迈向人工耳蜗植入手术中听力与结构保护的共识:HEARRING国际小组调查结果
Towards a consensus on hearing and structure preservation in cochlear implantation surgery: results of the HEARRING international group survey.
文献信息
| PMID | 42741278 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Paul Van de Heyning |
| 作者单位 | Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Edegem, Belgium. |
| 期刊 | Frontiers in surgery |
| SCI 分区 | Q2 |
| IF | 2.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景: 评估国际专家在人工耳蜗植入手术中关于听力与结构保护(HSP)的当前临床实践、态度和考量。
方法: 向75名HEARRING成员(包括外科医生、听力学家和科学家)发放了一份包含42个结构化条目的横断面在线调查。问卷涵盖HSP适应证和候选者评估、电极阵列选择、手术技术、调机策略和培训。
结果: 来自16个国家的31名专家完成了调查。大多数受访者(87.1%)支持对所有耳蜗解剖结构正常的患者进行HSP手术,无论听力损失严重程度如何,主要目的是保护耳蜗结构并优化长期结局。在无创原则方面形成了强烈共识,包括缓慢插入电极阵列、柔性电极阵列、圆窗入路和常规术中皮质类固醇使用。基于影像的规划在电极阵列选择方面获得一致认可,所有专家都倾向于使用更长的电极阵列,即使在具有功能性低频听力的患者中也是如此。在基因检测、围手术期管理、术中监测和调机策略的采用方面仍存在差异,尽管基于解剖的调机最常被选择。外科医生和听力学家的培训被普遍认为至关重要。
结论: 本调查表明,在面向HSP的人工耳蜗植入手术方面,已明显向共享的专家框架演变,若干原则正接近共识。剩余的差异凸显了a)未来研究和开发的方向,以及b)支持继续开展国际合作以实现标准化的HSP实践。
英文摘要
BACKGROUND: To evaluate current clinical practices, attitudes, and considerations regarding hearing and structure preservation (HSP) in cochlear implant surgery among international experts.
METHODS: A cross-sectional online survey comprising 42 structured items was distributed to 75 HEARRING members, including surgeons, audiologists, and scientists. The questionnaire covered HSP indications and candidate evaluation, electrode array selection, surgical techniques, fitting strategies, and training.
RESULTS: Thirty-one experts from 16 countries completed the survey. Most respondents (87.1%) supported HSP surgery in all patients with normal cochlear anatomy, regardless of the severity of hearing loss, primarily to preserve cochlear structures and optimize long-term outcomes. Strong consensus emerged regarding atraumatic principles, including slow electrode array insertion, flexible electrode arrays, round window access, and routine intraoperative corticosteroid use. Image-based planning was unanimously endorsed for electrode array selection, and all experts favoured longer electrode arrays even in patients with functional low-frequency hearing. Variability persisted in the adoption of genetic testing, perioperative management, intraoperative monitoring, and fitting strategies, although anatomy-based fitting was most frequently selected. Training of surgeons and audiologists was universally regarded as essential.
CONCLUSIONS: This survey demonstrates a clear evolution toward a shared expert framework for HSP-oriented cochlear implantation surgery, with several principles approaching consensus. Remaining variability highlights a) areas for future research and development and b) supports the continued international collaboration toward standardized HSP practice.