不全分隔Ⅰ型患者合并脑脊液漏人工耳蜗植入手术技术与术后效果研究  

Surgical techniques and postoperative outcomes of cochlear implantation for incomplete partition type I with cerebrospinal fluid leak

作　　者：薛书锦 魏兴梅 陈彪[1] 高振橙 崔丹默[1] 石颖[1] 陈婧媛[1] 孔颖[1] 李永新[1] Xue Shujin;Wei Xingmei;Chen Biao;Gao Zhencheng;Cui Danmo;Shi Ying;Chen Jingyuan;Kong Ying;Li Yongxin(Department of Otorhinolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京100730

出　　处：《首都医科大学学报》2024年第6期995-1000,共6页Journal of Capital Medical University

基　　金：国家重点研发计划项目(2022YFC2402705);北京市自然科学基金项目(7244308);北京市医院管理中心青年人才培养“青苗”计划(QML20230204)。

摘　　要：目的探究不全分隔Ⅰ型(incomplete partition typeⅠ,IP-Ⅰ)合并脑脊液漏患者人工耳蜗植入同期修补脑脊液漏手术技术及术后脑脊液漏控制及听觉言语康复效果。方法回顾性分析8例IP-Ⅰ合并脑脊液耳漏的患者临床资料及术后随访结果。所有患者均行人工耳蜗植入同期行经水平半规管开窗脑脊液漏修补术,术后1周内使用抗生素治疗,术后1个月人工耳蜗开机,并开始接受听觉言语康复训练。结果所有患者人工耳蜗电极顺利植入,术后随访时间1~17年,所有患者均未再次出现脑脊液耳漏,并获得不同程度的听觉获益。结论人工耳蜗植入同期行经水平半规管开窗脑脊液漏修补的手术方法能够有效解决IP-Ⅰ合并脑脊液漏患者的相关症状,预防脑脊液漏复发并帮助患者重建听力。Objective To explore the surgical technique for cochlear implantation and simultaneous repair of cerebrospinal fluid(CSF)leaks in patients with incomplete partition type I(IP-I)combined with CSF leakage,as well as the postoperative control of CSF leaks and auditory-verbal rehabilitation outcomes.Methods A retrospective analysis was conducted on the clinical data and postoperative follow-up results of 8 patients with IP-I combined with CSF otorrhea.All patients underwent cochlear implantation and simultaneous repair of CSF otorrhea via a transmastoid lateral semicircular canal approach.Antibiotic treatment was administered within the first week postoperation,and cochlear implants were activated one month post-surgery,followed by auditory-verbal rehabilitation training.Results Cochlear implant electrodes were successfully implanted in all patients.The follow-up period ranged from 1 to 17 years,during which no patients experienced recurrent CSF otorrhea,and all patients had varying degrees of auditory benefit.Conclusions The surgical method of cochlear implantation with simultaneous repair of CSF otorrhea via a transmastoid lateral semicircular canal approach effectively resolved symptoms associated with IP-I combined with CSF leakage,prevented the recurrence of CSF leaks,and aided in hearing reconstruction.

关 键 词：不全分隔Ⅰ型 脑脊液耳漏 内耳畸形 人工耳蜗植入 

分 类 号：R762[医药卫生—耳鼻咽喉科]