CAJ | 학술논문

目的探讨人工耳蜗植入手术中有效保护面神经和鼓索神经的方法.方法102例人工耳蜗植入患者,其中男65例,女37例,右侧72例,左侧30例.手术采取经耳后乳突进路轮廓面神经和鼓索神经,确定该神经的解剖标志后明视下予以保护,其中两例由于面神经、鼓索神经和外耳道骨壁的解剖关系变异使位于圆窗平面的面神经与鼓索神经之间的距离过窄而影响开窗,故将此部位鼓索神经周围的骨质磨除,使鼓索神经悬浮并推向前方,从而顺利行鼓阶钻孔电极植入.结果102例患者的面神经和鼓索神经均得到了完整有效的保护,均一次顺利将电极植入鼓阶.结论:经乳突进路轮廓面神经和鼓索神经的方法在人工耳蜗植入手术中安全有效,有望降低该神经损伤的发生率,值得临床应用.
목적탐토인공이와식입수술중유효보호면신경화고색신경적방법.방법102례인공이와식입환자,기중남65례,녀37례,우측72례,좌측30례.수술채취경이후유돌진로륜곽면신경화고색신경,학정해신경적해부표지후명시하여이보호,기중량례유우면신경、고색신경화외이도골벽적해부관계변이사위우원창평면적면신경여고색신경지간적거리과착이영향개창,고장차부위고색신경주위적골질마제,사고색신경현부병추향전방,종이순리행고계찬공전겁식입.결과102례환자적면신경화고색신경균득도료완정유효적보호,균일차순리장전겁식입고계.결론:경유돌진로륜곽면신경화고색신경적방법재인공이와식입수술중안전유효,유망강저해신경손상적발생솔,치득림상응용.
Objective To identify methods for effective protection of the facial nerve and chorda tympani during co?chlear implantation procedures. Methods One hundred and two cases of cochlear implantation (male=65 and female=37, right=72 and left=30) were reviewed. Post-auricular approach was used in these cases and the facial nerve and chorda tympani were visualized after mastoidectomy for protection. In two cases, aberrant anatomy of the facial nerve, chorda tym?pani and external ear canal led to extremely narrow space between the facial nerve and chorda tympani that hindered expo?sure of the round window. Bony structures around the chorda tympani had to be removed and the chorda tympani suspended and displaced forward in these cases for safe insertion of the electrode into the scala tympani. Results The facial nerve and chorda tympani were completely protected and electrode successfully implanted to the scala tympani in all 102 cases. Conclusion Identification of the facial nerve and chorda tympani is safe and effective in protecting the nerves during co?chlear implantation via mastoidectomy. This will help reduce incidence of facial nerve and chorda tympani injury and should be adopted by more surgeons.