CAJ | 학술논문

目的：探讨神经纤维瘤听力下降患者人工耳蜗植入手术可行性及疗效。方法对一例多发性神经纤维瘤伽马刀术后患者带瘤行CS-10A人工耳蜗植入，术前和术后3个月分别进行裸耳/助听听阈评估、单音节和双音节言语识别测试。结果患者术前右侧重度、左侧极重度感音神经性聋，术前言语识别率左耳最大声输出患者无反应，右耳最大单音节词言语识别率为12%，双耳双音节词言语识别率均为0%。听觉行为分级量表为2级。患者右侧成功植入人工耳蜗。术后3个月助听后声场评估右耳（人工耳蜗植入耳）平均听力42.5 dB HL，单音节词最大言语识别率为64%，双音节词最大言语识别率为47%，听觉行为分级量表为7级。结论在影像学证明听神经完整的情况下，神经纤维瘤伽马刀术后重度聋患者可植入人工耳蜗，以提升听力水平。
목적：탐토신경섬유류은력하강환자인공이와식입수술가행성급료효。방법대일례다발성신경섬유류가마도술후환자대류행CS-10A인공이와식입，술전화술후3개월분별진행라이/조은은역평고、단음절화쌍음절언어식별측시。결과환자술전우측중도、좌측겁중도감음신경성롱，술전언어식별솔좌이최대성수출환자무반응，우이최대단음절사언어식별솔위12%，쌍이쌍음절사언어식별솔균위0%。은각행위분급량표위2급。환자우측성공식입인공이와。술후3개월조은후성장평고우이（인공이와식입이）평균은력42.5 dB HL，단음절사최대언어식별솔위64%，쌍음절사최대언어식별솔위47%，은각행위분급량표위7급。결론재영상학증명은신경완정적정황하，신경섬유류가마도술후중도롱환자가식입인공이와，이제승은력수평。
Objective To explore the safety and efficacy of cochlear implantation in a neuroma resection patient with hearing loss. Methods One patient after bilateral acoustic neuroma resection by Gamma knife surgery received a CS-10A cochlear implant in right ear. Postoperative performance including unaided/aided hearing thresholds and monosyllable and disyllable recognition rates was evaluated and compared with the preoperative performance. Results The patient suffered a severe hearing loss in the right ear and a profound hearing loss in the left ear. The preoperative monosyllable recognition rates were 0% and 12% for the left and right ear, respectively. The preoperative disyllable recognition rates were 0% for both ears. The preoperative CAP score was 2. Three months after cochlear implantation, the average aided hearing threshold of the right ear (implanted ear) was 42.5 dB HL. The postoperative monosyllable recognition rate was 64% and disyllable recognition rate was 47%. The postoperative CAP score was 7. Conclusion Cochlear implantation is a safe and effective approach to improve the hearing of patients after acoustic neuroma resection by Gamma knife surgery if the acoustic nerve is intact according to the preoperative imaging tests.