loading大前庭水管综合征患儿人工耳蜗植入术8例
临床分析
【摘要】 目的 评判大前庭水管综合征患者人工耳蜗植入术的平安性和成效。方式 大前庭水管综合征患者8例为内耳畸形组,其中语前聋6例,语后聋2例,以8例耳蜗发育正常的植入者作为对照组,进行手术及术后成效对照。结果 8例患者人工耳蜗电极植入顺利,7例耳蜗底回开窗时发生井喷,迅速用颞肌筋膜牢固封锁开窗处制止井喷。全数患者术后未显现脑脊液漏、颅内感染、面瘫、中耳炎等并发症,畸形组与对照组术中和术后并发症不同无显著性意义。术后听阈畸形组多数患者达到30~45 dBHL,与内耳正常对照组相似,经统计学分析不同无显著性(P>,听觉语言康复成效畸形组多数与对照组接近。结论 大前庭水管综合征患者在人工耳蜗植入术中易发生井喷,术中可控,术后未显现并发症,所观看患者术后听力及语言康复成效中意,因此,大前庭水管综合征患者行人工耳蜗植入术是平安有效的。
【关键词】前庭水管;畸形;耳蜗植入;听力障碍康复
【Abstract】 Objective To evaluate the intraoperative safe and post-operative effect of cochlear implantation in children with large vestibularaqueduct 8 patients with large vestibular
aqueduct
syndrome(cochlear
malformation
group)received cochlear postoperative effect of8 cases with cochlear malformation were compared with 8 cases with norma
lcochlea(control group).Results Via cochleostomy pulsatile clear fluid gusher occurred in 7 cases,which were easily controlled by quickly inserting the electrode array and sealing the cochleostomy with muscle tissue in each implant was inserted without difficulty in all have been no post-operatively
complications,Post-operative
hearing
threshold of most cases were 30~45 dBHL,which similar with normal was no statistically significan difference between the group of malformation and the control group(P>,most of them received the similar hearing and speech recovering benefit from cochlear implantation opatients with normal inner Despite pulsatile clear fluid gusher in cochlear implantation,no post-operatively complications have been found,and the outcome of these 8 patients with cochlear implantation was implantation can be safely and effectively performed in patients with profound sensorineural hearing loss associated with large vestibular aqueduct syndrome
【Key words】
Vestibular aqueduct; Abnormalities; Cochlear
Implantation; Rehabilitation of hearing impaire
内耳畸形曾经是人工耳蜗植入的禁忌证,最近几年来,随着对
内耳畸形的解剖学、病理学和病因学研究的深切,此类患者耳蜗植入后成效也愈来愈受到确信[1-3]。大前庭水管综合征(large vestibular aqueduct syndrome,LVAS)是较常见的先本性内耳畸形,在儿童感音神经性聋中,LVAS 患者的比率高达13%~14%,男女发病率存在不同,约为1:1,显现进行性阶梯性感音神经性听力下降,最终常进展为重-极重度聋[4]。既往有学者期望通过内耳手术(如前庭水管阻塞术)阻止听力的进一步恶化,但实践证明这些手术大多无效[5]。当本病进展成极重度感音神经性聋时,人工耳蜗植入术是目前有效的听力康复方式。自2002年5月至2020年9月,我科为8例大前庭水管综合征患者实施人工耳蜗植入手术,经观看成效中意,报告如下。
1 资料与方式
临床资料 术前均行颞骨高分辨率CT 扫描,在CT图像上测量前庭导水管的宽度,选择内外口中点前后径的距离来测量,正常宽度在~ mm 之间,当大于 mm 时即被以为前庭水管扩大。
LVAS畸形组8例均为双侧前庭导水管扩大,其中单纯LVAS患者6例,LVAS归并Mondini畸形2例。随机选择同年龄段,重度感音神经性聋但耳蜗结构正常的患者8例,作为对照组。
LVAS畸形组:患者年龄~8岁,平均岁,男6例,女2例;6例为语前聋,2例为语后聋。全数患者均因听力障碍就医,2例在2~3岁可不能说话时才引发家长注意。4例佩带助听器后成效不明显,4例佩带助