摘要
目的探讨小儿微创圆窗入路人工耳蜗植入的可行性及关键手术技巧。方法回顾性分析2011年10月到2013年10月接受微创人工耳蜗植入术的56例患儿（年龄6个月~5岁8个月,平均14.9±3.5个月）的临床资料,其中54例行微创圆窗植入,描述术中的圆窗暴露方式并统计并发症;对于14例术前有一定残余听力的患儿（250、500、或1 000Hz三个频率中至少一个频率的纯音听阈≥75dB HL）,记录术前及术后的250、500及1 000Hz的纯音测听或行为测听听阈图,术后听力保护程度以完全保护（听力损失≤10dB）、中度损失（听力损失约11~20dB）、重度损失（听力损失约21~40dB）或无听力（听力损失〉40dB或最大声刺激无反应）为标准,统计分析残余听力保存率。结果 96.4%（54/56）的小儿使用微创圆窗入路顺利全植入人工耳蜗电极,随访5~28个月,所有小儿植入装置工作良好,3例（3/54,5.56%）发生小的并发症：2例为术区皮瓣肿胀,一周后治愈,1例并发周围性面瘫,3月后痊愈;术后残余听力完全保护8例（57.14%,8/14）,3例为中度听力损失（21.43%,3/14）,术后较术前低频听力平均损失10.5dB,中频听力平均损失12dB。结论微创圆窗入路人工耳蜗植入术安全有效,面隐窝开放技术有利于圆窗的暴露,有一定残余听力的儿童人工耳蜗植入后其残余听力可得到完全或部分保护。
Objective To discuss the feasibility of round window membrane（RWM）approaches and the key surgical techniques of CI with round window（RW）insertion in children with profound sensorineural hearing loss.Methods The prospective study included 56patients（October 2013 to October 2011）.Cochlear implantation electrode insertion was performed using a RW insertion in 54 patients.The minimal access technique and soft technique were performed in all children.Postoperative complications were evaluated in all RWM approaches.Pre-implant and post-implant pure tone thresholds and pure tone average（PTA）were calculated from unaided pre-and postoperative audiograms from 250,500,and 1 000 Hz in 14 patients.Hearing preservation rates were determined.Results CI was performed in a total of 56 children.Of these,54children（96.4%）had round window insertion.All children had full insertions of the electrode array,in which the CI went normally and the electrode array was protected well.All implant devices worked normally and all patients performed well during an average follow-up period of 5~28months.No major complications were encountered.Complete hearing preservation was achieved in 8/14patients（57.14%）,while 3/14（21.43%）had moderate hearing loss.Conclusion Cochlear implantation can be performed safely and effectively in children by minimal access surgery with RW insertion.Facial recess open technology may facilitate round window exposure in some children.
出处
《听力学及言语疾病杂志》
CAS
CSCD
北大核心
2016年第1期67-70,共4页
Journal of Audiology and Speech Pathology
基金
江苏省科教兴卫重点医学人才基金(RC2011028)
卫生部行业科研专项基金(201202005)
江苏省省级重点研发专项资金资助(BE2015608)联合资助
关键词
人工耳蜗植入
儿童
圆窗
听力保护
Cochlear implant
Pediatric
Round window
Hearing preservation
