耳硬化致极重度聋患者临床特点及人工耳蜗植入效果观察  

The Study of the Cochlear Implantation Surgery and the Clinical Characteristics in Otospongiosis Patients with Profound Sensory Hearing Loss

作　　者：李玉洁[1] 胡宝华[2] 张道行[1] 

机构地区：[1]首都医科大学附属北京友谊医院耳鼻咽喉科,北京100050 [2]宁波市第二医院耳鼻咽喉科

出　　处：《听力学及言语疾病杂志》2010年第3期278-280,共3页Journal of Audiology and Speech Pathology

摘　　要：目的总结5例耳硬化致极重度聋患者听力学及颞骨CT特点并观察人工耳蜗植入术后效果。方法对5例重度、极重度聋的耳硬化患者,行纯音测听、声导抗、耳声发射、听性脑干反应及颞骨CT检查。5例患者均按常规入路行人工耳蜗植入术(4例单侧,1例双侧)。术后1个月开机调试,术后6个月行声场下的纯音听阈、言语识别率检测。结果①临床特点:5例患者均呈渐进性双耳听力下降,双耳纯音平均听阈>90dBHL,呈混合性或感音神经性聋,双耳鼓膜正常,声导抗检查呈低峰型鼓室导抗图,声反射引不出;颞骨高分辨CT显示耳蜗周边呈海绵状改变的低密度透亮及双环状影,无正常耳蜗的骨性结构。②手术所见:5例(6耳)开放耳蜗鼓阶均较困难,耳蜗鼓阶内充满疏松的骨性组织,距圆窗口7～9mm才显示出耳蜗鼓阶的解剖标志,术中电极阻抗检测正常,5例(6耳)均引出标准的神经反应遥测波形。③术后随访8个月～3.1年,平均听阈为20～37dBHL,开放式汉语单声母、韵母言语识别率为95%～99%。结论耳硬化致极重度聋患者人工耳蜗植入后能获得较满意的听觉及言语识别效果。Objective To summarize 5 otospongiosis cases with profound sensory hearing loss who received cochlear implante（CI） in routine way. To analyze their characteristics in audiology and temporal CT , and the effects after CI. Methods 5 cases of profound sensorineural hearing loss with otospongiosis received pure tone test, otoacoustic emission,auditory brainstem evoked potential and temporal CT before operation. One of the patients received binaural CIs. Mapping was done one month after operation. Follow--up tests were provided 6 months after operation to assess the effects. Results 5 cases showed clinical characteristics of gradual binaural hearing reduction, PTA greater than 90 dB HL, mixed or sensorineural deafness, normal tympanic membranes, reduced peaks in acoustic impedance, and typical CT findings. 5 patients（6 ears） were implanted in routine manner. It was difficult to open the cochlea scala tympani. The scala tympani was filled with loose bony tissues. It was about 7-9 mm between the round window and the normal scala tympani. All patients showed the standard wave from in nerves reaction remote monitoring. The patients were followed up from 8 months to 3. lyears. The average PTA was 20-37dB HL. The speech discrimination score was 95%-99% for open Chinese audiometry. Conclusion CI was an effective way to help patients with profound sensory hearing loss and otospongiosis.

关 键 词：耳硬化 极重度耳聋 人工耳蜗植入术 

分 类 号：R764.32[医药卫生—耳鼻咽喉科]