人工耳蜗植入的临床分析

Clinical Analysis of Cochlear Implantation

目的探讨人工耳蜗植入术的适应证选择、手术方法与技巧及术后言语康复对疗效的影响。方法21例双耳重度或极重度感音神经性聋病人,经乳突-面隐窝入路行Nucleus 24导或Clarion C1人工耳蜗植入术。对适应证选择、听力学和影像学评估、术后听力言语康复等资料进行随访及总结分析。结果成功植入20例,其中1例术后4个月发生感染,1例术后出现内淋巴瘘,颞骨CT示电极位置不正确。术后1月开机调试,20例均能听到声音,均获得不同程度的听觉言语康复。结论手术适应证的选择、听力学及影像学评估是人工耳蜗植入术成功的重要前提,手术设备和手术技巧及方法是手术成功的关键,而术后调机及言语康复训练则是人工耳蜗植入效果的保证。

Objective To study the evaluation of the indications, surgical procedures and skills and systematic audition and speech skill rehabilitation trainings of cochlear implantation. Methods 21 bilateral severe or profound sensorineural deaf patients were enrolled in this study. All of them were implanted multichannel cochlear （model Nucleus 24 or Clarion C1） through facial nerve recess approach. To analyse the surgical indications, assessments by audiology and aural image, audition and speech or language skill re- habilitation trainings after surgery. Results All the 21 patients were implanted successfully, 1 patient had postoperative infection and 1 patient had endolymph fistula,of which a malposition was found by CT after half a year. Mapping was done one month after surgery showing that the hearing recovered completely in all patients distinctly. Conclusions The surgical indications, assessments by audiology and aural image is the premises of the cochlear implantation surgery; the surgical equipments and surgical procedures and skill is the key point; the mapping after surgery and audition and speech skill rehabilitation training is the guarantee.