乳突根治术后人工耳蜗植入患者再植入病例分析

Case Analysis of Cochlear Implant Reimplantation after Radical Mastoidectomy

王琪妹;王林娥;龚树生;韩曙光;刘攀;朱桢;张斯;

1:首都医科大学附属北京友谊医院耳鼻咽喉头颈外科

摘要

目的分析乳突根治术后人工耳蜗植入(CI)患者因电极脱落行人工耳蜗再植入的原因及手术方法。方法 2017年5月至2020年10月对3例乳突根治术后行CI的患者行人工耳蜗再植入术,分析其再植入的原因、手术方法、术后并发症及听觉言语康复效果。结果 3例患者均因耳蜗电极脱出乳突根治术腔,其中2例因"挖耳"致电极脱出,1例原因不清,复查时发现。3例患者均同侧耳顺利再植入电极,其中2例取腹部脂肪行术腔填塞、外耳道封闭,1例保留原开放式术腔,用骨粉和肌骨膜瓣加固覆盖电极。人工耳蜗再植入术后6个月,3例患者听觉行为分级(CAP)得分分别为9、6、7分,言语可懂度分级(SIR)得分均为5分,有意义听觉整合量表(MAIS)得分均为40分;听力均恢复至再植入前水平;2例患者随访超1年,1例患者随访7个月,均未再出现电极脱出,无术腔感染、面瘫、胆脂瘤复发、外耳道盲端裂开等并发症。结论乳突根治术后人工耳蜗再植入手术应根据患者具体情况,选择合适的手术方式;术中要注意保护面神经等重要结构,尽早选择同侧耳再植入,可以避免对患者听觉言语康复效果的影响。

关键词

乳突根治术;人工耳蜗再植入;电极脱出

基金项目(Foundation):

作者

王琪妹;王林娥;龚树生;韩曙光;刘攀;朱桢;张斯;

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