儿童与成人人工耳蜗植入术并发症比较及处理

Complications of cochlear implantation in children and adults

目的探讨儿童与成人人工耳蜗植入术并发症的不同特点,总结其处理经验。方法回顾性分析170例人工耳蜗植入患者的病历资料,根据年龄将其分为儿童组及成人组,分析比较两组人工耳蜗植入术并发症出现的特点及处理经验。结果 170例人工耳蜗电极均一期植入,成功率100%。术后3 d内出现发热患者15例,儿童13例(8.84%),成人2例(8.69%),发热率差异无统计学意义(P>0.05)。内耳发育正常的患者术后出现眩晕21例,儿童10例(10.20%),成人11例(52.38%),儿童术后眩晕率较成人低(P<0.05)。1例成人患者人工耳蜗植入出现术后头皮血肿,予头皮血肿抽吸后痊愈。1例儿童患者人工耳蜗植入术后外耳道口皮肤穿孔,经手术修复痊愈。1例儿童患者人工耳蜗植入术后18个月皮下植入体损坏,行再次人工耳蜗植入术。结论人工耳蜗植入术后不同并发症的发生在不同年龄阶段表现不一,对人工耳蜗植入术后并发症与年龄的趋向性进行比较分析,为临床工作者对其预见及处理提供相关经验及依据。

Objective To compare the characteristics of complications after cochlear implantation in children and adults,and to explore the management of these complications.Methods A total of 170 cases of cochlear implantation were retrospectively analyzed.These patients were divided into children group （n=147 ）and adult group （n =63 ） according to their age.The characteristics of complication and management were summarized.Results The success rate of implantation was 100 %.Three days after operation,13 children （8.84%）and 2 adults （8.69%）developed fever,and there was no significant difference in the incidence of fever between children and adults（P〉0.05）.Among those with normal inner ear,10 children （10.20%）and 1 1 adults （52.38%）had postoperative vertigo,and the inci-dence of vertigo was lower in children than that in adults （P〈0.05）.Scalp hematoma occurred in 1 adult and healed after extraction.External ear canal skin perforation was observed in 1 child which was cured with surgical repair.The cochlear implant was damaged 1 8 months after implantation in 1 child and was re-implanted.Conclusion Different complications may occur in different periods after cochlear implantation in various age groups,which need clinicians’ close attention.