儿童脑脊液耳漏修补与人工耳蜗植入同期手术的探讨  

Simultaneous Cerebrospinal Fluid(CSF)Otorrhea Repair and Cochlear Implantation in Children with Bilateral Inner Ear Malformation

作　　者：陈敏[1] 郑军[2] 刘薇[1] 杨扬[1] 韩忠龙[3] 张杰[1] CHEN Min;ZHENG Jun;LIU Wei;YANG Yang;HAN Zhonglong;ZHANG Jie(Department of Otorhinolaryngology Head and Neck Surgery,Beijing Children′s Hospital,Capital Medical University,National Center for Children′s Health,Beijing,China;Department of Otorhinolaryngology Head and Neck Surgery,Tongren Hospital,Capital Medical University,Beijing,China;Department of Radiology,Beijing Children′s Hospital,Capital Medical University,National Center for Children’s Health,Beijing,China)

机构地区：[1]首都医科大学北京儿童医院耳鼻咽喉头颈外科,国家儿童医学中心,北京100045 [2]首都医科大学北京同仁医院耳鼻咽喉头颈外科,北京100045 [3]首都医科大学北京儿童医院影像中心,北京100045

出　　处：《中华耳科学杂志》2020年第4期663-667,共5页Chinese Journal of Otology

基　　金：北京市医院管理中心儿科学科协同发展中心专项经费资助,编号:XTYB201828。

摘　　要：目的探讨双侧内耳畸形患儿脑脊液耳漏修补及耳蜗植入同期手术的可行性及效果。方法回顾性分析2018年12月-2020年3月双侧内耳畸形同期行脑脊液耳漏修补及耳蜗植入患儿的临床资料。结果共3例患儿,IP-Ⅰ3例4耳,IP-Ⅱ及耳蜗未发育伴前庭扩大各1耳。脑脊液耳漏术中诊断1例,术前诊断2例;均同期完成脑脊液耳漏修补+人工耳蜗植入术;术后随访2-16月,均无脑脊液耳漏或脑膜炎;病例1和2语言发育可,病例3因新冠疫情术后2月开机,电反应良好,继续随访。结论双侧内耳畸形合并脑脊液耳漏的诊断,需要结合听力筛查、病史、听力学及影像学结果综合判断;同期行脑脊液耳漏修补+人工耳蜗植入术具有可行性,术后效果可。Objective To investigate the feasibility and outcomes of simultaneous cerebrospinal fluid(CSF)otorrhea repair and cochlear implantation(CI)in children with bilateral inner ear malformation.Methods Data of children with bilateral inner ear malformation who had CSF otorrhea repair and CI simultaneously from December 2018 to March 2020,including clinical presentations,intervention and outcomes,were retrospectively analyzed.Results Malformations in the 3 cases included IP-Ⅰ(4 ears),IP-Ⅱ(1 ear)and cochlear aplasia with vestibule dilatation(1 ear).CSF otorrhea was diagnosed during operation in one case and preoperatively the other 2 cases.All patients underwent CSF otorrhea repair and CI simultaneously and successfully with no recurrence of CSF otorrhea during the 2-to 16-month follow-up.Cases 1 and 2 demonstrated improved speech ability.In case 3,CI was not mapped until 2 months after implantation due to covid-19 outbreak,and the patient is being followed-up.Conclusion The diagnosis of bilateral inner ear malformation with CSF otorrhea relies on the combination of Universal Neonatal Hearing Screening(UNHS),clinical presentations,and audiological and radiological evaluation.Simultaneous CSF otorrhea repair and CI is feasible,with satisfactory results.

关 键 词：内耳畸形 脑脊液耳漏修补 人工耳蜗植入 

分 类 号：R764[医药卫生—耳鼻咽喉科]