人工耳蜗植入术的并发症及对症处理

Complications of cochlear implantation and the corresponding treatment

目的探讨人工耳蜗植入术后并发症产生的原因及处理措施。方法回顾分析2005年5月~2012年10月在我科接受人工耳蜗植入的721例患者,发生并发症44例。通过分析其原因,提出预防及处理的措施。结果 44例并发症中,轻度并发症34例,包括骨膜下血肿15例;眩晕19例;重度并发症10例,包括面神经损伤2例;感染2例;植入体周围积液2例;耳蜗骨化电极误植入上半规管,后再次植入1例;磁铁移位及磁力消失各1例;植入体移位1例。无电极耳蜗内扭曲,电极移位,永久性面瘫发生等。结论人工耳蜗植入并发症的预防和处理不容忽视,尤其是要防治术后的严重并发症。

OBJECTIVE To investigate the reasons and therapy of postoperative complications of cochlear implantation. METHODS A retrospective analysis of 721 patients who had received cochlear implantation from May 2005 to October 2012 in our department was completed. 44 cases underwent the postoperative complications. Their possible causes were analyzed. And the clarified methods for prevention and therapy were discussed. RESULTS The complications of 44 cases included 34 cases minor complications and 10 cases major complications. The minor complications included 15 cases of subperiosteal hematoma, 19 cases of severe dizziness. And the major complications were 10 cases, including 2 cases of facial nerve injury, 2 cases of postoperative wound infection, 2 cases of effusion around the implant buttons, 1 case of operation failure due to cochlear ossification, in which the electrode was implanted in semicircular canal resulting in implantation again, 1 case of magnet displacement and magnetic force disappearance,and 1 case of implant button displacement. No distortion electrode within the cochlear, electrode displacement, or permanent facial palsy occurred. CONCLUSION The prevention and treatment of postoperative complications cannot be ignored for CI, especially for the severe postoperative complications.