反斯氏位和斯氏位在先天性耳聋儿童电子耳蜗植入术投照中的应用对比

Application and comparison of anti-Stenver's position and Stenver's position in radiography of cochlear implantation surgery in children with congenital deafness

目的:探讨反斯氏位或斯氏位在先天性耳聋儿童电子耳蜗植入术投照中的应用效果。方法:将80例先天性耳聋需行电子耳蜗植入术儿童随机分为反斯氏位组和斯氏位组各40例,两组手术前、后均行CT检测;反斯氏位组手术前、后均采用反斯氏位X线检查,斯氏位组手术前、后均采用斯氏位X线检查。结果:反斯氏位组手术前X线耳蜗未发育、急性化脓性中耳乳突炎、大前庭导水管综合征、耳蜗发育不良以及脑白质病变等禁忌证影像学检查结果与CT检查结果的kappa值分别为1、1、1、1和0.974,高于斯氏位组的0.66、0.66、0.66、0.974和0.66,差异有统计学意义(P<0.05)。反斯氏位组术后影像学检查对电子耳蜗电极扭曲、术后移位、电子耳蜗形态和位置良好显示结果与CT检查结果的kappa值分别为1、1和1,高于斯氏位组的0.768、0和0.585,差异有统计学意义(P<0.05)。反斯氏位组患者对X线体位摆放的依从性、听从指令的依从性以及总体依从性分别为90.0%、95.0%和95.0%,高于斯氏位组的70.0%、77.5%和80.0%(P<0.05)。结论:反斯氏位在先天性耳聋儿童电子耳蜗植入术投照中的应用效果良好,可较为准确地反映患儿内耳道影像学病变和术后电极形态和位置,且患儿对检测的依从性高、配合良好,值得临床推广使用。

Objective： To explore the application effects of anti-Stenver＇s position and Stenver＇s position in radiography of cochlear implantation surgery in children with congenital deafness. Methods： Eighty children with congenital deafness receiving cochlear implantation surgery were randomly divided into anti-Stenver＇ s position group and Stenver＇s position group,40 children in each group. CT scanning was performed in the two groups before and after surgery; anti-Stenver＇s position radiography was performed in anti-Stenver＇s position group before and after surgery,while Stenver ＇s position radiography was performed in Stenver＇ s position group before and after surgery. Results： Kappa values of radiographic results and CT scanning results of underdeveloped cochlear,acute purulent otitis media mastoiditis,large vestibular aqueduct syndrome,cochlear dysplasia and cerebral white matter lesion in anti-Stenver＇s position group before surgery were 1,1,1,1 and 0. 974,respectively,which were statistically significantly higher than those in Stenver＇ s position group（ 0. 66,0. 66,0. 66,0. 974 and 0. 66）（ P 0. 05）. Kappa values of radiographic results and CT scanning results of electronic cochlea electrode distortion,postoperative shift,electronic cochlea morphology and location in good conditions in anti-Stenver＇ s position group after surgery were 1,1 and 1,respectively,which were statistically significantly higher than those in Stenver＇ s position group（ 0. 768,0 and 0. 585）（ P 0. 05）. The compliance of body position,compliance of following instructions and the total compliance in the course of radiography in anti-Stenver＇s position group were 90. 0%,95. 0% and 95. 0%,respectively,which were statistically significantly higher than those in Stenver＇s position group（ 70. 0%,77. 5% and 80. 0%）（ P 0. 05）. Conclusion： The application effect of anti-Stenver＇s position in radiography of cochlear implantation surgery in children with congenital deafness is good,which can accurately reflect the inner ear images in children with pathological changes and postoperative cochlea shape and position,the compliance of children is high under the condition of good cooperation,the position is worthy of clinical application.