术侧伴分泌性中耳炎患者行人工耳蜗植入术的安全性与效果分析  

Analysis of the Safety and Effectiveness of Cochlear Implantation in Patients with Secretory Otitis Media

作　　者：刘学铭 罗建芬 晁秀华[1,2] 樊兆民 王海波 徐磊[1,2] Liu Xueming;Luo Jianfen;Cao Xiuhua;Fan Zaoming;Wang Haibo;Xu Lei(Department of Obolaryngology Heacl and Neck Surgery,Shandong Provincial ENT Hospital,Cheeloo College of Medicine,Shandong University,Jinan,250022,China)

机构地区：[1]山东省耳鼻喉医院,济南250022 [2]山东大学附属山东省耳鼻喉医院听觉植入科

出　　处：《听力学及言语疾病杂志》2022年第2期150-153,共4页Journal of Audiology and Speech Pathology

摘　　要：目的探讨双侧极重度感音神经性聋伴分泌性中耳炎(secretory otitis media,SOM)患者行人工耳蜗植入术的术中、术后安全性及术后听觉言语康复效果。方法对术侧伴分泌性中耳炎(SOM组)和不伴分泌性中耳炎(对照组)的极重度聋患者各36例行人工耳蜗植入术,SOM组术中彻底清除中耳及乳突粘液,保证上鼓室引流通畅,余电极植入方法同对照组;评估两组术中、术后并发症,术后12个月通过助听听阈、有意义听觉整合量表(MAIS)、听觉行为分级(CAP)、言语可懂度分级(SIR)评估听觉言语康复效果,比较两组结果。结果两组患者均顺利植入全部电极,术中均未出现面神经裸露、硬脑膜损伤等手术并发症,术后均未出现伤口感染、延迟愈合、急性中耳炎、化脓性中耳炎、面瘫、乳突炎等术后并发症;术后12个月SOM组助听听阈为31.5±5.9 dB HL,CAP为5.4±1.4分,SIR为3.1±1.3分,MAIS为35.0±4.5分;对照组助听听阈为34.2±3.7 dB HL,CAP为6.0±1.2分,SIR为3.6±1.1分,MAIS为35.4±4.2分,两组间差异无统计学意义(P>0.05)。结论双侧极重度感音神经性聋伴分泌性中耳炎的患者可一期行人工耳蜗植入术,不会增加其术中及术后的风险,术后可获得良好的听觉言语康复效果。Objective To investigate the intraoperative and postoperative safety of cochlear implantation in patients with bilateral extremely severe sensorineural hearing loss with secretory otitis media and the effect of postoperative auditory and speech rehabilitation.Methods Thirty-six severely deaf children with(OME group)and 36 cases without(control group)secretory otitis media were treated with cochlear implantation,the middle ear and mastoid mucus were completely removed during the operation to ensure drainage of the upper tympanic cavity unobstructed.The intraoperative and postoperative complications of the two groups were evaluated.Hearing aid threshold,MAIS,CAP,and SIR were used to evaluate the effect of hearing and speech rehabilitation at 12 months after the operation.The results of the two groups were compared.Results All the electrodes were successfully implanted in both groups.There were no surgical complications such as exposed facial nerve and dura mater during the operation.No wound infection,delayed healing,acute otitis media,suppurative otitis media,facial paralysis,mastoiditis occurred after the operation.Twelve months after operation,the cochlear hearing threshold of the OME group was 31.5±5.9 dB,CAP5.4±1.4,SIR3.1±1.3,MAIS35.0±4.5;in the control group,the cochlear hearing threshold was 34.2±3.7 dB,CAP 6.0±1.2,SIR 3.6±1.1,MAIS 35.4±4.2.There was no significant statistical difference between the two groups(P>0.05).Conclusion Patients with bilateral extremely severe sensorineural hearing loss with secretory otitis media can undergo cochlear implantation simultaneously,without increasing their intraoperative and postoperative risks,and good hearing and speech rehabilitation can be obtained after the operation.

关 键 词：分泌性中耳炎 人工耳蜗植入 并发症 听觉言语康复 

分 类 号：R764.21[医药卫生—耳鼻咽喉科] R764.5[医药卫生—临床医学]