人工耳蜗植入相关问题探讨

①目的　通过对接受人工耳蜗植入病人临床资料的分析与评估,探讨多通道人工耳蜗植入适应证选择、手术方法和技巧对双侧重度或极重度感音神经性聋临床疗效的影响。②方法　13例双耳重度或极重度感音神经性聋病人,经乳突 面隐窝入路行Nucleus 24导或Clarion C1人工耳蜗植入术。术前行听力学和影像学评估,并严格掌握手术适应证。术后1月开机调试。语前聋8例进行了3~19个月听觉言语康复训练,对所得临床资料进行分析。③结果　13例耳蜗电极全部成功植入,术中、术后无并发症发生。术后 2 周颞骨 X线摄片证实电极位于耳蜗内。术后1月开机调试,13例全部恢复听力。1例语后聋病人仅经简单语言训练即可对话与电话交流,11 例语前聋病人经训练均获得不同程度的听觉言语康复,1例因年龄过小,暂不进行语言康复训练。④结论　人工耳蜗植入术为治疗双侧重度或极重度感音神经性聋的常规有效的治疗方法,其主要适应证为任何年龄的语后聋、语前聋儿童和部分青少年。术前准备、听力学和影像学评估是人工耳蜗植入术成功的重要前提,而术后调机以及系统的听觉言语康复训练则是提高临床疗效的保证。

CLINICAL ANALYSIS OF MULTICHANNEL COCHLEAR IMPLANTATION

Objective To study the effect of the indications, surgical procedures and skills of multichannel cochlear implantation on bilateral severe or profound sensorineural deaf patients through analysis and evaluation of the data of those who had undergone the operation. Methods Thirteen patients were enrolled in this study. All of them were implanted multichannel cochlear(model Nucleus 24 or Clarion C1) through facial nerve recess approach. They were assessed by audiology and aural image before surgery. Eight prelingual patients underwent audition and speech or language skills rehabilitation training for 3-19 months. The clinical materials of them were analysed. Results All the 13 patients were implanted successfully without any complications intra- and postoperatively. An X-ray film of the temporal bones two weeks later proved that all the electrodes located properly in cochlears. Mapping was done one month after surgery showing that the hearing recovered completely in all patients. One postlingual deaf patient was able to do dialogue after simple speech training. Of the 11 prelingual patients recovered various extents in audition and speech after training. One case was too young to be trained. Conclusion The cochlear implantation is a routine treatment for bilateral severe or profound sensorineural deafness. The main indications were postlingual deaf in adults, prelingual deaf in children and in some youngsters. Preoperative preparations, audiology and aural image assessments are important premises for a successful cochlear implant. Mapping and adjustments of cochlear speech processor and systematic audition and speech skills rehabilitation training ensure the increase of the treatment.