人工耳蜗植入合并耳蜗神经缺陷患者影像学特征预后能力的评估
Evaluation of the Prognostic Capacity of the Imaging Features in Cochlear Implant Patients with Cochlear Nerve Deficiency.
文献信息
| PMID | 42867353 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Zhencheng Gao |
| 作者单位 | Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, P. R. China. |
| 期刊 | The journal of international advanced otology |
| SCI 分区 | Q3 |
| IF | 1.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 耳蜗神经缺陷（CND）是一种常见的内耳畸形，多项研究已发现CND人工耳蜗植入患者的影像学特征与术后结局之间存在相关性。然而，各种影像学特征对人工耳蜗植入（CI）术后结局的影响程度仍不明确。本研究旨在确定对CND患者术后结局影响最显著的影像学参数。
方法： 本研究共纳入107例CND儿童。评估的影像学特征包括内听道（IAC）直径、IAC神经分级、前庭蜗神经（VCN）面积以及前庭蜗神经与面神经的面积比（VCN/FN）。通过最大选择秩统计量计算每个连续影像学参数的最佳截断值。分析影像学特征和临床数据对CND儿童术后听觉和言语结局的影响。
结果： 单因素Cox回归确定较高的IAC神经分级（IV级）、IAC直径、VCN面积和VCN/FN比值是CI术后较好听觉表现的预测因素。女性、较高的IAC神经分级、IAC直径、VCN面积和VCN/FN比值与较好的言语表现相关。多因素分析显示，较高的IAC神经分级和VCN/FN比值可独立预测听觉表现，而仅VCN/FN比值可独立预测言语表现。
结论： 较高的VCN/FN比值是CND儿童术后结局最稳健的影像学预测因素，可独立预测CI术后的听觉和言语表现。
英文摘要
BACKGROUND: Cochlear nerve deficiency (CND) is a prevalent inner ear malformation, and several studies have identified a correlation between imaging features and postoperative outcomes in cochlear implant patients with CND. Nevertheless, the extent to which various imaging features influence postoperative cochlear implantation (CI) outcomes remains unclear. This study sought to identify the imaging parameter with the most significant impact on postoperative outcomes in CND patients.
METHODS: A total of 107 CND children were included in this study. Imaging features, including internal auditory canal (IAC) diameter, IAC nerve grade, vestibulocochlear nerve (VCN) area, and the area ratio of the vestibulocochlear nerve to the facial nerve (VCN/FN), were evaluated. The optimal cut-off values for each continuous imaging parameter were calculated via maximally selected rank statistics. The effects of imaging features and clinical data on the postoperative auditory and speech outcomes of CND children were analyzed.
RESULTS: Univariate Cox regression identified higher IAC nerve grade (Grade IV), IAC diameter, VCN area, and VCN/FN ratio as predictors of better auditory performance after CI. Female sex, higher IAC nerve grade, IAC diameter, VCN area, and VCN/FN ratio were associated with better speech performance. Multivariate analysis showed that higher IAC nerve grade and VCN/FN ratio independently predicted auditory performance, whereas only the VCN/FN ratio independently predicted speech performance.
CONCLUSION: A higher VCN/FN ratio is the most robust imaging predictor of postoperative outcomes in CND children, independently predicting both auditory and speech performance after CI.