CAJ | 학술논문

目的：探讨伴分泌性中耳炎的极重度聋患者一期行人工耳蜗植入术的可行性及术后听觉言语康复效果，并总结其护理体会。方法对11例伴分泌性中耳炎的极重度聋儿童一期行人工耳蜗植入，术中彻底清除中耳乳突病变黏膜，建立通畅引流后植入人工耳蜗电极，结合围手术期药物治疗、护理、听觉言语康复训练，术后定期随访，评估人工耳蜗植入后听觉与言语康复效果。结果11例患儿均一期完成单耳人工耳蜗植入，其中右耳8例，左耳3例；植入人工耳蜗型号：Nucleus 24 CA 7例，Clarion AB 90K 1例，Med el Combi 40＋2例，pulsar 1例，术中电极神经遥测均引出神经反应动作电位；术后一月开机，正常调机后均获得满意的主观听性反应，助听下0．25～4 kHz声场听阈为20～45 dB HL ；术后随访13～60个月，11例患儿人工耳蜗工作状态正常，分泌性中耳炎均痊愈；术后听觉言语康复效果满意，11例均进入普通幼儿园或小学学习。结论伴有分泌性中耳炎的极重度聋患者术前做好充分准备后可尽早行人工耳蜗植入，围手术期合理的治疗、护理及术后听觉言语康复有利于获得良好效果。
목적：탐토반분비성중이염적겁중도롱환자일기행인공이와식입술적가행성급술후은각언어강복효과，병총결기호리체회。방법대11례반분비성중이염적겁중도롱인동일기행인공이와식입，술중철저청제중이유돌병변점막，건립통창인류후식입인공이와전겁，결합위수술기약물치료、호리、은각언어강복훈련，술후정기수방，평고인공이와식입후은각여언어강복효과。결과11례환인균일기완성단이인공이와식입，기중우이8례，좌이3례；식입인공이와형호：Nucleus 24 CA 7례，Clarion AB 90K 1례，Med el Combi 40＋2례，pulsar 1례，술중전겁신경요측균인출신경반응동작전위；술후일월개궤，정상조궤후균획득만의적주관은성반응，조은하0．25～4 kHz성장은역위20～45 dB HL ；술후수방13～60개월，11례환인인공이와공작상태정상，분비성중이염균전유；술후은각언어강복효과만의，11례균진입보통유인완혹소학학습。결론반유분비성중이염적겁중도롱환자술전주호충분준비후가진조행인공이와식입，위수술기합리적치료、호리급술후은각언어강복유리우획득량호효과。
Objective To study the feasibility and rehabilitation outcomes of one -stage cochlear implantation (CI) in profound deaf children with secretory otitis media (SOM ) .Methods A total of 11 profound deaf children with soal receired one -soage unilateral cochlear implantation with a follow -up period from 13~60 months .In-flamed mucosa in the mastoid as well as exudates were removed radical1y at the time of implantation for adequate drainage of the middle ear .After the sugery ,the patients were followed up and the hearing and rehabilitating out-comes were eveluated .Results All 11 patients were successfully operated with 8 cases in the right ear and 3 cases in the left ear .Among them ,7 cases were nucleus 24 CA ,1 case losa clarion AB 90 K ,2 cases were medel combi 40+and 1 case was pulsar .All patients were successfully operated .No infectious complications occurred .No recurrence of secretory otitis media was observed .After initial stimulation and post regular fitting ,the status of the implant-able devices were all stable .All the implantees had satisfied hearing and entered normal kindergartens or schools . Conclusion Profound deaf pediatric patients with SOM are not an absolute contraindication for CI .With sufticient pre-operation preparontion ,proper trentment and nursing .Cochlear implantation should be condnote as early as possible better rehabilitation performance .