慢性中耳炎并发耳聋的人工耳蜗植入时机与方法探讨

Opportunity and methods of cochlear implantation for chronic otitis media combined with deafness

目的探讨慢性中耳炎并发耳聋的人工耳蜗植入时机、微创植入方式及术后情况。方法 10例慢性化脓性中耳炎、中耳胆脂瘤或中耳炎后遗疾病患者均并发耳聋,其中2例一期植入、8例二期植入人工耳蜗。遵循微创植入原则,所有病例均自圆窗植入力声特REZ-I型人工耳蜗。结果 10例患者均成功完成微创人工耳蜗植入手术,均未出现发热、切口感染、血肿、面瘫、颅内感染、电极裸露等并发症,均无中耳炎及胆脂瘤复发。结论对于慢性化脓性中耳炎、中耳胆脂瘤或中耳炎后遗疾病患者,应依据病情制订个体化的治疗方案。无论一期或二期植入人工耳蜗,均需注重微创植入原则,减少手术并发症的发生。

Objective To investigate the opportunity and technique of cochlear implantation for adult patients with chronic otitis media and deafness. Methods A retrospective analysis was performed in 10 patients with chronic suppurative otitis media, middle ear cholesteatoma or sequelae of otitis media, including 2 cases of primary implantation and 8 cases of two-staged implantation. According to the principle of minimally invasive implantation, all the cochleae were implanted via the round window. Results All of the 10 patients were successfully treated with minimally invasive cochlear implantation. All cases had no fever, incision infection, hematoma, facial paralysis, intracranial infection, electrode exposure or other complications. There was no recurrence of otitis media or cholesteatoma. Conclusions For the patients with chronic suppurative otitis media, middle ear cholesteatoma or sequelae of otitis media, the surgical staging and surgical procedures should be individualized according to the patient~ condition. The principle of minimal invasion should be followed in order to reduce the incidence of surgical complications, regardless of the implantation in the first or second stage.