先天性巨细胞病毒患儿的人工耳蜗调机特征：与GJB2相关听力损失的一年纵向比较
Cochlear Implant Fitting Profiles in Children with Congenital Cytomegalovirus: One-Year Longitudinal Comparison with GJB2-Related Hearing Loss.
文献信息
| PMID | 42940602 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Sara Ghiselli |
| 作者单位 | Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy. |
| 期刊 | Children (Basel, Switzerland) |
| SCI 分区 | Q1 |
| IF | 2.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景/目的： 先天性巨细胞病毒（cCMV）感染是儿童感音神经性听力损失的主要原因，并可能累及外周和中枢听觉通路。本研究以GJB2相关听力损失为参照，探讨cCMV相关听力损失患儿人工耳蜗（CI）调机参数的纵向变化，包括MRI可检测的脑异常的影响。方法：这项回顾性多中心研究纳入56例儿童（89只植入耳），分为cCMV组、cCMV异常组（伴MRI异常）和GJB2组。在开机时及开机后1、3、6和12个月评估结局，采用纵向混合效应模型，以参与者和嵌套于参与者内的耳作为随机截距。结果：eCAP、阻抗、C和T电平以及动态范围均发现显著的组别×时间交互作用。校正后的eCAP差异具有时间特异性，而非在整个随访期间一致。C和T电平未显示显著的校正组间对比，动态范围仅在1个月时于cCMV组与GJB2组之间存在差异。助听听阈（aided PTA）随时间改善，且cCMV组优于其他组。CAP评分随时间改善，cCMV异常组低于GJB2组和cCMV组。结论：CI调机参数在不同病因组之间呈现不同的纵向模式，但大多数组间差异具有时间特异性。MRI异常与较差的功能性听觉表现相关，而非一致的 eletrophysiological 特征。因此，在随访过程中应联合解读客观调机指标、助听听阈和功能性听觉表现。
英文摘要
Background/Objectives: Congenital cytomegalovirus (cCMV) infection is a major cause of paediatric sensorineural hearing loss and may involve peripheral and central auditory pathways. This study investigated longitudinal cochlear implant (CI) fitting parameters in children with cCMV-related hearing loss, including the influence of MRI-detectable brain abnormalities, using GJB2-related hearing loss as a reference. Methods: This retrospective multicentre study included 56 children (89 implanted ears) divided into cCMV, altered cCMV (with MRI abnormalities), and GJB2 groups. Outcomes were evaluated at activation and 1, 3, 6, and 12 months after activation using longitudinal mixed-effects models with participant and ear nested within participant as random intercepts. Results: Significant group-by-time interactions were identified for eCAP, impedance, C and T levels, and dynamic range. Adjusted eCAP differences were time-specific rather than uniform throughout follow-up. C and T levels showed no significant adjusted between-group contrasts, and dynamic range differed only between cCMV and GJB2 at 1 month. Aided PTA improved over time and was better in the cCMV group than in the other groups. CAP scores improved over time and were lower in the altered cCMV group than in both the GJB2 and cCMV groups. Conclusions: CI fitting parameters followed different longitudinal patterns across aetiological groups, but most between-group differences were time-specific. MRI abnormalities were associated with poorer functional auditory performance rather than a uniform electrophysiological profile. Objective fitting measures, aided audibility, and functional auditory performance should therefore be interpreted jointly during follow-up.