人工耳蜗植入后第一年电极阻抗与耳蜗微音电位的变化
Changes in Electrode Impedance and Cochlear Microphonic in Cochlear Implant Recipients in the First Year After Cochlear Implantation.
文献信息
| PMID | 42772304 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Imogen A M L van Beurden |
| 作者单位 | Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. |
| 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： 我们检查了植入后第一年电极阻抗和耳蜗微音电位（CM）的变化，并研究了阻抗变化与CM变化的相关程度。此外，我们探讨了残余听力是否与阻抗和/或CM相关。
研究设计： 前瞻性纵向设计。
地点： 荷兰乌得勒支的三级转诊中心。
患者： 21名成人于2020年1月至2025年1月期间接受了人工耳蜗植入手术。
干预： 在5个时间点（术中、术后6周、3个月、6个月和12个月）测量所有16个电极对纯音刺激（125、250和500 Hz；声级100至115 dB HL）的阻抗和CM反应。残余听力通过12个月时125至500 Hz（70至115 dB HL）的纯音平均听阈（PTA）测量。
主要结局指标： 按电极阵列段（顶部、中部和底部）进行阻抗和CM振幅的纵向分析。阻抗在段内电极间取平均值。CM振幅通过先平均每段电极的平均振幅，再对3个频率取平均值得出。进行了相关性分析：（a）绝对阻抗与CM之间；（b）阻抗差值与CM振幅比之间；（c）PTA与阻抗之间；（d）PTA与CM之间。
结果： 阻抗和CM随时间的变化在不同段之间不同。最显著的阻抗变化见于中部段，在手术与6周后随访之间。CM在术后下降，尤其是在顶部和中部段，在手术与6周后随访之间。阻抗和CM在绝对和相对测量中均不相关。当6周阻抗较高和3个月CM振幅较低时，术后12个月残余听力较差。
结论： CM和阻抗不相关，尽管这两种指标都可能受到电极阵列引发的组织生长的影响。需要更大规模的临床研究来探讨阻抗和CM对术后残余听力的预测价值。
英文摘要
OBJECTIVE: We examined changes in electrode impedance and cochlear microphonic (CM) during the first year after implantation and investigated the extent to which changes in impedance related to changes in CM. In addition, we explored whether residual hearing was related to impedance and/or CM.
STUDY DESIGN: Prospective longitudinal design.
SETTING: Tertiary referral center in Utrecht, the Netherlands.
PATIENTS: Twenty-one adults underwent cochlear implantation surgery between January 2020 and January 2025.
INTERVENTIONS: Impedance and CM responses to pure-tone stimuli (125, 250, and 500 Hz; sound levels 100 to 115 dB HL) at all 16 electrodes were measured at 5 timepoints: intraoperatively, postoperatively after 6 weeks, 3 months, 6 months, and 12 months. Residual hearing was measured by pure-tone average (PTA) to 125 to 500 Hz (70 to 115 dB HL) at 12 months.
MAIN OUTCOME MEASURES: Longitudinal analyses of impedance and CM amplitude were performed per segment of the electrode array (apex, middle, and base). Impedance was averaged across the electrodes of the segment. The CM amplitudes were derived by averaging the mean amplitudes of electrodes per segment and then averaging across the 3 frequencies. Correlation analyses were performed (a) between absolute impedance and CM; (b) between impedance differences and CM amplitude ratio; (c) between PTA and impedance; and (d) between PTA and CM.
RESULTS: Changes in impedance and in CM over time differed between segments. The most robust changes in impedance were seen in the middle segment between surgery and the visit after 6 weeks. CM decreased postoperatively, especially in the apical and middle segments between surgery and the visit after 6 weeks. Impedance and CM were uncorrelated for absolute and relative measures. Twelve-month postoperative residual hearing was poorer when 6-week impedance was higher and when 3-month CM amplitude was lower.
CONCLUSIONS: CM and impedance were not correlated, although both metrics can be affected by tissue growth triggered by the electrode array. Larger clinical studies are needed to investigate the predictive value of impedance and CM for postoperative residual hearing.