34例人工耳蜗植入术后再次手术患者的原因和处理方法分析

Causes and Treatment Methods of Reoperation after Cochlear Implantation in 34 Patients

孙春晖;温立婷;陈俊;查定军;胡鹏刚;许敏;邱建华;

1:空军军医大学西京医院耳鼻咽喉头颈外科

摘要

目的分析人工耳蜗植入术后再次手术患者的原因及处理方法。方法回顾性分析2009年1月～2017年12月1 693例接受人工耳蜗植入术后再次手术的34例(2.01%,34/1 693)患者的临床资料,分析导致再次手术的原因及处理方法。结果 34例中,皮下积液、感染12例(0.71%,12/1 693),皮瓣感染坏死4例(0.24%,4/1 693),植入体移位7例(0.41%,17/1 693),人工耳蜗损坏、故障5例(0.30%,5/1 693),外耳道后壁穿孔2例(0.12%,2/1 693),脑脊液耳漏2例(0.12%,2/1 693),异位植入1例(0.06%,1/1 693),排异反应1例(0.06%,1/1 693)。12例皮下积液、感染的患者均行切开引流、清理病变后保留人工耳蜗;4例皮瓣感染坏死患者均行皮瓣转移修复术,3例取出人工耳蜗并于对侧植入新人工耳蜗,1例保留人工耳蜗;7例植入体移位的患者5例手术复位,2例取出人工耳蜗,其中1例同侧再次植入人工耳蜗;5例人工耳蜗损坏、故障的患者均取出损坏的人工耳蜗,同侧重新植入同型号新人工耳蜗;2例外耳道后壁穿孔的患者均行外耳道后壁修补术,1例取出人工耳蜗,1例保留,均于对侧植入新人工耳蜗;2例脑脊液耳漏的患者堵塞耳蜗造瘘口后均取出人工耳蜗;1例异位植入的患者重新植入新人工耳蜗;1例排异反应的患者清理病灶后保留人工耳蜗。结论人工耳蜗植入术后再次手术的原因有患者自身原因、植入体原因及人工耳蜗植入手术原因,需根据不同原因进行相应的处理。

关键词

人工耳蜗植入术;并发症;再次手术

基金项目(Foundation):

作者

孙春晖;温立婷;陈俊;查定军;胡鹏刚;许敏;邱建华;

参考文献

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孙春晖温立婷陈俊查定军胡鹏刚许敏邱建华