人工耳蜗电极异位植入病例分析

Analysis of Cases with Misplaced Electrodes in Cochlear Implantation

目的分析人工耳蜗电极异位植入的原因及再植入手术方法。方法收集2015年至2022年首都医科大学附属北京友谊医院收治的因人工耳蜗电极异位植入行人工耳蜗再植入的4例患者,分析异位植入的原因、报告再植入手术方法。结果术后检查发现电极植入错误1例;开机后对声音反应差,检查发现电极植入错误3例。人工耳蜗电极植入上半规管2例,植入咽鼓管1例,植入内听道1例;4例患者均于同侧再次顺利植入电极。结论耳蜗电极异位植入是人工耳蜗植入手术十分罕见的并发症。异位植入的电极,术中神经反应测试可能存在,干扰术者对电极植入位置的判断。因此术前仔细阅片、规范的手术操作、及时神经反应测试和术后常规检查,对避免耳蜗电极异位植入至关重要。

Objective To report causes for electrode misplacement and methods of reimplantation in cochlear implantation.Methods Cases of cochlear re-implantation in our department due to cochlear electrode misplacement from 2015 to 2022(n=4)were identified,and the causes of electrode misplacement and re-implantation methods were reported.Results Electrode misplacement was revealed at postoperative examination in 1 case and at startup due to poor responses to sounds in 3 cases.Electrodes were implanted into the superior semicircular canal in 2 cases,into the eustachian tube in 1 case,and into the internal auditory canal in 1 case.Ipsilateral re-implantation was successfully in all 4 cases.Conclusion Electrode misplacement is a rare complication in cochlear implantation.The ectopic implanted electrode may respond to intraoperative nerve test,confusing surgeon's judgment of electrode implantation location.Therefore,careful preoperative imaging review,standardized surgical procedures,timely neural response testing,and routine postoperative examinations are crucial for avoiding ectopic electrodes implantation.