人工耳蜗植入术中阻抗异常的发生率及临床病程
Incidence and Clinical Course of Intraoperative Impedance Abnormalities in Cochlear Implantation.
文献信息
| PMID | 42924914 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yoshinori Fujiwara |
| 作者单位 | Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. |
| 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： 探讨人工耳蜗植入（CI）手术中术中阻抗异常的发生率、特征及术后病程，特别关注与持续性异常相关的特征。
研究设计： 回顾性观察性研究。
地点： 三级转诊大学医院。
患者： 2000年3月至2025年3月期间共实施324例人工耳蜗植入，并有可用的术中及术后阻抗测量数据。
干预： 人工耳蜗植入，并行术中及术后电极阻抗测量。
主要结局指标： 术中阻抗异常的发生率、恢复正常的时间、术后持续性及设备相关差异。
结果： 324个设备中有27个（8.3%）检测到术中阻抗异常，涉及7128个电极触点中的102个（1.4%）。25个设备中识别出开路（OC），涉及98个电极触点；2个设备中识别出短路（SC），涉及4个电极触点。所有12个术中完全解决的设备均为OC，所有83个记录到术中恢复正常的触点均为OC。在这83个OC触点中，80个（96%）在11分钟内首次记录为正常。在25个存在OC的设备中，受影响触点≤2个的设备持续性异常更常见（66.7%），高于受影响触点≥3个的设备（14.3%）（OR：12.0；95% CI：1.16-123.7；P=0.030）。细调制器电极（SME）阵列的异常发生率（8.1%）高于非SME阵列（2.8%）（OR：3.04；95% CI：1.05-8.79；P=0.048）。
结论： 大多数术中恢复正常的OC在11分钟内首次记录为正常。超过该时间间隔仍持续的OC可能在术后持续存在。SME设备需要仔细监测，而关于设备验证或更换的决定应谨慎做出，并需要进一步验证。
英文摘要
OBJECTIVE: To investigate the incidence, characteristics, and postoperative course of intraoperative impedance abnormalities during cochlear implant (CI) surgery, with particular attention to features associated with persistent abnormalities.
STUDY DESIGN: Retrospective observational study.
SETTING: Tertiary referral university hospital.
PATIENTS: A total of 324 cochlear implantations were performed between March 2000 and March 2025 with available intraoperative and postoperative impedance measurements.
INTERVENTIONS: Cochlear implantation with intraoperative and postoperative electrode impedance measurements.
MAIN OUTCOME MEASURES: Incidence of intraoperative impedance abnormalities, time to normalization, postoperative persistence, and device-related differences.
RESULTS: Intraoperative impedance abnormalities were detected in 27 of 324 devices (8.3%), involving 102 of 7128 electrode contacts (1.4%). OCs were identified in 25 devices involving 98 electrode contacts, whereas SCs were identified in 2 devices involving 4 electrode contacts. All 12 devices with complete intraoperative resolution had OCs, and all 83 contacts with documented intraoperative normalization were OCs. Among these 83 OC contacts, 80 (96%) were first recorded as normal within 11 minutes. Among the 25 devices with OCs, persistent abnormalities were more frequent in devices with ≤2 affected contacts (66.7%) than in those with ≥3 affected contacts (14.3%) (OR: 12.0; 95% CI: 1.16-123.7; P=0.030). The incidence of abnormalities was higher in the slim modiolar electrode (SME) arrays (8.1%) than in the non-SME arrays (2.8%) (OR: 3.04; 95% CI: 1.05-8.79; P=0.048).
CONCLUSION: Most OCs that normalized intraoperatively were first recorded as normal within 11 minutes. OCs persisting beyond this interval may persist postoperatively. Careful monitoring is warranted for SME devices, while decisions regarding device verification or replacement should be made cautiously and require further validation.