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感音神经性聋耳蜗病理改变及其干预措施
  • ISSN号:1672-2922
  • 期刊名称:《中华耳科学杂志》
  • 时间:0
  • 分类:R764.44[医药卫生—耳鼻咽喉科;医药卫生—临床医学] R764.5[医药卫生—耳鼻咽喉科;医药卫生—临床医学]
  • 作者机构:[1]北京首都医科大学附属北京同仁医院耳鼻咽喉头颈外科人工耳蜗中心,100730, [2]北京市耳鼻咽喉科研究所
  • 相关基金:国家自然科学基金(30572028);北京市自然科学基金(7032008);十五科技攻关课题(2004BA720A18-02);北京市科技新星资助项目(9558101300)
中文摘要:

目的探讨耳蜗骨化状态下人工耳蜗植入手术的经验及分析术后效果。方法北京同仁医院自1996年开展多道人工耳蜗植入手术以来,截止到2006年12月已开展手术600余例,遇到双侧耳蜗骨化患者7例。其中4例有明确的脑膜炎病史,3例耳蜗骨化原因不明。3例为耳蜗完全骨化;1例鼓阶完全骨化,前庭阶未受累;1例耳蜗部分骨化;2例耳蜗部分纤维化。总结术前、术中及术后的处理原则、方法及术后康复效果。结果1例术中出现镫井喷,但比其他内耳畸形术中出现镫井喷的程度轻微;4例电极完全插入耳蜗内,2例植入部分电极,1例家属放弃植入;术后无面神经麻痹、脑脊液瘘等并发症;术后开机调试发现部分患者T值、C值比正常形态耳蜗植入偏高(因病例数量少未做统计学分析),但听阈无明显区别。术后语训听力及言语能力均有不同程度的提高。结论对于耳蜗部分骨化患者,术中只要将其骨化成分自鼓阶内清除后可顺利植入电极;对于完全骨化患者可以将围绕蜗轴的鼓阶顶壁钻开,将电极嵌入骨槽内即可。脑膜炎后出现重度感音性聋应考虑耳蜗骨化的可能,常规颞骨CT及MRI检查,一旦确诊应尽快手术,以免耳蜗完全骨化。人工耳蜗植入术可以作为伴有耳蜗骨化的深度感音性聋患者的治疗和康复手段。

英文摘要:

Objective To explore the problems and describe clinical experiences associated with muhichannel cochlear implantation in patients with cochlear ossification. Methods Seven cochlear implant cases with bilateral cochlear ossification from 1996 to 2006 in Beijing Tongren Hospital were retrospectivly reviewed,4 of which were the consequence of meningitis. Three patients'cochlear were completely ossified, 1 patient's tympanic scala was completely ossified, 1 patient's cochlear was partially ossified, and 2 patients' cochlear were partially fibrotic. This article addressed the components of the preoperative evaluation, surgical decision-making, and specific techniques for cochlear implant array insertion in all kinds of ossified cochlea. Results Gusher was found in 1 case but less serious than that with inner ear malformations. The electrodes were inserted in the cochleostomy in full length in 4 cases, 1 case gave up, and the cochlear implant array were partially inserted in the remains. No serious complications occurred after implantation. All patients had auditory sensations. The impedance of the electrodes, the T level, C level and the hearing threshold were slightly higher than that of the normal cochlear implantation. Conclusions The key influencing factor of ossified cochlear patients were the degree of the disease and whether the electrode implanted completely or not. So, the profound sensorineural hearing loss patients after meningitis should be paled more attention. Patients with ossified cochlear could be benefit from cochlear implantation.

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期刊信息
  • 《中华耳科学杂志》
  • 北大核心期刊(2011版)
  • 主管单位:解放军总医院
  • 主办单位:解放军耳鼻咽喉科研究所
  • 主编:杨仕明
  • 地址:北京市复兴路28号中华耳科学杂志社
  • 邮编:100853
  • 邮箱:Zhek301@sina.com.cn
  • 电话:010-66939502
  • 国际标准刊号:ISSN:1672-2922
  • 国内统一刊号:ISSN:11-4882/R
  • 邮发代号:82-114
  • 获奖情况:
  • 国内外数据库收录:
  • 中国中国科技核心期刊,中国北大核心期刊(2011版),中国北大核心期刊(2014版)
  • 被引量:4954