
研究类型	临床研究 · 临床
所属专科	耳科

中文摘要

目的： 识别影响成人人工耳蜗（CI）植入者听力保留的耳蜗微解剖变量。
研究设计： 回顾性研究。
地点： 三级学术转诊中心。
患者： 42例CI植入者，术前250 Hz未助听听阈≤45 dB HL。
干预： 使用24、28或31.5 mm直电极阵列进行人工耳蜗植入。
主要结局指标： 使用术前和术后影像提取鼓阶（ST）体积、耳蜗导管长度（CDL）和横截面测量值（高度、宽度、面积和直径），以及角度插入深度（AID）和最顶端电极（EA）处的横截面测量值。在开机时和开机后6个月计算低频纯音平均听阈（LFPTA；125、250和500 Hz）的变化。
结果： 采用线性混合效应模型分析耳蜗微解剖结构（即ST体积、CDL和AID）、EA处横截面测量值（高度、宽度、面积和直径），以及时间间隔、手术时年龄和生物学性别对LFPTA变化的影响。显著效应包括生物学性别（P = 0.01）和ST体积（P = 0.005）。年龄显示出接近显著的趋势（P = 0.052）。时间间隔（P = 0.26）、CDL（P = 0.80）、AID（P = 0.40）、ST高度（P = 0.71）、ST宽度（P = 0.65）、ST直径（P = 0.56）和ST横截面积（P = 0.14）对LFPTA变化无显著影响。
结论： ST体积和生物学性别可显著预测成人CI植入者的听力保留。听力保留可能更多受整体ST体积的影响，而非电极与局部环境的相互作用。间接创伤机制，例如电极插入时的液压压力，可能在耳蜗内结构损伤中占主导地位。未来需要研究通过测量阵列插入过程中与ST体积相关的术中液体压力瞬变来验证这些发现。

英文摘要

OBJECTIVE: Identify cochlear microanatomic variables that influence hearing preservation in adult cochlear implant (CI) recipients.
STUDY DESIGN: Retrospective review.
SETTING: Tertiary academic referral center.
PATIENTS: Forty-two CI recipients with preoperative unaided thresholds ≤45 dB HL at 250 Hz.
INTERVENTIONS: Cochlear implantation with a 24, 28, or 31.5-mm straight electrode array.
MAIN OUTCOME MEASURES: Preoperative and postoperative imaging were used to extract scala tympani (ST) volume, cochlear duct length (CDL), and cross-sectional measurements (height, width, area, and diameter), as well as angular insertion depth (AID) and cross-sectional measures at the most apical electrode (EA). Shift in low-frequency pure tone average (LFPTA; 125, 250, and 500 Hz) was computed at activation and at 6 months post activation.
RESULTS: A linear mixed-effects model analyzed the effects of cochlear microanatomy (ie, ST volume, CDL, and AID), cross-sectional measurements at EA (height, width, area, and diameter), as well as interval, age at surgery, and biological sex on the shift in LFPTA. Significant effects included biological sex (P = 0.01) and ST volume (P = 0.005). Age demonstrated a trend toward significance (P = 0.052). Interval (P = 0.26), CDL (P = 0.80), AID (P = 0.40), ST height (P = 0.71), ST width (P = 0.65), ST diameter (P = 0.56), and ST cross-sectional area (P = 0.14) did not significantly influence shift in LFPTA.
CONCLUSIONS: ST volume and biological sex are significantly predictive of hearing preservation for adult CI recipients. Hearing preservation may be more affected by overall ST volume than by interactions of the electrode with the local environment. Indirect mechanisms of trauma, such as hydraulic pressure as the electrode is inserted, may predominate in damage to intracochlear structures. Future studies are needed to validate these findings with measurement of intraoperative fluid pressure transients in relation to ST volume during array insertion.