中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2008年
7期
514-518
,共5页
李永新%梁爽%赵啸天%郑军%陈雪清%孔颖%刘博%刘莎%莫玲燕%张华%韩德民
李永新%樑爽%趙嘯天%鄭軍%陳雪清%孔穎%劉博%劉莎%莫玲燕%張華%韓德民
리영신%량상%조소천%정군%진설청%공영%류박%류사%막령연%장화%한덕민
耳蜗植入术%骨化%异位性%电极%植入%康复%听力障碍
耳蝸植入術%骨化%異位性%電極%植入%康複%聽力障礙
이와식입술%골화%이위성%전겁%식입%강복%은력장애
Cochlear implantation%Ossification,heterotopic%Electrodes,implanted%Rehabilitation of hearing impaired
目的 探讨耳蜗骨化状态下人工耳蜗植入手术的经验及分析术后效果.方法 北京同仁医院自1996年开展多道人工耳蜗植入手术以来,截止到2006年12月已开展手术600余例,遇到双侧耳蜗骨化患者7例.其中4例有明确的脑膜炎病史,3例耳蜗骨化原因不明.3例为耳蜗完全骨化;1例鼓阶完全骨化,前庭阶未受累;1例耳蜗部分骨化;2例耳蜗部分纤维化.总结术前、术中及术后的处理原则、方法及术后康复效果.结果 1例术中出现镫井喷,但比其他内耳畸形术中出现镫井喷的程度轻微;4例电极完全插入耳蜗内,2例植入部分电极,1例家属放弃植入;术后无面神经麻痹、脑脊液瘘等并发症;术后开机调试发现部分患者T值、C值比正常形态耳蜗植入偏高(因病例数量少未做统计学分析),但听阈无明显区别.术后语训听力及言语能力均有不同程度的提高.结论 对于耳蜗部分骨化患者,术中只要将其骨化成分自鼓阶内清除后可顺利植入电极;对于完全骨化患者可以将围绕蜗轴的鼓阶顶壁钻开,将电极嵌入骨槽内即可.脑膜炎后出现重度感音性聋应考虑耳蜗骨化的可能,常规颞骨CT及MRI检查,一旦确诊应尽快手术,以免耳蜗完全骨化.人工耳蜗植入术可以作为伴有耳蜗骨化的深度感音性聋患者的治疗和康复手段.
目的 探討耳蝸骨化狀態下人工耳蝸植入手術的經驗及分析術後效果.方法 北京同仁醫院自1996年開展多道人工耳蝸植入手術以來,截止到2006年12月已開展手術600餘例,遇到雙側耳蝸骨化患者7例.其中4例有明確的腦膜炎病史,3例耳蝸骨化原因不明.3例為耳蝸完全骨化;1例鼓階完全骨化,前庭階未受纍;1例耳蝸部分骨化;2例耳蝸部分纖維化.總結術前、術中及術後的處理原則、方法及術後康複效果.結果 1例術中齣現鐙井噴,但比其他內耳畸形術中齣現鐙井噴的程度輕微;4例電極完全插入耳蝸內,2例植入部分電極,1例傢屬放棄植入;術後無麵神經痳痺、腦脊液瘺等併髮癥;術後開機調試髮現部分患者T值、C值比正常形態耳蝸植入偏高(因病例數量少未做統計學分析),但聽閾無明顯區彆.術後語訓聽力及言語能力均有不同程度的提高.結論 對于耳蝸部分骨化患者,術中隻要將其骨化成分自鼓階內清除後可順利植入電極;對于完全骨化患者可以將圍繞蝸軸的鼓階頂壁鑽開,將電極嵌入骨槽內即可.腦膜炎後齣現重度感音性聾應攷慮耳蝸骨化的可能,常規顳骨CT及MRI檢查,一旦確診應儘快手術,以免耳蝸完全骨化.人工耳蝸植入術可以作為伴有耳蝸骨化的深度感音性聾患者的治療和康複手段.
목적 탐토이와골화상태하인공이와식입수술적경험급분석술후효과.방법 북경동인의원자1996년개전다도인공이와식입수술이래,절지도2006년12월이개전수술600여례,우도쌍측이와골화환자7례.기중4례유명학적뇌막염병사,3례이와골화원인불명.3례위이와완전골화;1례고계완전골화,전정계미수루;1례이와부분골화;2례이와부분섬유화.총결술전、술중급술후적처리원칙、방법급술후강복효과.결과 1례술중출현등정분,단비기타내이기형술중출현등정분적정도경미;4례전겁완전삽입이와내,2례식입부분전겁,1례가속방기식입;술후무면신경마비、뇌척액루등병발증;술후개궤조시발현부분환자T치、C치비정상형태이와식입편고(인병례수량소미주통계학분석),단은역무명현구별.술후어훈은력급언어능력균유불동정도적제고.결론 대우이와부분골화환자,술중지요장기골화성분자고계내청제후가순리식입전겁;대우완전골화환자가이장위요와축적고계정벽찬개,장전겁감입골조내즉가.뇌막염후출현중도감음성롱응고필이와골화적가능,상규섭골CT급MRI검사,일단학진응진쾌수술,이면이와완전골화.인공이와식입술가이작위반유이와골화적심도감음성롱환자적치료화강복수단.
Objective To explore the problems and describe clinical experiences associated with multichannel cochlear implantation in patients with cochlear ossification.Methods Seven cochlear implant cases with bilateral cochlear ossification from 1996 to 2006 in Beijing Tongren Hospital were retrospectivly reviewed,4 of which were the consequence of meningitis.Three patients'cochlear were completely ossified,1 patient's tympanic scala was completely ossified,1 patient's cochlear was partially ossified,and 2 patients'cochlear were partially fibrotic.This article addressed the components of the preoperative evaluation,surgcal decision-making,and specific techniques for cochlear implant array insertion in all kinds of ossified cochlea.Results Gusher was foond in 1 case but less serious than that with inner ear malformations.The electrodes were inserted in the cochleostomy in full length in 4 cases,1 case gave up,and the cochlear implant array were partially inserted in the remains.No serious complications occurred after implantation.All patients had auditory sensations.The impedance of the electrodes,the T level,C level and the heating threshold were slightly higher than that of the normal cochlear implantation.Conclusions The key influencing factor of ossified cochlear patients were the degree of the disease and whether the electrode implanted completely or not.So,the profound sensorineural hearing loss patients after meningitis should be paled more attention.Patients with ossified cochlear could be benefit from cochlear implantation.
