面神经发育异常遮挡圆窗患者人工耳蜗植入手术技术

Surgical technique of cochlear implantation in patients with facial nerve developmental abnormalities obstructing round window

目的报告面神经发育异常遮挡圆窗患者人工耳蜗植入(cochlear implantation,CI)手术技术。方法回顾性分析2009年3月至2023年7月收治的6例面神经发育异常遮挡圆窗的重度或极重度聋患者的临床资料,包括病史、听力学资料、影像学资料、手术方法等。结果6例患者中,1例患者行前庭窗植入,2例患者行面后径路植入,3例患者行经耳道径路或耳道/耳后联合径路植入。6例患者均顺利植入电极,1例患者术后面瘫情况较术前无明显变化,余5例患者术后未见面神经损伤,6例患者均未出现外耳道后壁塌陷、脑脊液耳瘘等并发症发生。结论重度或极重度聋患者人工耳蜗植入术中发现面神经发育异常遮挡圆窗情况时可根据面神经走行情况选择不同径路,完成人工耳蜗电极植入。

Objective To explore the application of the surgical technique of cochlear implantation(CI)in patients with facial nerve developmental abnormalities obstructing round window.Methods A retrospective analysis of medical history,audiological data,imaging data and surgical methods was conducted on the clinical data of 6 severely or extremely severely deaf patients with facial nerve developmental abnormalities obstructing round window from March 2009 to July 2023.Results Among the 6 patients,1 patient underwent oval window implantation,2 patients underwent retro-facial approach implantation,and 3 patients underwent ear canal or ear canal/posterior combined approach implantation.Six patients were successfully implanted with electrodes.One patient showed no significant change in facial paralysis after surgery compared to before,and the others did not experience facial nerve damage after surgery.all 6 patients experienced complications such as collapse of the posterior wall of the external auditory canal and cerebrospinal fluid ear fistula.Conclusions When abnormal facial nerve development is found during CI surgery in patients with severe or extremely severe hearing loss,various pathways can be selected based on the shape of the facial nerve to complete cochlear electrode implantation.