伴分泌性中耳炎患者的人工耳蜗植入效果及护理  

Cochlear Implantation in Children with Secretory Otitis Media

作　　者：郑智[1] 李原[1] 赵建辉[1] 毕青玲[1] 刘洋[1] 王娜亚[1] 杨大章[1] 

机构地区：[1]中日友好医院耳鼻咽喉科,北京100029

出　　处：《听力学及言语疾病杂志》2014年第2期180-183,共4页Journal of Audiology and Speech Pathology

摘　　要：目的探讨伴分泌性中耳炎的极重度聋患者一期行人工耳蜗植入术的可行性及术后听觉言语康复效果，并总结其护理体会。方法对11例伴分泌性中耳炎的极重度聋儿童一期行人工耳蜗植入，术中彻底清除中耳乳突病变黏膜，建立通畅引流后植入人工耳蜗电极，结合围手术期药物治疗、护理、听觉言语康复训练，术后定期随访，评估人工耳蜗植入后听觉与言语康复效果。结果1l例患儿均一期完成单耳人工耳蜗植入，其中右耳8例，左耳3例；植入人工耳蜗型号：Nucleus24CA7例，ClarionAB90K1例，MedelCombi40＋2例，pulsar1例，术中电极神经遥测均引出神经反应动作电位；术后一月开机，正常调机后均获得满意的主观听性反应，助听下0．25～4kHz声场听阈为20～45dBHL；术后随访13～60个月，11例患儿人工耳蜗工作状态正常，分泌性中耳炎均痊愈；术后听觉言语康复效果满意，11例均进入普通幼儿园或小学学习。结论伴有分泌性中耳炎的极重度聋患者术前做好充分准备后可尽早行人工耳蜗植入，围手术期合理的治疗、护理及术后听觉言语康复有利于获得良好效果。Objective To study the feasibility and rehabilitation outcomes of one-- stage cochlear implantation （CI） in profound deaf children with secretory otitis media（SOM）. Methods A total of 11 profound deaf children with soal receired one--soage unilateral cochlear implantation with a follow--up period from 13 - 60 months. In- flamed mucosa in the mastoid as well as exudates were removed radically at the time of implantation for adequate drainage of the middle ear. After the sugery, the patients were followed up and the hearing and rehabilitating out- comes were eveluated. Results All 11 patients were successfully operated with 8 cases in the right ear and 3 cases in the left ear. Among them,7 cases were nucleus 24 CA,1 case losa clarion AB 90 K,2 cases were medel combi 40＋ and 1 case was pulsar. All patients were successfully operated. No infectious complications occurred. No recurrence of secretory otitis media was observed. After initial stimulation and post regular fitting , the status of the implant- able devices were all stable. All the implantees had satisfied hearing and entered normal kindergartens or schools. Conclusion Profound deaf pediatric patients with SOM are not an absolute contraindication for CI. With sufticient pre--operation preparontion, proper trentment and nursing. Cochlear implantation should be condnote as early as possible better rehabilitation performance.

关 键 词：分泌性中耳炎 人工耳蜗植入 护理 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]