人工耳蜗植入术后中耳乳突感染的手术治疗  

Surgical Management of Middle Ear and Mastoid Infection after Cochlear Implantation

作　　者：刘维 马妍佳 杨曙[1] 赖若沙[1] 谢鼎华[1] 伍伟景[1] LIU Wei;MA Yanjia;YANG Shu;LAI Ruosha;XIE Dinghua;WU Weijing(Department of Otolaryngology head and neck surgery,Second Xiangya Hospital of Central South University,Changsha,Hunan 410000,China)

机构地区：[1]中南大学湘雅二医院耳鼻咽喉头颈外科,长沙410000

出　　处：《中华耳科学杂志》2020年第4期718-722,共5页Chinese Journal of Otology

摘　　要：目的急性化脓性中耳炎是儿童常见疾病,接受人工耳蜗植入的儿童也是中耳乳突感染的高发人群。由于人工耳蜗植入术后中耳乳突的结构改变,易造成感染扩散,甚至累及并需手术取出植入体。本文评估人工耳蜗植入术后中耳乳突感染患儿在常规抗生素治疗基础上,早期外科干预的方法和效果。方法对2015年1月至2019年10月因人工耳蜗植入术后发生中耳乳突感染住院行手术治疗的9例儿童患者,总结其临床表现、外科治疗过程和预后。结果在所有研究对象中,感染相关症状出现时间最早为术后1月,最晚为术后3年4个月。经过外科干预7例感染控制,预后良好。2例因反复感染、炎症累及范围广,最终取出植入体。结论人工耳蜗植入术后中耳乳突区感染,单纯抗生素治疗不能及时控制,应及时进行外科干预。早期手术治疗,可防止感染累及植入体,避免感染导致再次植入手术。Objective Acute suppurative otitis media is a common disease in children,including those with cochlear implants.Structural changes in the middle ear and mastoid after cochlear implantation can facilitate infection spread and can lead to implant extraction.This article reports methods and outcomes of early surgical intervention in addition to routine antibiotic treatment in children with middle ear and mastoid infection after cochlear implantation.Method Clinical presentation,surgical treatment and outcomes in 9 children hospitalized for otitis media and mastoid infection after cochlear implantation between January 2015 and October 2019 were summarized.Result The onset time of infection-related symptoms was from 1 to 40 months after implantation.Surgical intervention yielded good outcomes in,7 cases and implants were removed in 2 cases due to uncontrollable infection and extensive inflammation.Conclusion When antibiotic therapy fails to control infection of the middle ear and mastoid after cochlear implantation,surgical intervention should be implemented in a timely manner.Early surgical treatment helps prevent infection from involving the implant and avoid re-implantation operations.

关 键 词：人工耳蜗植入 感染 中耳 

分 类 号：R764[医药卫生—耳鼻咽喉科]