人工耳蜗术后严重皮瓣并发症的临床特征及处治效果  

Clinical characteristics and treatment effect of severe skin flap complications after cochlear implantation

作　　者：杨凯琪 彭皎皎[1] 郑虹[1] 卓路芳 YANG Kaiqi;PENG Jiaojiao;ZHENG Hong;ZHUO Lufang(Department of Otolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China)

机构地区：[1]四川大学华西医院耳鼻咽喉头颈外科,四川成都610041

出　　处：《西部医学》2022年第3期424-428,共5页Medical Journal of West China

摘　　要：目的探讨人工耳蜗植入(CI)术后发生皮瓣相关严重并发症患者的临床表现特征及处理治疗效果。方法回顾性分析2008年1月~2019年12月在四川大学华西医院耳鼻咽喉头颈外科接受CI手术的1204例患者中发生术后皮瓣相关严重并发症后取出植入体并重新植入人工耳蜗的病例,比较分析其临床特点、处理过程及预后情况。结果皮瓣相关并发症61例(发生率5.1%),其中严重皮瓣相关并发症12例(发生率1.0%)。12例患者在发生首次皮瓣并发症后均予以至少1次的保守治疗,因治疗效果不佳取出原植入体。12例患者均在我科成功进行同侧或对侧人工耳蜗再植入,再植入后人工耳蜗均可达到或超过再植入前听觉言语水平,且与对侧再植入相比听觉言语效果无差别。结论人工耳蜗植入术后皮瓣相关严重并发症是一类复杂的并发症,原因及表现形式多样,常保守治疗无效,需要取出原植入体,同侧或对侧再植入人工耳蜗后总体预后较好。Objective To report clinical features and management of severe flap-related complications after cochlear implantations(CI)and discuss their treatment outcome.Methods Data from 1204 patients treated at the department of Otolaryngology-Head and Neck Surgery,West China Hospital,Sichuan University from January 2008 to December 2019 were analyzed,retrospectively.Patients with flap-related complications,especially severe flap-related complications,were identified and their clinical features,courses of treatment and outcomes were analyzed.Results 61 patients(5.1%)suffered from flap-related complications,including 12 cases(1.0%)of severe flap-related complications.All the 12 patients received at least one conservative treatment,and the implants were removed.12 patients successfully received cochlear reimplantation in our department.Audiologic performances were stable or improved following reimplantation in all cases,and there is no different between ipsilateral and contralateral reimplantation.Conclusion Severe flap-related complications are a kind of complicated complications,with various causes and manifestations.Conservative treatment is often ineffective,and the implants need to be removed.All cases had satisfactory prognosis.

关 键 词：人工耳蜗植入 皮瓣严重并发症 再植入 听觉言语效果 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]