人工耳蜗在前庭水管扩大患者中的应用

Cochlear implants in children with enlargement of vestibular aqueduct

目的 研究前庭水管扩大患者人工耳蜗植入手术的经验。方法 对 15例 (15耳 )双侧前庭水管扩大伴重度感音神经性聋的患者行多导人工耳蜗植入术 ,并对术后结果进行随访。经面隐窝径路行人工耳蜗植入术 ,在圆窗龛前下方行鼓岬钻孔 ,植入多导人工耳蜗电极。结果 ①术中电极完全插入耳蜗 ,其中 6耳出现轻微井喷 ;②术后无面瘫、脑脊液耳漏等并发症 ;③所有患者人工耳蜗植入术后都有听觉 ;④术后听阈与耳蜗结构正常植入患者无明显区别 (自由声场平均听阈 30dBHL) ;⑤术后语训在北京同仁医院或中国聋儿康复中心进行 ,听力及言语能力均有不同程度提高 ,其中 2例患者已经进入正常学校就读。结论 前庭水管扩大伴重度感音神经性聋的人工耳蜗植入与耳蜗结构正常患者植入术后效果基本一致 。

Objective To describe the clinical experiences with multi channel cochlear implantation in the children with enlargement of vestibular aqueduct Method Fifteen patients were diagnosed with enlargement of vestibular aqueduct and received multi channel cochlear implantation at Beijing Tongren Hospital A cochleostomy was performed for all patients by a standard facial recess approach to anterior inferior to the round window niche Results (1) Most of the electrodes were totally inserted in the cochlear, and gusher appeared in 6 implantations (2) No serious complications occurred after implantation (3) All patients have auditory sensations after implantations (4) The hearing threshold in this series were similar to that of the normal cochlear implantation (the average threshold was 30 dB) (5) The rehabilitation concept was developed by Rehabilitation Research Center for Deaf Children in Beijing and Beijing Tongren Hospital The training sessions included sound detection, word discrimination, auditory comprehension and spoken language skill development The abilities of speech discrimination and spoken language were improved comparing with that of pre operation Two of the patients could go to the normal school after implantations Conclusion The outcome of hearing rehabilitation for children with enlargement of vestibular aqueduct were similar to those children with 'normal' cochlear structure followed the multi channel cochlear implantation