鼻咽癌放疗所致听力损失的耳蜗植入：一项系统综述。
Cochlear Implants for Radiation-Induced Hearing Loss in Nasopharyngeal Cancer: A Systematic Review.
文献信息
| PMID | 42811759 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Kaitlyn A Roberts |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA. |
| 期刊 | The Laryngoscope |
| SCI 分区 | Q2 |
| IF | 2.3 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 评估耳蜗植入对鼻咽癌（NPC）患者放疗后听觉康复的安全性和有效性。
数据来源： 检索CINAHL、Cochrane Library、PubMed和Scopus，从建库至2026年2月。
综述方法： 纳入报告因NPC放疗后听力损失而接受耳蜗植入的研究。提取主观和客观听力指标，包括阈值、言语感知、生活质量结局和手术并发症。对可获得结局采用随机效应模型计算合并均数和比例及其95%置信区间（CI）。使用牛津证据水平和Joanna Briggs研究所批判性评价工具评估研究质量和偏倚风险。
结果： 共纳入12项研究（N=69耳）。耳蜗植入最常通过标准乳突切开术加后鼓室切开术进行，替代入路选择性使用。手术和装置相关并发症不常见，80.4%（95% CI：55.1-96.7）无术中并发症，96.5%（95% CI：88.3-99.5）无术后并发症。91.3%的患者（95% CI：73.1-98.8）观察到听力学改善，言语感知和患者报告结局也有获益。植入前重度听力损失的平均持续时间为6.5年。
结论： NPC患者放疗后耳蜗植入总体安全有效，即使对于长期听力损失也能提供有意义的听觉和功能获益。这些发现支持放疗后常规听力学监测，以便及时转诊进行康复。
证据水平： 不适用。
英文摘要
OBJECTIVES: To evaluate the safety and efficacy of cochlear implantation for auditory rehabilitation in patients with nasopharyngeal carcinoma (NPC) after radiation.
DATA SOURCES: CINAHL, Cochrane Library, PubMed, and Scopus were searched from inception through February 2026.
REVIEW METHODS: Studies reporting cochlear implantation for hearing loss after radiation for NPC were included. Subjective and objective measures of hearing, including thresholds, speech perception, quality-of-life outcomes, and surgical complications, were extracted. Pooled means and proportions with 95% confidence intervals (CI) were calculated for available outcomes using random-effects models. Study quality and risk of bias were assessed using Oxford Levels of Evidence and Joanna Briggs Institute critical appraisal tools.
RESULTS: Twelve studies (N = 69 ears) were included. Cochlear implantation was most commonly performed via standard mastoidectomy with posterior tympanotomy, with alternative approaches used selectively. Surgical and device-related complications were uncommon, with 80.4% (95% CI: 55.1-96.7) without intraoperative complications and 96.5% (95% CI: 88.3-99.5) without postoperative complications. Audiometric improvement was observed in 91.3% of patients (95% CI: 73.1-98.8), with gains in speech perception and patient-reported outcomes. Mean duration of profound hearing loss prior to implantation was 6.5 years.
CONCLUSION: Cochlear implantation after radiation in patients with NPC is generally safe and effective, providing meaningful auditory and functional benefits even in long-standing hearing loss. These findings support routine audiologic surveillance after radiation to enable timely referrals for rehabilitation.
LEVEL OF EVIDENCE: NA.