正常耳蜗解剖儿童中侧壁与细长蜗轴型人工耳蜗电极的长期疗效比较
Comparative Long-Term Outcomes of Lateral Wall and Slim Modiolar Cochlear Implant Electrodes in Children With Normal Cochlear Anatomy.
文献信息
| PMID | 42813402 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Faisal Zawawi |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, Cochlear Implants and Hearing Aids Unit, King Abdulaziz University, Jeddah, Saudi Arabia. |
| 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
背景： 电极设计可能影响神经刺激效率、言语疗效和长期稳定性。虽然侧壁电极和细长蜗轴型电极均广泛用于儿童人工耳蜗植入，但正常耳蜗解剖儿童的长期比较性结局数据仍然有限。
方法： 这项回顾性比较研究纳入双侧语前重度至极重度感音神经性听力损失儿童，这些儿童于2017年至2021年间在一家三级学术中心接受人工耳蜗植入，使用侧壁电极（CI522/622）或细长蜗轴型电极（CI532/632）。所有儿童均具有正常耳蜗解剖，且随访至少4年。分析了人口学数据、手术细节、术中电生理指标、术后听力学和言语结局、数据记录以及影像学评估。
结果： 共纳入161耳（83耳侧壁电极，78耳细长蜗轴型电极）。两组植入时的平均年龄无差异。细长蜗轴型电极组表现出显著更低的术中NRT阈值和阻抗值、更高的4年言语识别得分（75.5% vs. 68.8%；P=0.001）以及更大的平均每日设备使用时间（11.2 vs. 9.7小时；P=0.02）。电极移位仅发生在侧壁电极组（8.4%），而细长蜗轴型电极组未观察到电极移位。疑似阶间移位总体不常见，但侧壁电极更常见（4.8% vs. 1.2%；P=0.02）。
结论： 在耳蜗解剖正常的儿童中，与侧壁电极相比，细长蜗轴型电极与更优的长期言语结局、更低的刺激需求、更大的设备使用以及更好的耳蜗内稳定性相关。
英文摘要
BACKGROUND: Electrode design may influence neural stimulation efficiency, speech outcomes, and long-term stability. While both lateral wall and slim modiolar electrodes are widely used in pediatric cochlear implantation, comparative long-term outcome data in children with normal cochlear anatomy remain limited.
METHODS: This retrospective comparative study included children with bilateral prelingual severe-to-profound sensorineural hearing loss who underwent cochlear implantation with either a lateral wall electrode (CI522/622) or a slim modiolar electrode (CI532/632) at a tertiary academic center between 2017 and 2021. All children had normal cochlear anatomy and a minimum follow-up of 4 years. Demographic data, surgical details, intraoperative electrophysiologic measures, postoperative audiologic and speech outcomes, data logging, and radiologic assessments were analyzed.
RESULTS: A total of 161 ears were included (83 lateral wall, 78 slim modiolar). Mean age at implantation did not differ between groups. The slim modiolar group demonstrated significantly lower intraoperative NRT thresholds and impedance values, higher 4-year speech discrimination scores (75.5% vs. 68.8%; P=0.001), and greater mean daily device use (11.2 vs. 9.7 h; P=0.02). Electrode migration occurred exclusively in the lateral wall group (8.4%), while none was observed in the slim modiolar group. Suspected scalar translocation was uncommon overall but more frequent with lateral wall electrodes (4.8% vs. 1.2%; P=0.02).
CONCLUSION: In children with normal cochlear anatomy, slim modiolar electrodes were associated with superior long-term speech outcomes, lower stimulation requirements, greater device use, and improved intracochlear stability compared with lateral wall electrodes.