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
2010年
10期
812-817
,共6页
杨仕明%李佳楠%冀飞%陈艾婷%洪梦迪%戴朴%郗昕%韩东一%翟所强
楊仕明%李佳楠%冀飛%陳艾婷%洪夢迪%戴樸%郗昕%韓東一%翟所彊
양사명%리가남%기비%진애정%홍몽적%대박%치흔%한동일%적소강
耳蜗植入术%老年人%听觉丧失%耳外科手术
耳蝸植入術%老年人%聽覺喪失%耳外科手術
이와식입술%노년인%은각상실%이외과수술
Cochlear implantation%Aged%Hearing loss%Otologic surgical procedures
目的 探索人工耳蜗在双耳重度或极重度聋和全聋的老年患者中的临床应用安全性和效果.方法 2008年11月至2009年11月解放军总医院先后对8例50岁以上患者行人工耳蜗植入术,其中男5例,女3例;年龄52～76岁,中位数58岁.所有患者术前均为双侧极重度感音神经性听力损失,佩戴助听器无效或效果不佳.观察患者手术耐受及并发症情况.开机后3个月进行助听听阈评估和言语评估.结果 8例患者手术顺利,术中神经反应遥测均引出反应.术后康复顺利,无任何并发症.开机3个月后声场内言语频率平均助听听阈啭音(听力级)为35～50 dB,但言语测听结果个体差异较大.部分患者单音节、双音节、安静及噪声环境下的句子可实现较好识别率.结论 老年前期及老年患者可耐受全身麻醉状态下的人工耳蜗植入,只要术前准备充分则为安全的手术,但部分病例为中耳炎(胆脂瘤)或颞骨外伤等因素导致,需要特别注意中耳情况.老年重度以上听力损失患者人工耳蜗植入可明显改善言语识别能力.
目的 探索人工耳蝸在雙耳重度或極重度聾和全聾的老年患者中的臨床應用安全性和效果.方法 2008年11月至2009年11月解放軍總醫院先後對8例50歲以上患者行人工耳蝸植入術,其中男5例,女3例;年齡52～76歲,中位數58歲.所有患者術前均為雙側極重度感音神經性聽力損失,珮戴助聽器無效或效果不佳.觀察患者手術耐受及併髮癥情況.開機後3箇月進行助聽聽閾評估和言語評估.結果 8例患者手術順利,術中神經反應遙測均引齣反應.術後康複順利,無任何併髮癥.開機3箇月後聲場內言語頻率平均助聽聽閾囀音(聽力級)為35～50 dB,但言語測聽結果箇體差異較大.部分患者單音節、雙音節、安靜及譟聲環境下的句子可實現較好識彆率.結論 老年前期及老年患者可耐受全身痳醉狀態下的人工耳蝸植入,隻要術前準備充分則為安全的手術,但部分病例為中耳炎(膽脂瘤)或顳骨外傷等因素導緻,需要特彆註意中耳情況.老年重度以上聽力損失患者人工耳蝸植入可明顯改善言語識彆能力.
목적 탐색인공이와재쌍이중도혹겁중도롱화전롱적노년환자중적림상응용안전성화효과.방법 2008년11월지2009년11월해방군총의원선후대8례50세이상환자행인공이와식입술,기중남5례,녀3례;년령52～76세,중위수58세.소유환자술전균위쌍측겁중도감음신경성은력손실,패대조은기무효혹효과불가.관찰환자수술내수급병발증정황.개궤후3개월진행조은은역평고화언어평고.결과 8례환자수술순리,술중신경반응요측균인출반응.술후강복순리,무임하병발증.개궤3개월후성장내언어빈솔평균조은은역전음(은력급)위35～50 dB,단언어측은결과개체차이교대.부분환자단음절、쌍음절、안정급조성배경하적구자가실현교호식별솔.결론 노년전기급노년환자가내수전신마취상태하적인공이와식입,지요술전준비충분칙위안전적수술,단부분병례위중이염(담지류)혹섭골외상등인소도치,수요특별주의중이정황.노년중도이상은력손실환자인공이와식입가명현개선언어식별능력.
Objective To explore the safety and efficacy of cochlear implantation among elderly patients with severe to profound hearing loss. Methods Eight pre-elderly and elderly patients with an medium age of 58 years who suffered from bilateral severe to profound sensorineural hearing loss received cochlear implantation between November 2008 and November 2009. The patients' tolerance to implant surgery and the occurrence of complications were observed. Three months after switch-on, aided threshold and speech performance were measured. Results The surgery was uneventful in all cases with normal intraoperative neural response telemetry elicited. Three months after switch-on, average aided threshold across speech frequencies was 35 -50 dB HL measured in sound field with warble tone. The results of speech audiometry showed large variation between individuals. Some patients achieved good performance in monosyllable recognition test, disyllables threshold test and sentences recognition test under both bubble noise and quiet conditons. Conclusions Pre-elderly and elderly patients can endure a state of general anesthesia for cochlear surgery without complications. Cochlear implant can provide reconstruction of speech recognition capabilities for elderly patients suffering from severe to profound hearing loss. Cochlear implantation can improve the quality of life of elderly patients with hearing loss.
