伴有中耳胆脂瘤的重度或极重度感音神经性耳聋患者的人工耳蜗植入  

Cochlear Implantation in Patients with Cholesteatoma and Severe or Profound Sensorineural Hearing Loss

作　　者：张志利[1] 蒋壮 李鹏军 肖念慈 周水洪[1] ZHANG Zhi-li;JIANG Zhuang;LI Peng-jun;XIAO Nian-ci;ZHOU Shui-hong

机构地区：[1]浙江大学医学院附属第一医院耳鼻咽喉头颈外科,杭州310000

出　　处：《中国听力语言康复科学杂志》2024年第4期356-360,共5页Chinese Scientific Journal of Hearing and Speech Rehabilitation

摘　　要：目的探讨在伴有中耳胆脂瘤的重度或极重度感音神经性耳聋患者中行胆脂瘤切除并人工耳蜗植入手术的适应证、手术技巧及术后并发症管理。方法回顾性分析2022年6月~2023年10月我科收治的7名伴有中耳胆脂瘤的极重度感音神经性耳聋患者。总结手术方案的选择、手术技巧及术后并发症的处理措施,对患者术后康复情况进行跟踪和观察。结果1例患者由于耳蜗骨化程度超过360°,因此仅植入了8个电极,其余患者均成功植入全部电极。截至目前,除首例患者随访6个月,其余患者随访12~20个月,均未出现电极裸露、移位、术腔感染、面瘫或胆脂瘤复发等并发症。1例部分植入电极的患者有听觉,但言语功能不佳,其他患者的听觉功能均得到显著改善,对人工耳蜗装置的使用感到满意。结论对于伴随中耳胆脂瘤及极重度感音神经性耳聋患者,彻底切除胆脂瘤并尽早行人工耳蜗植入是可行的。Objective This study aims to present the indications,surgical techniques,and management of complications associated with cholesteatoma excision and cochlear implantation in patients with profound sensorineural hearing loss.Methods This retrospective analysis included 7 patients treated from June 2022 to October 2023 in our department,who had profound sensorineural hearing loss associated with cholesteatoma.These patients received cochlear implantation surgeries after complete excision of the cholesteatoma.We analyzed the reasons for choosing surgical plans,the surgical techniques employed,and the management of postoperative complications.The patients'postoperative rehabilitation conditions were also tracked and observed.Results One patient received only 8 electrodes due to cochlear ossification exceeding 360°,while all other patients successfully received the full set of electrodes.As of now,except for the first patient who was followed up for 6 months,the other patients were followed up for 12 to 20 months.None of the patients experienced complications such as electrode exposure,displacement,surgical cavity infection,facial paralysis,or cholesteatoma recurrence.The first patient with partial electrode implantation has hearing but poor speech function,whereas the other patients showed significant improvement in hearing function and were satisfied with the use of the cochlear implant device.Conclusion For patients with cholesteatoma and profound sensorineural hearing loss,it is feasible to perform cochlear implantation early after complete excision of the cholesteatoma.

关 键 词：人工耳蜗植入 中耳胆脂瘤 感音神经性耳聋 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]