伴中耳胆固醇肉芽肿患者同期人工耳蜗植入的初步探讨  

Preliminary Study on Simultaneous Cochlear Implantation in Patients with Cholesterol Granuloma in the Middle Ear

作　　者：张静 张建 鲁雪雪 曹玮 邱建新 姚昆[1] Zhang Jing;Zhang Jian;Lu Xuexue;Cao Wei;Qiu Jianxin;Yao Kun(Department of Otorhinolaryngology,Head and Neck Surgery,Fuyang Hospital of Anhui Medical University,Fuyang,236000,China;不详)

机构地区：[1]安徽医科大学附属阜阳医院耳鼻咽喉头颈外科,阜阳236000 [2]安徽医科大学第一附属医院耳鼻咽喉头颈外科

出　　处：《听力学及言语疾病杂志》2024年第4期330-333,共4页Journal of Audiology and Speech Pathology

基　　金：安徽医科大学校基金资助项目(2022xkj066)。

摘　　要：目的总结伴中耳胆固醇肉芽肿(cholesterol granuloma,CG)的语后聋患者同期人工耳蜗植入(CI)的临床经验。方法对2018年12月~2022年12月在安徽医科大学附属阜阳医院就诊,伴中耳CG行CI的6例语后聋患者的临床资料进行回顾性分析,对同期CI手术的手术方式、疗效及术后并发症等进行总结,并使用听觉行为分级(categories of auditory performance,CAP)和言语可懂度分级(speech intelligibility rating,SIR)评估听觉言语康复效果。结果6例患者根据术前CT表现选择个体化手术方式,对于病变仅累及乳突、鼓窦或上鼓室的3例患者,采用完璧式乳突改良根治术+CI;另3例患者术前阅片病变较为广泛,完璧式乳突切开难以彻底清理病变,或伴有咽鼓管鼓室口被病变堵塞或术中探查咽鼓管通畅度较差,采用开放式乳突根治术+CI+中耳封闭术,均成功完成CI手术。所有患者术后及随访期间均未出现切口感染、面瘫、迷路炎、颅内感染、复发、电极裸露等并发症;术后患者CAP和SIR评分较术前显著提高,差异有统计学意义(P<0.05)。结论对合并中耳CG的重度感音神经性聋患者可同期行CI手术,术后可获得良好的听觉康复效果,但应根据病变范围选择合适的手术方式,防止术后并发症的发生。Objective To investigate the clinical experience of cochlear implantation(CI)in patients with postlingual hearing loss accompanied by cholesterol granuloma(CG)in the middle ear.Methods A retrospective study was conducted on the clinical data of 6 patients with postlingual hearing loss who underwent CI with middle ear CG at Fuyang hospital of Anhui Medical University from December 2018 to December 2022.The selection of surgical methods,surgical efficacy,and postoperative complications of patients undergoing CI surgery during the same period were summarized and analyzed.The categories of auditory performance(CAP)and speech intelligibility rating(SIR)were used to evaluate the effectiveness of auditory speech rehabilitation.Results Six patients were treated by individualized surgical methods based on preoperative CT findings and successfully completed cochlear implant surgery.According to the scope of the lesion,three patients were treated with canal wall up mastoidectomy(CWUM)and CI,the other three patients were treated with radical mastoidectomy(RM),CI and middle ear closure(MEC).All patients did not experience complications such as incision infection,facial paralysis,labyrinthitis,intracranial infection,recurrence,or electrode exposure after surgery and during follow-up.The CAP and SIR scores of postoperative patients were significantly improved compared to preoperative with statistical significance(P<0.05).Conclusion For patients with severe sensorineural hearing loss and middle ear CG,simultaneous cochlear implantation can achieve good auditory rehabilitation effects.However,appropriate surgical methods should be selected based on the lesion range,and the lesion must be completely removed to prevent postoperative complications.

关 键 词：中耳胆固醇肉芽肿 耳蜗植入 语后聋 

分 类 号：R764.93[医药卫生—耳鼻咽喉科]