CAJ | 학술논문

目的探讨中国聋儿采用耳道上径路耳蜗植入的手术方法 .方法 2005年5月至2007年1月为50例(53侧)极重度感音性聋患儿采用耳道上径路行耳蜗植入.电极通过上鼓室的隧道于砧骨体与鼓索神经之间植入耳蜗鼓阶.结果 53侧手术电极全部植入者51侧;1例患儿(1侧)因耳蜗骨化只植入9对电极(Med-E1 C40+);另1例患儿(1侧)因耳蜗重度发育不良仅植入8对电极(Med-E1 C40+),该患儿术中发生井喷,植入电极时取出了砧骨并切断鼓索神经.1例患儿因鼓索神经与砧骨不易分离,电极经上鼓室隧道沿鼓索神经外侧植入鼓阶.所有病例术后无严重并发症发生.所有患儿耳蜗植入术后声场测听(听力级)均在30～40 dB;50例患儿随访均达6个月以上,其中26例具开放环境下的言语辨别力,己可进行交流;18例患儿可以讲短句,交流不太清楚;6例患儿只会讲单词.结论耳道上径路耳蜗植入术是一种简单、安全的技术,中耳腔暴露好,不需要行乳突、面隐窝切开,无误伤面神经、鼓索神经的危险,尤其适用于面隐窝狭窄或面神经前移的患儿.
목적 탐토중국롱인채용이도상경로이와식입적수술방법 .방법 2005년5월지2007년1월위50례(53측)겁중도감음성롱환인채용이도상경로행이와식입.전겁통과상고실적수도우침골체여고색신경지간식입이와고계.결과 53측수술전겁전부식입자51측;1례환인(1측)인이와골화지식입9대전겁(Med-E1 C40+);령1례환인(1측)인이와중도발육불량부식입8대전겁(Med-E1 C40+),해환인술중발생정분,식입전겁시취출료침골병절단고색신경.1례환인인고색신경여침골불역분리,전겁경상고실수도연고색신경외측식입고계.소유병례술후무엄중병발증발생.소유환인이와식입술후성장측은(은력급)균재30～40 dB;50례환인수방균체6개월이상,기중26례구개방배경하적언어변별력,기가진행교류;18례환인가이강단구,교류불태청초;6례환인지회강단사.결론 이도상경로이와식입술시일충간단、안전적기술,중이강폭로호,불수요행유돌、면은와절개,무오상면신경、고색신경적위험,우기괄용우면은와협착혹면신경전이적환인.
Objective To investigate the technique of the suprameatal approach for cochlear implantation in Chinese profound sensory heating loss children.Methods Suprameatal approach for cochlear implantation were used in 50 cases(total 53 ears)with profound sensory hearing loss from May 2005 to January 2007.The electrode was passed through the suprameatal tunnel and went between the incus and chorda tympani into the scala tympani.Results Electrodes were completely inserted in 51 ears.There were no postoperative complications in all cases.Although the long effect need to be observed,all cases received better heating and speech development benefit from cochlear implantation in the follow-up period.Among the 50 cases,26 had speech perception in the open condition;18 patients could speak short sentences although not clearly;and 6 patients learned to speak individual words only.Conclusions The suprameatal approach was found to be a simple and safe technique that does not need mastoidectomy and avoid endangeting the facial nerve and the chorda tympani.It enables wide exposure of middle ear and is especially suitable for cases with narrow facial recess or anteriorly located facial nerve.