Tricuspid regurgitation associated with cardiac implantable electronic devices (CIED) constitutes a significant subset of secondary tricuspid regurgitation, characterized by a multifactorial etiology involving pacing lead-mediated mechanical interference and CIED-related systemic factors. The pathogenesis of CIED-related tricuspid regurgitation encompasses direct mechanical trauma or functional disruption of the tricuspid valve apparatus by pacing leads, pacing mode-induced hemodynamic alterations, and clinical risk factors such as permanent atrial fibrillation, apical pacing, and high right ventricular pacing burden. The natural progression and clinical outcomes of CIED-related tricuspid regurgitation parallel those of tricuspid regurgitation stemming from other etiologies. Advanced imaging modalities, including echocardiography, cardiac computed tomography, and cardiac magnetic resonance imaging, enable precise diagnosis and longitudinal assessment of CIED-related tricuspid regurgitation. Management strategies emphasize multidisciplinary collaboration as well as integration of preventive approaches-such as refined lead implantation techniques and tailored pacing modalities-with therapeutic interventions ranging from pharmacotherapy to surgical valve repair or replacement. This article reviews the current understanding of CIED-related tricuspid regurgitation to provide a reference for clinical practice and research.
Tricuspid Valve Insufficiency/diagnosis* ; Humans ; Defibrillators, Implantable/adverse effects* ; Pacemaker, Artificial/adverse effects*

OBJECTIVE: To investigate the efficacy of 3D-printed navigation guided pudendal lead implantation on nervous regulation of lower urinary tract symptoms（LUTS） in male patients. METHODS: Twenty-eight male patients who underwent perineal nervous regulation treatment for LUTS in Gongli Hospital of Pudong New Area from October 2021 to October 2023 were randomly divided into observation group and control group. The technology assisted with 3D-printed navigation to regulate the genital nerves was used in observation group. And the patients in control group were treated with regulation of the genital nerves by routine puncture. Operation time of puncture, number of surgical punctures, and stimulator debugging time compared between the two groups. The improvement of postoperative symptoms and surgical complications of patients in the observation group were recorded as well. RESULT: A total of 12 male LUTS patients were included in the observation group, with an average age of 36.5±6.5 years, including 7 cases of frequent micturition, 3 cases of perineal pain, and 2 cases of dysuria. Four patients showed no significant improvement in symptoms, including two patients with pain and two cases of frequent micturition who did not undergo secondary surgery. While the other eight patients showed significant improvement in symptoms. The average time for successful puncture in control group was (21.13 ± 4.53) minutes, which was longer than that of the 3D-printed navigation group (［10.32 ± 3.42］ min) significantly (P<0.05). The average number of punctures in the ordinary puncture group was 5.62 ± 1.43, which was significantly higher than that in the 3D-printed navigation group (1.5 ± 0.56). There was no statistically significant difference in the average time for stimulator debugging between the two groups of patients. The conversion rate of the 3D-printed navigation group in the second phase was 66.7%, which was higher than that (37.5%) significantly (P<0.05). CONCLUSION 3D printing navigation of pudendal nerve electrode wire implantation can improve the accuracy of electrode implantation and the conversion rate to a certain extent, which has the advantages of reducing the difficulty of surgery.
Humans ; Male ; Printing, Three-Dimensional ; Lower Urinary Tract Symptoms/surgery* ; Adult ; Pudendal Nerve ; Middle Aged ; Electrodes, Implanted

In the YY 0989.3-2023 standard, clause 27.106 specifies the protection test against electromagnetic interference, but it only briefly describes the test level for electromagnetic exposure, and does not detail the parameters of the torso. This study aims to explore the internal field distribution for different torso parameters under electromagnetic exposure, and explore the patterns of field distribution through modeling and simulation. The results indicate that the parameters of the torso significantly affect the internal field distribution. The findings of this study provide a basis and reference for the electromagnetic compatibility test for implantable neurostimulator products.
Electromagnetic Fields ; Implantable Neurostimulators ; Computer Simulation

Phantom limb pain (PLP) is a form of neuropathic pain occurring after limb amputation, and its underlying mechanisms remain unclear, posing significant challenges for clinical management. Spinal cord stimulation (SCS), a neuromodulation technique, has shown potential in relieving chronic pain, though its long-term efficacy and safety in treating PLP require further validation. This report presents a case of a 42-year-old male experiencing persistent radiating, lightning-like pain [Visual Analog Scale (VAS) score 8-9], following right upper limb amputation. Preoperative imaging revealed signal loss in the right nerve roots at C₆-T₁. A percutaneous electrode was implanted surgically to achieve full coverage of the painful region. Five days postoperatively, the VAS score dropped to 2-3, and after 1 year of follow-up, the patient continued to experience significant pain relief (VAS 1-2), with complete resolution of depressive symptoms and cessation of analgesic medication. Existing studies suggest that the long-term outcomes of SCS may fluctuate, and attention should be paid to potential complications such as infection and electrode displacement.
Humans ; Phantom Limb/therapy* ; Male ; Adult ; Spinal Cord Stimulation/methods* ; Electrodes, Implanted ; Amputation, Surgical/adverse effects*

Cochlear nerve deficiency（CND） is a rare inner ear malformation characterized by a hypoplastic or absent cochlear nerve, resulting in variable hearing loss or total deafness, depending on the quantity of nerve fibers present. About 18% of congenital hearing loss are associated with CND. It is a disease of uncertain cause. The outcome of auditory implant in CND patients varies widely. This article will discuss the related issues of CND.
Humans ; Cochlear Nerve/abnormalities* ; Cochlear Implants ; Child ; Cochlear Implantation/methods* ; Deafness ; Hearing Loss

Objective:This study aims to investigate the perception of Mandarin aspirated and unaspirated consonants by children with cochlear implants （CIs） under quiet and noisy conditions. It also examines factors that may affect their acquisition, such as auditory conditions, place of articulation, manner of articulation, chronological age, age at implantation, and non-verbal intelligence. Methods:Twenty-eight CI children aged 3 to 5 years who received implantation from 2018 to 2023 were recruited. Additionally, 88 peers with normal hearing （NH） were recruited as controls. Both groups participated in a perception test for aspirated/unaspirated consonants under quiet and noisy conditions, along with tests for speech recognition, speech production, and non-verbal intelligence. The study analyzed the effects of group （CI vs. NH）, auditory condition, and consonant characteristics on children's perception of aspirated/unaspirated consonants in Mandarin, as well as the factors contributing to CI children's acquisition of these consonants. Results:①CI children's ability to perceive aspirated/unaspirated consonants was significantly poorer than that of their NH peers （χ²= 14.16, P<0.01）, and their perception accuracy was influenced by the acoustic features of consonants （P<0.01）; ②CI children's consonant perception abilities were adversely affected by noise （P<0.01）, with accuracy in noisy conditions particularly influenced by the manner of articulation （P<0.05）; ③The age at implantation significantly affected CI children's ability to perceive aspirated/unaspirated consonants （β= -0.223, P=0.012）, with earlier implantation associated with better performance. Conclusion:It takes time for CI children to acquire Mandarin aspirated/unaspirated consonants, and early implantation shows many advantages, especially for the perception ability of fine speech features.
Humans ; Cochlear Implants ; Child, Preschool ; Speech Perception ; Cochlear Implantation ; Male ; Female ; Language

Objective:Over the past decades, minimally invasive cochlear implantation（CI） have achieved significant advancements, evolving from initial emphasis on incision miniaturization to comprehensive strategies for preserving intracochlear structures and functions, as well as optimizing overall minimally invasive surgical procedure. However, current academic debates persist regarding standardized definitions and consensus on technical protocols. Future research should prioritize innovations in surgical-assistive robots, refinement of hidden cochlear implant, and exploration of drug deliver electrodes. These efforts aim to advance surgical methodologies toward enhanced minimally invasive approaches, functional preservation, and personalized therapeutic interventions.
Humans ; Cochlear Implantation/trends* ; Minimally Invasive Surgical Procedures/trends* ; Cochlear Implants

Objective:To evaluate the perioperative safety and long-term complications of simultaneous bilateral cochlear implantation（BCI） in young infants, providing reference data for clinical BCI in young children. Methods:Seventy-four infants aged 6-23 months with congenital severe to profound sensorineural hearing loss who were candidates for cochlear implantation at the Department of Otolaryngology, Chinese PLA General Hospital between August 2018 and August 2019 were consecutively enrolled. Parents made the decision to implant either unilaterally or bilaterally. Participants were divided into unilateral cochlear implantation（UCI） group（before and after 12 months of age） and simultaneous BCI group（before and after 12 months of age）. Safety indicators, including perioperative risk variables, complications, and other postoperative adverse events were monitored, with complications followed up for 5-6 years. Comparisons were made between the BCI and UCI, as well as between implantation before and after 12 months of age regarding perioperative safety and long-term complications. Results:A total of 40 BCI patients（23 before 12 months, 17 after 12 months） and 34 UCI patients（20 before 12 months, 14 after 12 months） were included in the study. Regarding perioperative risk variables, the BCI group showed significantly longer anesthesia duration, operative time, and greater blood loss compared to the UCI group, though less than twice that of the UCI group; no anesthetic complications occurred in either group; and there was no significant difference in postoperative hospital stay between the groups. Regarding surgical complications during the 5-year follow-up period, the BCI group experienced 7 complications（2 major, 5 minor）, while the UCI group had 7 complications（1 major, 6 minor）, with no statistical differences between groups. Regarding other postoperative adverse events, the BCI group demonstrated significantly higher total adverse event rates than the UCI group（80.0% vs 38.2%）, with higher rates of moderate to severe anemia（60.0% vs 20.6%） and lower mean hemoglobin levels[（92.35±12.14） g/L vs（102.39±13.09） g/L]. No significant differences were found in postoperative fever rates（50.0% vs 52.9%） or C-reactive protein levels between groups. Within the BCI group, patients implanted before 12 months indicated notably higher rates of total adverse events（91.3% vs 64.7%）, high fever（26.1% vs 0）, and moderate to severe anemia（78.3% vs 35.3%） compared to those implanted after 12 months. Conclusion:Simultaneous BCI in young children under 2 years of age demonstrates controllable overall risks. Compared to UCI, while it shows no increase in anesthetic or surgical complications, it presents higher perioperative risks and adverse event rates, especially in patients implanted before 12 months of age, warranting special attention from medical staff.
Humans ; Cochlear Implantation/methods* ; Infant ; Postoperative Complications ; Hearing Loss, Sensorineural/surgery* ; Follow-Up Studies ; Male ; Perioperative Period ; Female ; Cochlear Implants

Objective:The aim of this study was to present an institution's experience with cochlear reimplantation（CRI）, to assess surgical challenges and post-operative outcomes and to increase the success rate of CRI. Methods:We retrospectively evaluated data from 76 reimplantation cases treated in a tertiary center between 2001 and 2022. Clinical features include caused of CRI, type of failure, surgical issues, and auditory speech performance were analyzed. Categorical Auditory Performance （CAP） and Speech Intelligibility Rating （SIR） scores were used to evaluate pre-and post-CRI outcomes. Our center's consecutive cohort of 1 126 patients had seven patients, while 69 patients were from other cochlear implant centers. Device failure was the most common cause of CRI（68/76）, with the remaining cases including flap complications（3/76）, magnet displacement（3/76）, secondary meningitis（1/76）, and foreign bodies around the implant（1/76）. Postoperative auditory and speech outcome improved in 31.6%（24/76） of patients, remained unchanged in 63.2%（48/76）, and decreased in CAP and SIR scores in 5.2%（4/76） of patients. Postoperatively, the seven patients with cochlear ossification and fibrosis scored lower on the overall CAP and SIR scale than non-ossification individuals, which is a significant factor in surgical success rates and auditory-speech outcomes. Conclusion:CRI surgery is a challenging but relatively safe procedure, and most reimplanted patients experience favorable postoperative outcomes. Medical complications and intracochlear damage are the main causes of poor postoperative results. Therefore, minimally invasive CI has a positive significance for reducing the difficulty of CRI surgery and improving the CI performance.
Humans ; Cochlear Implantation/methods* ; Retrospective Studies ; Cochlear Implants ; Male ; Female ; Postoperative Period ; Treatment Outcome ; Adult ; Speech ; Middle Aged ; Postoperative Complications ; Replantation ; Cochlea/surgery*

Objective:To investigate the application value of intraoperative electrocochleography（ECochG） monitoring technique and insertion techniques in cochlear implant（CI） and analyze its relationship with postoperative residual hearing（RH） preservation. Methods:Thirty-one patients（35 ears） who received CI in our hospital from June 2022 to July 2024 were enrolled. The Advanced Bionics Active Insertion Monitoring（AIM） system was used for real-time ECochG monitoring during surgery. Intraoperative cochlear microphonics （CM） waveform changes were recorded and analyzed in relation to postoperative RH preservation. Results:①ECochG recordings were successfully obtained in 34 of 35 ears （97.1%）. ②According to Harris classification, there were 7 ears（20.6%） of Type A（rising）, 7 ears（20.6%） of Type C（declining）, 8 ears（23.5%） of Type CC（fluctuating）, and 12 ears（35.3%） of Type D（no response）. ③The total CM amplitude decrease was significantly moderately correlated with postoperative low-mid frequency hearing loss（r=0.67, P=0.017）. The total CM amplitude decrease was significantly moderately correlated with postoperative low frequency hearing loss（r=0.65, P=0.023）. ④For the mean amplitude variation, the Amax was 30.70 μV, the Amin was 8.64 μV, and the Aend was 18.27 μV. ⑤Sixteen cases completed postoperative follow-up, with an average low-mid frequency（125-1 000 Hz） residual hearing loss of 15.25 dB HL and a RH preservation rate of 87.5%. Conclusion:Intraoperative ECochG monitoring can effectively predict postoperative residual hearing changes, effectively guide surgical manipulation, and improve residual hearing preservation rate.
Humans ; Cochlear Implantation/methods* ; Audiometry, Evoked Response ; Cochlear Implants ; Male ; Female ; Adult ; Middle Aged ; Monitoring, Intraoperative ; Adolescent ; Young Adult ; Minimally Invasive Surgical Procedures ; Child ; Aged ; Postoperative Period