<meta charset="utf8"></head><body>Hearing Preservation with Long Electrodes in Electric-Acoustic Stimulation(전기-음향 자극에서 긴 전극을 사용한 청력 보존)

<ol>
	<li>Von Ilberg, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Electric-acoustic+stimulation+of+the+auditory+system.+New+technology+for+severe+hearing+loss.">Electric-acoustic stimulation of the auditory system. New technology for severe hearing loss.</a> ORL J Otorhinolaryngol Relat Spec. 61 (6), 334-340 (1999).</li><li>Gstoettner, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+new+electrode+for+residual+hearing+preservation+in+cochlear+implantation:+First+clinical+results.">A new electrode for residual hearing preservation in cochlear implantation: First clinical results.</a> Acta Otolaryngol. 129 (4), 372-379 (2009).</li><li>Moteki, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Feasibility+of+hearing+preservation+for+residual+hearing+with+longer+cochlear+implant+electrodes.">Feasibility of hearing preservation for residual hearing with longer cochlear implant electrodes.</a> Acta Otolaryngol. 138 (12), 1080-1085 (2018).</li><li>Usami, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Achievement+of+hearing+preservation+in+the+presence+of+an+electrode+covering+the+residual+hearing+region.">Achievement of hearing preservation in the presence of an electrode covering the residual hearing region.</a> Acta Otolaryngol. 131 (4), 405-412 (2011).</li><li>Usami, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hearing+preservation+and+clinical+outcome+of+32+consecutive+electric+acoustic+stimulation+(EAS)+surgeries.">Hearing preservation and clinical outcome of 32 consecutive electric acoustic stimulation (EAS) surgeries.</a> Acta Otolaryngol. 134 (7), 717-727 (2014).</li><li>Yoshimura, H., Moteki, H., Nishio, S. Y., Usami, S. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Electric-acoustic+stimulation+with+longer+electrodes+for+potential+deterioration+in+low-frequency+hearing.">Electric-acoustic stimulation with longer electrodes for potential deterioration in low-frequency hearing.</a> Acta Otolaryngol. 140 (8), 632-638 (2020).</li><li>Yoshimura, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Genetic+testing+has+the+potential+to+impact+hearing+preservation+following+cochlear+implantation.">Genetic testing has the potential to impact hearing preservation following cochlear implantation.</a> Acta Otolaryngol. 140 (6), 438-444 (2020).</li><li>Van de Heyning, P. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Systematic+literature+review+of+hearing+preservation+rates+in+cochlear+implantation+associated+with+medium-+and+longer-length+flexible+lateral+wall+electrode+arrays.">Systematic literature review of hearing preservation rates in cochlear implantation associated with medium- and longer-length flexible lateral wall electrode arrays.</a> Front Surg. 9, 893839 (2022).</li><li>Buchman, C. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Influence+of+cochlear+implant+insertion+depth+on+performance:+A+prospective+randomized+trial.">Influence of cochlear implant insertion depth on performance: A prospective randomized trial.</a> Otol Neurotol. 35 (10), 1773-1779 (2014).</li><li>Buchner, A., Illg, A., Majdani, O., Lenarz, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Investigation+of+the+effect+of+cochlear+implant+electrode+length+on+speech+comprehension+in+quiet+and+noise+compared+with+the+results+with+users+of+electro-acoustic-stimulation,+a+retrospective+analysis.">Investigation of the effect of cochlear implant electrode length on speech comprehension in quiet and noise compared with the results with users of electro-acoustic-stimulation, a retrospective analysis.</a> PLoS One. 12 (5), e0174900 (2017).</li><li>Canfarotta, M. W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-term+influence+of+electrode+array+length+on+speech+recognition+in+cochlear+implant+users.">Long-term influence of electrode array length on speech recognition in cochlear implant users.</a> Laryngoscope. 131 (4), 892-897 (2021).</li><li>Nassiri, A. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hearing+preservation+outcomes+using+a+precurved+electrode+array+inserted+with+an+external+sheath.">Hearing preservation outcomes using a precurved electrode array inserted with an external sheath.</a> Otol Neurotol. 41 (1), 33-38 (2020).</li><li>O'Connell, B. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Electrode+location+and+angular+insertion+depth+are+predictors+of+audiologic+outcomes+in+cochlear+implantation.">Electrode location and angular insertion depth are predictors of audiologic outcomes in cochlear implantation.</a> Otol Neurotol. 37 (8), 1016-1023 (2016).</li><li>Moteki, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-term+results+of+hearing+preservation+cochlear+implant+surgery+in+patients+with+residual+low+frequency+hearing.">Long-term results of hearing preservation cochlear implant surgery in patients with residual low frequency hearing.</a> Acta Otolaryngol. 137 (5), 516-521 (2017).</li><li>Von Ilberg, C. A., Baumann, U., Kiefer, J., Tillein, J., Adunka, O. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Electric-acoustic+stimulation+of+the+auditory+system:+A+review+of+the+first+decade.">Electric-acoustic stimulation of the auditory system: A review of the first decade.</a> Audiol Neurootol. 16, 1-30 (2011).</li><li>Ariyasu, L., Galey, F. R., Hilsinger, R., Byl, F. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Computer-generated+three-dimensional+reconstruction+of+the+cochlea.">Computer-generated three-dimensional reconstruction of the cochlea.</a> Otolaryngol Head Neck Surg. 100 (2), 87-91 (1989).</li><li>Danielian, A., Ishiyama, G., Lopez, I. A., Ishiyama, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Morphometric+linear+and+angular+measurements+of+the+human+cochlea+in+implant+patients+using+3-dimensional+reconstruction.">Morphometric linear and angular measurements of the human cochlea in implant patients using 3-dimensional reconstruction.</a> Hear Res. 386, 107874 (2020).</li><li>Kawano, A., Seldon, H. L., Clark, G. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Computer-aided+three-dimensional+reconstruction+in+human+cochlear+maps:+Measurement+of+the+lengths+of+organ+of+Corti,+outer+wall,+inner+wall,+and+Rosenthal's+canal.">Computer-aided three-dimensional reconstruction in human cochlear maps: Measurement of the lengths of organ of Corti, outer wall, inner wall, and Rosenthal's canal.</a> Ann Otol Rhinol Laryngol. 105 (9), 701-709 (1996).</li><li>Rask-Andersen, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Human+cochlea:+Anatomical+characteristics+and+their+relevance+for+cochlear+implantation.">Human cochlea: Anatomical characteristics and their relevance for cochlear implantation.</a> Anat Rec (Hoboken). 295 (11), 1791-1811 (2012).</li><li>Skarzynski, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Towards+a+consensus+on+a+hearing+preservation+classification+system.">Towards a consensus on a hearing preservation classification system.</a> Acta Otolaryngol Suppl. 564, 3-13 (2013).</li><li>Yoshimura, H., Watanabe, K., Nishio, S. Y., Takumi, Y., Usami, S. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Determining+optimal+cochlear+implant+electrode+array+with+OTOPLAN.">Determining optimal cochlear implant electrode array with OTOPLAN.</a> Acta Otolaryngol. 143 (9), 748-752 (2023).</li><li>Skarzynska, M. B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preservation+of+hearing+following+cochlear+implantation+using+different+steroid+therapy+regimens:+a+prospective+clinical+study.">Preservation of hearing following cochlear implantation using different steroid therapy regimens: a prospective clinical study.</a> Med Sci Monit. 24, 2437-2445 (2018).</li><li>Geerardyn, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Human+histology+after+structure+preservation+cochlear+implantation+via+round+window+insertion.">Human histology after structure preservation cochlear implantation via round window insertion.</a> Laryngoscope. 134 (2), 945-953 (2023).</li><li>Campbell, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intraoperative+real-time+cochlear+response+telemetry+predicts+hearing+preservation+in+cochlear+implantation.">Intraoperative real-time cochlear response telemetry predicts hearing preservation in cochlear implantation.</a> Otol Neurotol. 37 (4), 332-338 (2016).</li></ol>

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>DEXART 3.3 mg</td>
			<td>Fuji Pharma</td>
			<td>22100AMX01404</td>
			<td>equal to dexamethasone sodium phosphate (4 mg)</td>
		</tr>
		<tr>
			<td>DEXART 6.6 mg</td>
			<td>Fuji Pharma</td>
			<td>22100AMX01402</td>
			<td>equal to dexamethasone sodium phosphate (8 mg)</td>
		</tr>
		<tr>
			<td>Fentanyl injection 0.1 mg</td>
			<td>TERUMO</td>
			<td>22100AMX00009</td>
			<td></td>
		</tr>
		<tr>
			<td>MAESTRO 7.0</td>
			<td>MED-EL</td>
			<td>4582290238456</td>
			<td>fitting software for map settings</td>
		</tr>
		<tr>
			<td>Midas Rex MR8&#160;</td>
			<td>Medtronic</td>
			<td>301ADBZX00046000</td>
			<td>high speed drill</td>
		</tr>
		<tr>
			<td>OTOPLAN software</td>
			<td>Cascination / MED-EL</td>
			<td>REF 20125</td>
			<td>for measuring cochlear duct length (CDL)&#160;</td>
		</tr>
		<tr>
			<td>Predonine tablets</td>
			<td>Shionogi</td>
			<td>16000AMZ01740000</td>
			<td></td>
		</tr>
		<tr>
			<td>Propofol 1% 50 mL</td>
			<td>Maruishi Pharmaceutical Co.,Ltd</td>
			<td>30100AMX00158</td>
			<td></td>
		</tr>
		<tr>
			<td>Remifentanil 2 mg</td>
			<td>Daiichi-Sankyo</td>
			<td>22800AMX00090</td>
			<td></td>
		</tr>
		<tr>
			<td>Rocuronium bromide 50 mg/50 mL</td>
			<td>Maruishi Pharmaceutical Co.,Ltd</td>
			<td>22800AMX00534</td>
			<td></td>
		</tr>
		<tr>
			<td>SONNET2 EAS</td>
			<td>MED-EL</td>
			<td>4582290241807</td>
			<td>processor</td>
		</tr>
		<tr>
			<td>Synchrony2 FLEX28</td>
			<td>MED-EL</td>
			<td>4571573943026</td>
			<td>cochlear implant (electrode)</td>
		</tr>
		<tr>
			<td>Xylocaine 0.5% with epinephrine</td>
			<td>Sandoz Pharma</td>
			<td>4KUZ13127</td>
			<td></td>
		</tr>
	</tbody>
</table>

enhanced cochlear coverage and hearing preservation in high-frequency hearing loss via electric acoustic stimulation with longer electrode

Conventional cochlear implantation (CI) is a standard treatment for improving hearing ability in patients with severe-to-profound hearing loss (HL). Subsequently, electric-acoustic stimulation (EAS) is used to treat patients with severe high-frequency hearing loss and residual low-frequency hearing1. In such patients, preserving the residual acoustic hearing is important to achieve better speech perception in noise, sound localization, and improved sound quality when listening to music2. To address this,&#160;the use of&#160;shorter electrodes in EAS patients has been preferred to avoid interfering with the residual function in the acoustic region of the cochlea. However, our earlier studies3,4,5,6&#160;documented that even in EAS cases, less invasive CI surgery combined with thin, straight, and flexible &#34;longer&#34; electrodes enabled the preservation of residual hearing. Additionally, we reported that hearing preservation was unrelated to the length of the inserted cochlear implant electrode7, consistent with the systematic review8.
In patients who underwent conventional CI, longer electrodes led to better speech perception9,10,11&#160;as longer electrodes provide broader cochlear coverage and better place-pitch matching. Similarly, a&#160;correlation between a deeper angle of insertion (AID) and better hearing was reported12,13. In most EAS patients, the residual hearing gradually deteriorates over time14. Identifying the responsible gene for HL allows&#160;one to predict future hearing. When it is anticipated that their hearing would be lost across all frequencies in the future, EAS with longer electrodes, not shorter electrodes, is&#160;ideal in providing&#160;a higher percentage of cochlear coverage15. The optimal AID was thought to range from 630&#176; to 720&#176;16,17,18, corresponding to the distribution of spiral ganglion neurons in the human cochlea. However, as each cochlear duct length (CDL) has a wide range of variation19, measuring the CDL in each case was required to achieve the appropriate AID, even in EAS patients. Recently, commercially available software (see Table of Materials) allowed the measurment&#160;of each CDL easily based on computed tomography (CT) data, which was clinically feasible.
This protocol describes the following: (1) a preoperative evaluation that included genetic analysis to identify the etiology of HL and cochlear duct length measurement to determine the optimal electrode length, (2) a less invasive surgical procedure via exoscopy and endoscopy, and (3) the postoperative hearing outcome and mapping strategy in patients with high-frequency HL who underwent EAS with a longer electrode.

<meta charset="utf8"></head><body>저자 스포트라이트: 달팽이관 적용 범위 및 청력 보존을 위해 긴 전극으로 EAS 최적화

더 긴 전극을 사용한 전기 음향 자극을 통한 고주파 청력 손실에서 향상된 달팽이관 적용 범위 및 청력 보존

Electric acoustic stimulation with longer electrodes can offer a broader cochlear coverage and various type of map in case of high-frequency hearing loss. We are working on a safer approach to EAS surgery using less invasive techniques, flexible electrodes and steroid administration. This allows deeper insertion with minimal surgical trauma, preserving hearing well.Our earlier studies showed even in EAS cases, this invasive CI surgery combined with thin, straight, and flexible longer electrode enabled the preservation of acoustic hearing. Additionally, we reported that the hearing preservation scores were independent of the length of the inserted electrode are consistent with the systematic review. As most patient gradually lose residual hearing due to the natural cause of hearing loss, in these cases, providing broader cochlear coverage using longer electrode was beneficial for better place-pitch matching.Advanced surgical techniques and steroid administration are important to minimize surgical trauma. Additionally, we think EAS with longer electrodes was useful not only to prepare for future hearing deterioration, but also to offer a couple of types of maps, map strategies. Identification of the etiology of hearing loss using genetic analysis is essential for predicting the future audiogram.

Electric-acoustic stimulation (EAS) is a promising treatment to improve hearing ability in patients with high-frequency hearing loss (HL). In EAS ...

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Research

Enhanced Cochlear Coverage and Hearing Preservation in High-Frequency Hearing Loss via Electric Acoustic Stimulation with Longer Electrode

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Medicine

418 조회수.  Shinshu University School of Medicine. 더 긴 전극을 사용한 전기 음향 자극은 고주파 난청의 경우 더 넓은 달팽이관 범위와 다양한 유형의 MAP를 제공할 수 있습니다. 우리는 덜 침습적인 기술, 유연한 전극 및 스테로이드 투여를 사용하여 EAS 수술에 대한 보다 안전한 접근 방식을 연구하고 있습니다. 이를 통해 외과적 외상을 최소화하면서 더 깊게 삽입할 수 있어 청력을 잘 보존할 수 있?...