分泌性中耳炎患者的人工耳蜗植入效果分析

A Clinical Study of Cochlear Implantation in Children with Secretory Otitis Media

目的总结伴分泌性中耳炎的患者人工耳蜗植入的手术经验,并探讨术后中耳炎相关并发症及听觉、言语康复情况。方法回顾性分析解放军总医院2011年1月至2013年3月期间接受人工耳蜗植入术的15例伴分泌性中耳炎患者的临床资料,15例患者手术均采用面隐窝入路,术中彻底清除中耳及乳突内病变再植入人工耳蜗,其中6例患者术中取出砧骨,以扩大后鼓峡,保证上鼓室通畅引流。术后随访2月至24月不等。结果 15例患者手术均一次成功,术后随访未发现中耳炎相关并发症,使用CAP及SIR问卷调查患者术后听觉、言语康复情况,15例患者开机后均可听到声音,言语康复情况不同。结论合并分泌性中耳炎的重度或极重度感音神经性聋患者,一期行人工耳蜗植入术是安全的,手术经验重在术中彻底清理病变,保证上鼓室引流通畅,术后听觉及言语康复情况影响因素较多。

Objective To present the experiences of cochlear implantation（CI） and to study the complications and effec- tiveness of cochlear implants in patients with secretory otitis media（SOM）. Methods Retrospective study based on data from 15 bilateral serious senserineural hearing loss children with secretory otitis media, all the implantation was performed in PLA hospital from January 2011 to March 2013. Among them, 6 cases were removed their incus in the operations as a prevention measure of postoperative recurrent secretoty otitis media. Results The implantation through mastoid-facial recess was suc- cessful in all cases without any otitis media related complications during a 2 to 24 months follow-up. All the children had au- ditory sensations after the devices starting to work while their speech rehabilitation was quite different. Conclusions one-stage cochlear implantation is safe and effective for children with secretory otitis media, it is essential to eradicate all pathological lesions of middle ear and mastoid and to ensure an adequate drainage.