手动与机器人辅助插入技术下听力保留随角度插入深度的变化
Hearing Preservation as a Function of Angular Insertion Depth With Manual Versus Robotic-Assisted Insertion Techniques.
文献信息
| PMID | 42956820 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Carlos A Perez-Heydrich |
| 作者单位 | Department of Otolaryngology/Head and Neck Surgery. |
| 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： 本研究回顾了接受人工耳蜗植入的听力保留候选者在采用手动或机器人辅助插入电极阵列后的低频听力早期变化，并评估了角度插入深度（AID）、术前听力和年龄等可能的 contributing 因素。
患者： 接受直电极阵列手动或机器人辅助插入人工耳蜗植入的成人听力保留候选者（≥18岁，250 Hz处≤70 dB HL）。
主要结局指标： 低频纯音平均听阈（125、250和500 Hz）由术前及术后最初数周内获得的无助听阈值计算得出。查询的数据包括术中及人工耳蜗激活时测量的阻抗值，以及最顶端电极触点的AID。
结果： 在120例（66例女性）中，92例接受手动插入（中位年龄=69.0岁，四分位距=63.5至79.0），28例接受机器人辅助插入（中位年龄=67.0岁，四分位距=60.9至76.3）。患者接受23、24、26、28或31.5 mm电极阵列。机器人辅助插入（P=0.028）、较浅的AID（P=0.010）和较年轻患者（P=0.001）的低频纯音平均听阈偏移显著更小。插入组与AID之间存在显著交互作用（P=0.010），机器人辅助插入在AID超过490°时表现出更好的听力保留。术中及人工耳蜗激活时，插入组间阻抗值无显著差异。
结论： 与手动插入相比，机器人辅助电极阵列插入可能有助于更好的早期听力保留，尤其是对于电极阵列置于更深AID的患者。
证据等级： IV级；回顾性队列研究。
英文摘要
OBJECTIVE: This study reviewed the early shifts in low-frequency hearing for cochlear implant (CI) hearing preservation candidates who underwent cochlear implantation using either manual or robotic-assisted insertion of the electrode array and evaluated possible contributing factors such as angular insertion depth (AID), preoperative hearing, and age.
PATIENTS: Adult CI hearing preservation candidates (≥18 yr, ≤70 dB HL at 250 Hz) who underwent cochlear implantation with a straight electrode array through a manual or robotic-assisted insertion.
MAIN OUTCOME MEASURES: A low-frequency pure tone average (125, 250, and 500 Hz) was calculated from the unaided thresholds obtained preoperatively and within the initial weeks following surgery. Queried data included impedance values measured intraoperatively and at CI activation, and the AID of the most apical electrode contact.
RESULTS: Of 120 cases (66 females), 92 underwent manual insertion (median age = 69.0 yrs, interquartile range = 63.5 to 79.0) and 28 underwent robotic-assisted insertion (median age = 67.0 yrs, interquartile range = 60.9 to 76.3). Patients received either a 23, 24, 26, 28, or 31.5 mm electrode array. Significantly less low-frequency pure tone average shift was observed for robotic-assisted insertions (P = 0.028), shallower AIDs (P = 0.010), and younger patients (P = 0.001). There was a significant interaction between insertion group and AID (P = 0.010), with robotic-assisted insertion demonstrating better hearing preservation at AIDs exceeding 490°. Impedance values did not differ significantly between insertion groups intraoperatively or at CI activation.
CONCLUSIONS: Robotic-assisted electrode array insertion may support better early hearing preservation compared with manual insertions, particularly for patients with electrode arrays placed at deeper AIDs.
LEVEL OF EVIDENCE: Level IV; retrospective cohort study.