匈牙利首例下一代“智能”人工耳蜗（Cochlear™ Nucleus® Nexa™）的引入：我们的早期经验

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中文摘要

引言： 塞格德大学阿尔伯特·圣捷尔吉医学院耳鼻咽喉头颈外科于1995年完成了首例人工耳蜗植入。此后，我机构共实施了1077例植入手术。2025年6月25-26日，我科完成了匈牙利首例Cochlear™ Nucleus® Nexa™系统的植入。制造商将该装置介绍为全球首款“智能”人工耳蜗。
目的： 本研究旨在总结匈牙利Nexa™植入的早期经验，这可能代表现代人工耳蜗技术的一个新里程碑。
方法： 两名感音神经性听力损失患者——一名11岁儿童和一名56岁女性——接受了左侧新型植入系统的人工耳蜗植入。两例手术均采用标准经乳突入路，随后行后鼓室切开及圆窗入路。术中电生理测量，包括阻抗测试、跨阻抗矩阵测量、电诱发镫骨肌反射阈值测量和神经反应遥测，用于评估装置和电极功能。
结果： 两例手术均顺利完成，无并发症。术中测量证实植入物功能适当，两例患者术后病程均平稳。外部声音处理器的首次激活和调机遵循与既往系统相似的工作流程，并补充了植入电子装置的编程。两例的初始编程和调机均无技术困难完成，早期听力学经验良好。
讨论： Nexa™系统的新颖之处在于内部单元的 future 可升级性、植入物层面的数据管理，以及支持术中监测和长期护理的新技术解决方案。基于我们的初步经验，该植入系统可以安全地整合到既有的手术和听力学工作流程中。
结论： Nexa™系统在匈牙利的首次使用可能代表匈牙利人工耳蜗护理的一项重要技术进步。其可升级架构可能使接受者受益于未来的技术发展。Orv Hetil. 2026; 167(44): 1778-1784。

英文摘要

INTRODUCTION: The first cochlear implantation at the Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Albert Szent-Györgyi Medical School, University of Szeged, was performed in 1995. Since then, 1077 implantations have been carried out at our institution. On 25-26 June 2025, we performed the first Hungarian implantations of the Cochlear™ Nucleus® Nexa™ system at our department. The manufacturer presents this device as the world's first "smart" cochlear implant.
OBJECTIVE: The aim of our study was to summarize the early experience with Nexa™ implantations in Hungary, which may represent a new milestone in modern cochlear implant technology.
METHOD: Two patients with sensorineural hearing loss - an 11-year-old child and a 56-year-old woman - underwent left-sided cochlear implantation with the new implant system. Both procedures were performed through a standard transmastoid approach, followed by posterior tympanotomy and round-window access. Intraoperative electrophysiological measurements, including impedance testing, transimpedance matrix measurement, electrically evoked stapedius reflex threshold measurement and neural response telemetry, were used for device and electrode function assessment.
RESULTS: Both operations were completed without complications. Intraoperative measurements confirmed appropriate implant function, and the postoperative course was uneventful in both patients. Initial activation and fitting of the external sound processor followed a workflow similar to that used with previous systems, supplemented by programming of the implanted electronics. Initial programming and fitting were completed without technical difficulties in both cases, and the early audiological experience was favorable.
DISCUSSION: The novelty of the Nexa™ system lies in the future upgradeability of the internal unit, implant-level data management, and new technological solutions supporting intraoperative monitoring and long-term care. Based on our initial experience, the implant system can be safely integrated into established surgical and audiological workflows.
CONCLUSION: The first Hungarian use of the Nexa™ system may represent an important technological advance in cochlear implant care in Hungary. Its upgradeable architecture may allow recipients to benefit from future technological developments. Orv Hetil. 2026; 167(44): 1778-1784.