人工耳蜗植入康复大前庭水管合并重及极重度听力损失

目的：了解人工耳蜗植人法康复大前庭水管综合征(LVAS)重度和极重度听力损失的效果。方法：3例LVAS畸形(LVAS组)与10例无畸形(无畸形组)重度以上感音神经性听力损失患者进行人工耳蜗植人。比较2组间手术植人情况、开机时映射调试时的伴随症状及听阈(T-level)、最大舒适阈(C-level)和补偿听阈。结果：①手术中LVAS组出现“井喷”现象1例。开机映射调试时出现耳鸣及头胀痛1例，眩晕及心慌气短1例；无畸形组中出现下眼睑跳动l例。②开机时LVAS组1例C—T level差值仅1～2个电流级，1例平均7个电流级。1例平均15个电流级；无畸形组除1例15个电流级外．其它均在20～25个电流级。开机1周、1个月时LVAS组的C—T level差值平均为30、50个电流级，补偿听阈平均为69和50dB SPL；无畸形组为43、58个电流级，62和47dB SPL。结论：LVAS畸形患者进行人工耳蜗手术时要迅速准确地插入电极；开机时C-T level范围较无畸形患者窄，出现伴随症状给予相应处理；经过一段时间的康复调试后其范围与无畸形患者相差不大，补偿听阈亦差异无显著性。

Rehabilitation for Severe to Profound Hearing Loss of Large Vestibular Aqueduct with Cochlear Implants

Objective:To know the rehabilitation for s ev ere to profound hearing loss of large vestibular aqueduct syndrome(LVAS) with co chlear implants. Methods: Cochlear implantations were performed on 3 cases of LVAS with severe to profound hearing loss (LVAS group). Ten cases of severe to profound hearing los s without any malformations of the external, middle and inner ear served as cont rol group. Planted condition in surgery, non-auditory sensation in mapping and switch on, the C-level, T-level and hearing threshold after cochlear implantat ion were compared between two groups. Results: One case in LVAS group had surgi cal gusher, one had tinitus and headache and one had vertigo and palpitation. On e in control group had facial nerve stimulation. The difference between C-level and T-level in LVAS group was smaller than that in control group at the beginn ing, but there was no difference at a month of switch on. There was difference i n aided threshold between LVAS group and control group at first week, but there was no difference at first month. Conclusion: It is necessary to rapidly implant and carefully seal the intracochlear multichannel electrodes. Non-auditory sen sations should be treated. There was no difference in the aided threshold after rehabilitation.