Purpose

To assess the role of flat panel computed tomography (FPCT) in the evaluation of cochlear implant (CI) electrode position and its relation to speech perception.

Methods

From March 2015 to March 2019, we retrospectively enrolled deaf subjects ≥ 18 years who underwent unilateral CI by one surgeon, imaged with FPCT and assessed with disyllabic words score before CI and at 6 months of follow-up. We calculated the disyllabic score difference before CI and after CI (ΔSDS) and divided the subjects in favorable and unfavorable outcome groups using the median ΔSDS as a cutoff. We compared the demographic, clinical, electrode characteristics, and the CI positioning variables scalar position, surgical insertion depth (SID), linear insertion depth (LID), angular insertion depth (AID) and wrapping factor (WF).

Results

We studied 50 subjects (F/M = 27/23; median age = 60.5 years, IQR: 50–70 years). The median ΔSDS was 80% (interquartile range [IQR]: 60–100%) in quiet and 80% (IQR: 47.5–100%) in noise. Of the subjects 23 demonstrated a favorable outcome and had earlier age at CI (median 52 years; IQR 45–67 years versus median 62 years; IQR: 56–71 years p = 0.032) and a significantly higher SID (median: 4.02 mm IQR: 3.00–5.35 mm versus median: 2.94 mm IQR: 2.06–3.90 mm; p = 0.029). No difference was found for LID (p = 0.977), AID (p = 0.302), and WF (p = 0.224). A logistic regression model built with the age at CI, number of CI electrodes, and the SID was significant χ2 ((df = 3, N = 50) = 14.517, p = 0.002). The model explained 33.7% (Nagelkerke R2) of ΔSDS variance and correctly classified 76% of the cases.

Conclusion

The SID measured by FPCT predicts the ΔSDS at 6 months follow-up, alongside with age at implantation and number of CI electrodes.

中文翻译：

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人工耳蜗阵列放置对语音感知的影响

目的

评估平板计算机断层扫描 (FPCT) 在评估人工耳蜗 (CI) 电极位置及其与语音感知的关系中的作用。

方法

从 2015 年 3 月到 2019 年 3 月，我们回顾性招募了 18 岁以上的失聪受试者，他们接受了一名外科医生的单侧 CI，用 FPCT 成像，并在 CI 前和随访 6 个月时用双音节词评分进行评估。我们计算了 CI 之前和之后的双音节分数差异 (ΔSDS)，并使用中值 ΔSDS 作为截止值将受试者分为有利和不利的结果组。我们比较了人口统计学、临床、电极特征和 CI 定位变量标量位置、手术插入深度 (SID)、线性插入深度 (LID)、角度插入深度 (AID) 和包裹因子 (WF)。

结果

我们研究了 50 名受试者（F/M = 27/23；中位年龄 = 60.5 岁，IQR：50-70 岁）。安静时的 ΔSDS 中位数为 80%（四分位距 [IQR]：60-100%），噪音时为 80%（IQR：47.5-100%）。在受试者中，23 人表现出良好的结果，并且 CI 年龄较早（中位数 52 岁；IQR 45-67 岁，中位数 62 岁；IQR：56-71 岁p  = 0.032）和显着更高的 SID（中位数：4.02 mm IQR ：3.00-5.35 mm 与中位数：2.94 mm IQR：2.06-3.90 mm；p  = 0.029）。LID ( p  = 0.977)、AID ( p  = 0.302) 和 WF ( p  = 0.224)没有发现差异。使用 CI 年龄、CI 电极数量和 SID 建立的逻辑回归模型显着 χ2 ((df = 3, N  = 50) = 14.517,p  = 0.002)。该模型解释了 33.7% (Nagelkerke R2) 的 ΔSDS 方差并正确分类了 76% 的案例。

结论

FPCT 测量的 SID 可预测 6 个月随访时的 ΔSDS，以及植入时的年龄和 CI 电极的数量。