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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Impact of electrode design and surgical approach on scalar location and cochlear implant outcomes
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Impact of electrode design and surgical approach on scalar location and cochlear implant outcomes

机译：电极设计和手术方法对标量位置和人工耳蜗植入结果的影响

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Objectives/Hypothesis: Three surgical approaches: cochleostomy (C), round window (RW), and extended round window (ERW); and two electrodes types: lateral wall (LW) and perimodiolar (PM), account for the vast majority of cochlear implantations. The goal of this study was to analyze the relationship between surgical approach and electrode type with final intracochlear position of the electrode array and subsequent hearing outcomes.Study Design: Comparative longitudinal study.Methods: One hundred postlingually implanted adult patients were enrolled in the study. From the postoperative scan, intracochlear electrode location was determined and using rigid registration, transformed back to the preoperative computed tomography which had intracochlear anatomy (scala tympani and scala vestibuli) specified using a statistical shape model based on 10 microCT scans of human cadaveric cochleae. Likelihood ratio chi-square statistics were used to evaluate for differences in electrode placement with respect to surgical approach (C, RW, ERW) and type of electrode (LW, PM).Results: Electrode placement completely within the scala tympani (ST) was more common for LW than were PM designs (89% vs. 58%; P<0.001). RW and ERW approaches were associated with lower rates of electrode placement outside the ST than was the cochleostomy approach (9%, 16%, and 63%, respectively; P<0.001). This pattern held true regardless of whether the implant was LW or PM. When examining electrode placement and hearing outcome, those with electrode residing completely within the ST had better consonant-nucleus-consonant word scores than did patients with any number of electrodes located outside the ST (P50.045).Conclusion: These data suggest that RW and ERW approaches and LW electrodes are associated with an increased likelihood of successful ST placement. Furthermore, electrode position entirely within the ST confers superior audiological outcomes.
机译：目的/假设：三种手术方法：耳蜗切开术（C），圆窗（RW）和扩展圆窗（ERW）;以及两种电极类型：侧壁（LW）和膜旁突（PM），占绝大多数的人工耳蜗植入。这项研究的目的是分析手术方法和电极类型与电极阵列最终的耳蜗内位置和随后的听力结果之间的关系。研究设计：纵向比较研究方法：研究纳入了一百名舌后植入的成年患者。从术后扫描中，确定耳蜗内电极的位置并使用刚性配准，然后转换回术前计算机体层摄影术，该术式计算机断层摄影术采用基于人类尸体耳蜗的10次microCT扫描的统计形状模型指定的耳蜗内解剖结构（鼓膜鼓室和前庭瘢痕）。可能性比卡方统计量用于评估相对于手术入路（C，RW，ERW）和电极类型（LW，PM）的电极放置差异。结果：将电极完全放置在ty鼓内（ST） LW比PM设计更常见（89％vs. 58％; P <0.001）。与耳蜗切开术相比，RW和ERW方法与ST外电极放置率较低相关（分别为9％，16％和63％; P <0.001）。无论植入物是LW还是PM，此模式均适用。在检查电极放置和听力结果时，那些完全位于ST内的电极比在ST之外具有任意数量的电极的患者具有更好的辅音-核辅音单词评分（P50.045）。结论：这些数据表明RW ERW方法和LW电极与成功放置ST的可能性增加相关。此外，电极完全位于ST内可提供更好的听觉效果。

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