内耳畸形与耳蜗骨化患者的耳蜗植入

Cochlear implant in patients with congenital malformation of inner ear and cochlear ossification

目的探讨先天性内耳畸形与耳蜗骨化患者耳蜗植入术的有关问题。方法对我院2002年10月～2004年2月间行耳蜗植入术的8例内耳畸形和2例耳蜗骨化的患者进行回顾性分析。结果4例大前庭水管综合征患者术中有外淋巴液搏动;3例Mondini畸形和1例共同腔畸形患者术中出现井喷;1例耳蜗部分骨化患者术中误将电极插入内听道后纠正;另一例耳蜗部分骨化患者植入短电极。1例Mondini畸形患者术后发生少量脑脊液耳鼻漏,保守治疗3月后痊愈,其余患者无并发症。所有患者均成功开机。结论对于内耳畸形或耳蜗骨化的患者,耳蜗植入术前详细的影像学评估,对术中困难的充分估计和正确。

Objective To explore the problems associated with cochlear implant in patients with inner ear malformations or cochlear ossification.Method Retrospective review of 10 cochlear implant cases with inner ear malformations or cochlear ossification from October 2002 to February 2004. Results 4 patients with enlarged vestibular aqueduct (EVA) had slight leakage of perilymph, while 3 patients with Mondini malformation and 1 patient with common cavity experienced cerebrospinal fluid gushers , however, the electrodes were inserted successfully .In one patient with cochlear ossification, the electrode was misplaced into inner auditory canal at first, and was reinserted into cochlea finally.In another, short electrode was applied.All patients were programmed successfully.1 patient with Mondini malformation experienced leakage of cerebrospinal fluid postoperatively and was cured after 3 months.Conclusions Cochlear implantation can be successfully performed in patients with inner ear malformations and cochlear ossification.Preoperative detailed radiological evaluation and intraoperative exactly performing are essential factors of the successful operation.