再次人工耳蜗植入术

Cochlear reimplantation

目的 通过总结6例再次人工耳蜗植入术中所发现的问题,总结经验并探讨注意事项。方法 与常规的人工耳蜗植入术基本相同,采用“H”型切口切开肌骨膜,有助于缩短手术时间。结果 全部病例均能顺利地再次完全植入电极,再次手术的原因有1例是首次手术未能植入正确的部位;1例是外伤造成植入体断裂;4例植入体不能正常工作,但原因不明。结论 手术切口不宜过小;参照电极应该放在骨膜下;固定植入体的骨床周围要光滑;不要使用不可吸收的缝线;要在抽出旧电极后迅速植入新电极;开机后需要3-4周的时间适应新的电极。

Objective To analyze retrospectively the outcome of 6 cases of cochlear reimplantation to summarize its experience. Methods The operation method of cochlear reimplantation was similar to routine cochlear implantation. A 'H' incision for the muscle-periosteum was used to shorten the operation time. Results Of all the cases, the electrodes are successfully and totally inserted into the cochlea The causes for revision are different. The electrode was found to be not in the proper situ of the cochlea after the first operation in one patient. The out part was ruptured because of trauma in another patient. The causes of the other four patients were unknown. Conclusions The incision should not be too small. The control electrode should be put beneath the periosteum. The site used to fix up the out part need be burnished. Unabsorpted suture should do not be used. It is important to insert the new electrode quickly after drawing the old one out. The time to accommodate the new electrode often needs 3-4 weeks.