微创人工耳蜗植入术及常规人工耳蜗植入术临床比较

Comparison of Clinical Outcomes between Minimally Invasive Cochlear Implantation and Conventional Cochlear Implantation

目的通过微创人工耳蜗植入术与常规人工耳蜗植入术的临床效果比较,探讨微创人工耳蜗植入术的临床优势。方法回顾性分析121例人工耳蜗植入患者,根据人工耳蜗植入术式的不同分为微创人工耳蜗植入术组(微创组)及常规人工耳蜗植入术组(常规组),比较两组患者的手术时间、电极植入情况、手术切口及并发症的不同,分析两种术式之间的特点。结果 121例人工耳蜗电极均全植入鼓阶,成功率100%。微创组与常规组的平均手术总时间分别为89.53±12.42分钟、92.30±14.16分钟,电极植入平均用时分别为112.16±16.01秒、117.05±26.90秒,平均电极植入次数分别为1.07±0.26次、1.22±0.49次。两组的手术总时间无明显差别(P>0.05),电极植入用时亦无明显差别(P>0.05),微创组平均电极植入次数较常规组少(P<0.05)。微创组及常规组的手术切口长度分别为2.53±0.12cm、8.30±0.56cm,微创组的手术切口长度明显小于常规组(P<0.05)。微创组术后未发现皮下血肿及感染,常规组术后出现皮下血肿3例(4.76%),微创组术后皮下血肿率与常规组比较无明显变化(P>0.05)。微创组和常规组的术后眩晕出现率分别为5.88%、21.83%,微创组术后眩晕率低于常规组术后眩晕率(P<0.05)。结论与常规人工耳蜗植入术相比较,微创人工耳蜗植入术在手术时间不增加的前提下,可确保电极位于鼓阶,并具有外形美观,手术切口小,术中创伤小,术后并发症少等优点。

Objective To compare clinical outcomes between minimally invasive cochlear implantation and conven- tional cochlear implantation, and to investigate clinical advantages of minimally invasive cochlear implantation. Methods One hundred and twenty one cases were retrospective analyzed and divided into a minimally invasive group and a conven- tional group based on the type of surgeries they underwent. Surgery time, electrodes insertion time and number of trials, inci- sion size and postoperative complications were compared and analyzed. Results Implantation was successful in all cases. Surgery time was 89.53±12.42 minutes in the minimally invasive group and 92.30±14.16 minutes in the conventional group （P〉0.05）, and electrode insertion time was 112.16±16.01 seconds and 117.05±26.90 seconds （P〉0.05）, respectively. Aver- age number of electrodes insertion trials were 1.07±0.26 and 1.22 ± 0.49 for the two groups （P〈0.05）. The length of incision of the minimally invasive group （2.53±0.12 cm） was shorter than that of the conventional group （8.30 ±0.56 cm） （P〈 0.05）. Subcutaneous hematoma occurred in 3 cases （4.76%） in the conventional group, but none in the minimally invasive group, although there was no statistically significant difference between the two groups （P〉 0.05）. The rate of postoperative vertigo in the two groups was 5.88% and 21.83% respectively, lower in the minimally invasive group （P〈0.05）. Conclusions Mini mally invasive cochlear implantation does not increase surgery time but can ensure insertion of electrode in the scala tym pang. Its other benefits include better cosmetic appearance, smaller incision, less surgical trauma and lower rates of compli- cations.