人工耳蜗植入术中因内耳畸形发生“井喷”的危险因素分析

Risk factors of ’Blowout’ due to inner ear malformation during cochlear implantation

目的分析人工耳蜗植入术治疗内耳畸形中发生"井喷"的危险因素。方法回顾性分析湘南学院附属医院耳鼻咽喉头颈外科及中南大学湘雅二医院耳鼻咽喉科2010年1月~2015年10月收治的25例内耳畸形行人工耳蜗植入术患者的病例资料。结果 8例患者术后出现"井喷",其中植入右侧6例、左侧2例。畸形类别:双侧耳蜗内听道相通伴Mondini畸形或前庭导水管扩大分别为4例、2例,双侧耳蜗内听道不相通+前庭导水管扩大1例,右侧耳蜗内听道相通+左侧Michel畸形右侧Mondini畸形1例。25例患者术后均获得满意听力。结论内耳畸形中前庭导水管扩大、Mondini畸形和耳蜗听道相通是人工耳蜗植入术中的常见危险因素,术前需行影像学检查,全面评估"井喷"发生风险,降低其发生率,确保手术效果及人工耳蜗听觉建立。

OBJECTIVE To analyze the risk factors of blowout in the treatment of inner ear malformation by cochlear implantation.METHODS The clinical data of 25 patients with inner ear malformation and cochlear implantation admitted to the Affiliated Hospital of Xiangnan College and the Second Xiangya Hospital of Central South University from January 2010 to October 2015 were retrospectively analyzed.RESULTS Blowout occurredin 8 patients,including 6 on the right side and 2 on the left.The types of malformations were as follows:4 and 2 cases of bilateral internal auditory canal communication with Mondini malformation or enlarged vestibular aqueduct,1 case of bilateral internal auditory canal communication with enlarged vestibular aqueduct,1 case of right internal auditory canal communication with left Michel malformation and right Mondini malformation.All 25 patients obtained satisfactory hearing after operation.CONCLUSION Enlargement of vestibular aqueduct,Mondini malformation and communication of cochlear auditory canal are common risk factors for "blowout" during cochlear implantation.Preoperative imaging examination is required to comprehensively evaluate the risk of ’blowout’ to reduce its incidence and ensure the establishment of cochlear implantation hearing.