A Meta-analysis of cochlear implantation in deafness patients with Mondini malformation
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摘要: 目的 通过比较Mondini畸形与内耳结构正常聋病患者的人工耳蜗植入效果，明确人工耳蜗植入术能否成为Mondini畸形聋病患者重建听力的有效方式，从而指导临床工作。方法 在PubMed、医知网、维普医学、万方数据、中国医院知识书仓(CHKD)、中国知网(CNKI)等电子数据库进行文献检索关于Mondini畸形和内耳结构正常的耳聋患者术后康复效果的病例对照研究，使用RevMan 5.3软件对原始数据进行Meta分析。结果 11篇文章被纳入研究，共包括1 371例患者。Meta分析显示Mondini畸形患者术中并发症发生率(Z=6.62，P < 0.01)、电极反应T值(Z=6.08，P < 0.01)、术后听阈(500、1 000、2 000Hz)均高于对照组，而神经反射遥测(Z=3.44，P < 0.01)、听觉行为分级标准(CAP)评分(Z=5.27，P < 0.01)均低于对照组，术后并发症(Z=1.01，P>0.05)、言语可懂度分级标准SIR评分(Z=1.41，P>0.05)与对照组比较差异无统计学意义。结论 人工耳蜗植入术可以成为Mondini畸形的聋病患者的治疗和康复手段，为听力重建提供必要条件。更长随访期和更大样本的多参数对照研究将会增加人工耳蜗植入对Mondini畸形聋病患者疗效的可信度。Abstract: Objective To compare the efficacy of cochlear implantation in deaf patients with Mondini malformation and normal anatomical structure of inner ear, and to determine whether cochlear implantation can be an effective way to reconstruct hearing in hearing loss patients with Mondini malformation, so as to guide clinical work.Method Literature search was conducted on PubMed, YZ365. com, Wip medicine, Wanfang data, CHKD, CNKI and other electronic databases to search case control studies on postoperative rehabilitation effect of deafness patients with Mondini deformity and normal structure of inner ear. Execute Meta-analysis by using RevMan 5.3 software.Result Eleven articles were included and 1 371 patients were involved. Meta-analysis showed that the probability of Mondini abnormalities in patients with intraoperative complications(Z=6.62, P < 0.01), electrode reaction T value(Z=6.08, P < 0.01), postoperative hearing threshold(500 Hz, 1 000 Hz and 2 000 Hz) is greater than the control group, neural response telemetry(Z=3.44, P < 0.01) and categories of auditory performance score(Z=5.27, P < 0.01) is lower than the control group, about postoperative complications(Z=1.01, P>0.05) and speech intelligibility rating score(Z=1.41, P>0.05) there was no statistically significant difference with the control group.Conclusion Cochlear implantation can be a mean of treatment and rehabilitation for deafness patients with Mondini deformity, and is necessary for hearing reconstruction. Further multi-parameter controlled studies with longer follow-up periods and larger samples will increase the credibility for the efficacy of cochlear implants in deafness patients with Mondini malformation.
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Key words:
- Mondini malformation /
- cochlear implantation /
- Meta analysis
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表 1 文献质量评价表
作者 年份 Mondini畸形组 正常对照组 例数 结局指标 评分 王斌等[9] 2017 31 20 51 A B C D E F G 8 李永新等[8] 2004 15 15 30 A B C E H 7 王林娥等[6] 2005 19 10 29 A B C H 7 万良财等[7] 2010 12 12 24 A B C H 7 陈艳丹等[13] 2017 6 43 49 A B H 7 韩德民等[14] 2004 12 100 112 A B C D H 7 陈秀兰等[11] 2015 7 21 28 C H 6 Qi等[5] 2018 108 592 700 G H 6 高芳芳等[10] 2018 41 233 274 F G 6 张宏征等[12] 2011 12 30 42 A B H 6 胥亮等[15] 2017 8 24 32 A B 6 A：术中并发症；B：术后并发症；C：术后听阈；D：NTR；E：T值；F：CAP；G：SIR；H：其他言语康复水平测试。 
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