17例人工耳蜗再植入原因分析  

Cause analysis of revision cochlear implantation in 17 cases

作　　者：张山山 刘军[1,2] 刘明波[1,2] 戴朴[1,2] ZHANG Shan-shan;LIU Jun;LIU Ming-bo;DAI Pu(Department of Otolaryngology,Hainan Hospital,Chinese PLA General Hospital,Sanya 572013,China;Department of Otolaryngology Head and Neck Surgery,Institute of Otolaryngology,Chinese PLA General Hospital,China National Clinical Research Center for Otolaryngologic Diseases,Key Lab of Hearing Impairment Science of Ministry of Education,Key Lab of Hearing Impairment Prevention and Treatment of Beijing,Beijing 100853,China)

机构地区：[1]解放军总医院海南医院耳鼻咽喉头颈外科,海南三亚572013 [2]中国人民解放军总医院耳鼻咽喉头颈外科耳鼻喉科研究所国家耳鼻咽喉疾病临床医学研究中心中国教育部聋病重点实验室北京市聋病防治重点实验室,北京100853

出　　处：《中国耳鼻咽喉颅底外科杂志》2019年第5期462-465,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：解放军总医院临床科研扶持基金(2012FC-TSYS-4017);北京市科技计划首都市民健康项目培育基金(Z131100004013019)

摘　　要：目的总结17例人工耳蜗患者耳蜗再植入的原因,探讨降低耳蜗再植入风险的方法,提高患者手术治疗满意度及术后听力言语康复水平。方法回顾性分析2012年11月—2018年7月解放军总医院海南医院17例采用面隐窝入路圆窗再植入人工耳蜗患者的临床资料,分析其再植入原因。结果17例患者均顺利完成耳蜗再植入手术,再植入术后随访观察患者满意度高,人工耳蜗助听听阈大幅改善,言语分辨能力明显提高,患者听力言语康复效果提升。17例人工耳蜗再植入原因分别为:植入体故障6例;植入体不工作2例;植入体受撞击后损坏2例;植入体接收刺激器移位1例;植入体接收刺激器部位破裂1例;皮瓣感染3例,其中1例为右侧感染后原植入体同侧再植入,皮瓣感染切口无法愈合后右侧植入体取出后行左侧人工耳蜗植入;电极未完全植入1例;应患者要求取出旧植入体同侧再植入新型植入体1例。结论人工耳蜗再植入原因复杂多样,选择合适材料的植入体、避免剧烈撞击、执行严格的无菌操作以及进行准确的人工耳蜗植入术前评估是避免人工耳蜗再植入的关键。Objective To summarize the causes of revision cochlear implantation in 17 cases,explore the methods to reduce the risk of revision cochlea implantation,and improve the satisfaction of surgical treatment and the level of postoperative hearing speech rehabilitation.Methods Clinical data of 17 patients underwent revision cochlea implantation via facial recess approach in Hainan Hospital,Chinese PLA General Hospital from Nov 2012 to July 2018 were analyzed retrospectively to summarize the reasons of revision implantation.Results The causes for revision implantation in the 17 patients were different,including implant failure in 6 cases,implant inoperation in 2,implant damage after impact in 2,displacement of implant receiving device in one,rupture of implant receiving device in one,skin flap infection in 3,incomplete insertion of electrode in one,and removal of the old implant with ipsilateral reimplantation of a late model implant in response to patient’s demand in one.Revision cochlea implantation was successfully completed in all the 17 patients with high satisfaction to the outcomes.Their cochlear aided hearing thresholds and speech discrimination ability were greatly improved with promoted hearing speech rehabilitation effect.Conclusion The causes of revision cochlear implantation are complicated and varied,and the key to avoid revision implantation is to choose suitable materials of implant,avoid severe impact,perform strict aseptic operation and accurate preoperative evaluation.

关 键 词：人工耳蜗 耳聋 听觉植入 再植入 原因分析 

分 类 号：R764.93[医药卫生—耳鼻咽喉科]