人工耳蜗植入手术并发症及临床分析

目的 探讨人工耳蜗植入手术并发症的预防及处置.方法 回顾分析2000年12月至2010年8月在我科由单一术者完成的416例人工耳蜗植入手术,发生并发症29例(29/416),占7%,随访时间1个月～10年,并对其原因进行分析,提出预防及处置的措施.结果 29例并发症中,按轻重程度分为:轻度并发症23例,占5.5%,包括术后皮下血肿13例,急性中耳炎2例,术后迟发性切口感染2例,术后迟发性面瘫1例,面肌抽搐1例,术后重度眩晕4例;重度并发症6例,占1.5%,包括脑脊液漏2例、切口感染致植入体外露1例、鼓膜穿孔致电极外露1例、耳蜗骨化至电极未能全部植入1例,磁铁移位1例.无电极耳蜗内扭曲、未植入耳蜗、植入体移位及脑膜炎、永久性面瘫发生.轻度并发症经处置后均痊愈,脑脊液漏经二次手术修补痊愈.电极、植入体外露2例病人,均取出植入体,行对侧耳蜗植入.1例磁铁移位经二次手术予以复位.结论 如何降低人工耳蜗植入手术严重并发症的发生,仍是人工耳蜗植入亟待解决的问题.     

经耳道皮下径路人工耳蜗植入术

目的:探讨经耳道皮下径路爱益声人工耳蜗植入手术的可能性.方法:40例双耳重度或极重度聋患儿采用经耳道皮下径路行爱益声人工耳蜗植入,术中行电极阻抗测试和电诱发听性脑干反应,术后拍耳蜗位X线片,术后4周开机验证电极植入位置及工作情况.结果:所有患儿电极全部顺利植入耳蜗内,人工耳蜗装置工作状态正常,术后随访6个月无电极脱出或其它严重并发症发生.结论:爱益声人工耳蜗可以安全地经耳道皮下径路植入.     

23例儿童再次人工耳蜗植入手术的临床分析

目的分析23例人工耳蜗植入患儿再植入的原因、处理方法及预后。方法回顾性分析2013年9月—2019年6月行人工耳蜗再植入术患者的临床资料,分析再植入的原因、处理方法及预后。结果人工耳蜗植入后造成再植入的原因：外伤1例,手术固定电极不良1例,术区感染5例,排除言语处理器、手术植入及患者自身原因的助听效果差2例,不明原因植入体故障14例。5例感染患者均为一期行人工耳蜗取出,感染控制后行二期人工耳蜗手术,均为单耳再植入,2例同侧植入,3例对侧植入。23例患者首次均为右耳单侧植入,再次植入时2例患者行双侧人工耳蜗植入,3例患者改为对侧再次植入。再植入术后随访1个月至5年10个月,1例患者术中出现井喷,术后眩晕,3d后缓解;1例患者出现头皮下血肿,术后2周内自行吸收。所有患者术后人工耳蜗听声效果正常。结论人工耳蜗再植入的原因有外伤、手术原因、感染、助听效果差、植入体故障,其中植入体故障和感染是儿童人工耳蜗再次植入的主要原因。再植入手术不影响人工耳蜗的效果,并发症发生率较初次手术无明显提高。为了减少人工耳蜗再植入,提倡精准的微创人工耳蜗植入预防并发症发生,同时加强对患者家长的教育,减少外伤等造成的人工耳蜗故障。     

259例人工耳蜗植入患者的并发症分析及处理

目的分析259例人工耳蜗植入(cochlear implantation,CI)患者的并发症,探讨并发症产生的原因、处理方法和预后。方法对1997年3月～2006年12月在我科接受人工耳蜗植入的259例患者的并发症及其处理和预后情况进行回顾性分析。结果259例人工耳蜗植入患者平均年龄8.4岁,最小11个月,最大52岁。随访时间平均2.9年。有4例患者发生严重的手术并发症(1例鼓膜穿孔行二期修补术、2例面神经麻痹行面神经减压术、1例脑脊液耳漏合并脑膜炎)。有39例患者出现轻度手术并发症,包括鼓膜穿孔、血肿、切口感染、面神经部分暴露等,经保守治疗或术中简单处理均得到有效控制。与人工耳蜗装置相关的并发症10例(3例人工耳蜗电极未植入或仅部分植入耳蜗内、1例术后电极脱出、5例人工耳蜗装置故障、1例耳蜗内植入后无反应)。所有手术并发症经过保守治疗或手术干预,预后良好。10例人工耳蜗装置故障经调整或再植入后,9例得到圆满解决,1例植入体取出。结论人工耳蜗植入是相对安全的手术。大部分手术并发症为轻度并发症,通过保守治疗或小的手术干预预后良好。人工耳蜗植入病例的选择要注意适应症。     

经耳道皮下径路人工耳蜗植入术

目的:探讨经耳道皮下径路爱益声人工耳蜗植入手术的可能性.方法:40例双耳重度或极重度聋患儿采用经耳道皮下径路行爱益声人工耳蜗植入,术中行电极阻抗测试和电诱发听性脑干反应,术后拍耳蜗位X线片,术后4周开机验证电极植入位置及工作情况.结果:所有患儿电极全部顺利植入耳蜗内,人工耳蜗装置工作状态正常,术后随访6个月无电极脱出或...     

人工耳蜗植入术的并发症及对症处理

目的　探讨人工耳蜗植入术后并发症产生的原因及处理措施。方法　回顾分析2005年5月～2012年10月在我科接受人工耳蜗植入的721例患者,发生并发症44例。通过分析其原因,提出预防及处理的措施。结果　44例并发症中,轻度并发症34例,包括骨膜下血肿15例;眩晕19例;重度并发症10例,包括面神经损伤2例;感染2例;植入体周围积液2例;耳蜗骨化电极误植入上半规管,后再次植入1例;磁铁移位及磁力消失各1例;植入体移位1例。无电极耳蜗内扭曲,电极移位,永久性面瘫发生等。结论　人工耳蜗植入并发症的预防和处理不容忽视,尤其是要防治术后的严重并发症。     

人工耳蜗植入术后皮瓣相关并发症的临床特点及处理方法分析北大核心CSCD

目的探讨人工耳蜗植入术后发生皮瓣相关并发症患者的临床特点及处理方法。方法回顾性分析2002年10月至2016年12月在我科接受人工耳蜗植入手术的679例患者,术前常规检查包括听力学、影像学及小儿肢体、智力发育评估,均符合人工耳蜗植入手术适应症。筛选术后发生皮瓣相关并发症的患者,分析其临床特点、处理过程及预后情况。结果皮瓣相关并发症6例,发生率0.88%,植入年龄最小1岁,最大2岁9个月,仅1例无植入体外露,其余5例均有皮瓣坏死及植入体外露,清创术中均发现植入体周围及深面较多炎性肉芽组织生长。施行人工耳蜗植入手术至发生并发症的时间间隔最短13天,最长1年6个月。经全身应用抗生素、局部换药(包括伤口置管冲洗、放置引流片、抗生素溶液湿敷)、清创及皮瓣转移整复术治疗后,痊愈2例;经多次清创及皮瓣转移整复术治疗无效,最终取出植入体4例。结论人工耳蜗植入术后皮瓣相关并发症发生率低,伴有皮瓣坏死及植入体外露的病例预后不良。主要原因包括切口/皮瓣设计不合理、外伤、细菌生物膜与异物反应等。局部换药、清创及皮瓣转移整复术治疗并不能完全解决皮瓣感染的问题,大部分患者需面临最终取出植入体的结果。手术至发生皮瓣感染的时间越短,保留植入体的可能性越大。     

人工耳蜗植入手术远期并发症的临床处理

目的总结和分析人工耳蜗植入患者术后的远期并发症,探讨并发症的发生原因、临床处理方法和预后。方法对2002年3月~2016年11月在北京大学第三医院由作者潘滔完成人工耳蜗植入手术且随访资料完整的280例患者进行回顾性研究。结果在所有研究对象中,出现各类远期并发症(发生于术后3个月之后的并发症)共6例,总发生率为2.1%,并发症出现时间最早为术后4个月,最晚为术后5年。其中术后远期中耳炎合并植入体周围感染3例,发生率1.1%,经过抗生素及对症治疗后痊愈。植入体装置故障2例,发生率0.7%,行植入体取出及同侧再植入。皮瓣感染及坏死1例,发生率0.4%,先后4次行耳后清创、皮瓣转移术,仍不能控制感染,遂行植入体取出、乳突清创、皮瓣转移成形术并同期行对侧人工耳蜗植入,最终痊愈。以上出现远期并发症的患者经过上述治疗干预后均预后良好。结论即使人工耳蜗植入患者术后恢复良好,远期的并发症仍值得关注,及时的发现和处理可挽救或避免进一步的危害后果。     

开放式乳突根治术后患者人工耳蜗植入

目的报告开放式乳突根治术后伴重度或极重度耳聋患者人工耳蜗植入的手术方法及术后听觉康复效果。方法收集自2014年1月-2015年6月于我科行人工耳蜗植入的5例开放式乳突根治术后伴极重度耳聋患者,对其手术方法进行分析,并于术后6个月对患者行CAP、SIR、MAIS、M-LNT等听觉康复测试。5例患者均经圆窗入路植入电极,于外耳道下壁与面神经嵴交界处磨出骨槽放置蜗外电极,以骨粉及颞肌筋膜覆盖保护。结果 5例患者顺利植入全部电极。术中发现上鼓室胆脂瘤1例,鼓阶部分骨化3例。术后30天开机,患者听性反应明确。术后随访第6个月,4例患者(1例失访)对听觉康复效果满意,SIR、MAIS均满分,除1例患者外,CAP得分均≥8分,双难词表M-LNT得分均≥55%。目前3例患者随访超过1年,1例患者随访6个月,均未出现电极裸露、移位,术腔感染、面瘫、味觉丧失及胆脂瘤复发等并发症。结论对于已行开放式乳突根治术的极重度耳聋患者,在干耳情况下尽早行人工耳蜗植入术,术后听觉康复效果满意。但因原解剖结构破坏,操作者需经验丰富,以免找不到圆窗或术中发现鼓阶骨化,而导致植入失败。     

小儿人工耳蜗植入手术切口选择及其相关并发症问题

目的探讨小儿人工耳蜗植入手术的切口选择。方法回顾性分析2001年6月～2007年7月开展的5岁以下患儿人工耳蜗植入手术589例,均设计小“S”切口。其中,行澳大利亚CI24M植入174例,切口长3.5cm;CI24CA植入137例,CI24K植入62例,切口均长3.0cm。行美国Bionics90K植入26例,切口长3.5cm。行奥地利MedelCombi40^＋植入190例,切口长6.0cm。均制备两个肌骨膜瓣,一个用于包裹植入体,另一个用于覆盖开放的乳突腔。术后随访6个月～6.5年,观察术后切口愈合状况以及与切口有关的并发症发生情况。结果植入的人工耳蜗均有听觉语言效果。12例于术后1～2年开始沿切口表面出现1.5～3.5mm的瘢痕隆起（2.0%）;4例于术后1～3年出现与皮下感染有关的植入体裸露（0.68%）。通过清除炎症及瘢痕组织、重新固定植入体、颞肌瓣转移覆盖均获痊愈,随访6个月～2.1年,未再出现植入体裸露。结论作者设计的小切口效果满意,可以减小皮肤切口瘢痕的范围,术后植入体裸露的发生率低。     

人工耳蜗植入术后发生面瘫的预防及处理

目的分析人工耳蜗植入术(CI)后的面瘫并发症病例,探讨并发症的预防和处理方法.方法对1998年3月~2012年1月在解放军总医院耳鼻咽喉-头颈外科接受人工耳蜗植入的1299例患者中发生的面瘫并发症及其处理和预后情况进行回顾性分析.结果1299例患者中,4例患者行人工耳蜗植入术后发生面神经麻痹,其中3例为迟发性面瘫,2例行面神经减压术,预后良好.结论人工耳蜗植入是相对安全的手术,面神经麻痹的发生率较低,为0.31%,经保守治疗或手术干预预后良好.     

Auditory brainstem implant as a salvage treatment after unsuccessful cochlear implantation.

OBJECTIVE: The present article investigates on an individual basis the performance achieved with the auditory brainstem implant in patients who had been treated unsuccessfully with a cochlear implant. STUDY DESIGN: An intrasubject comparison between results achieved with the cochlear implant and the auditory brainstem implant is reported. SETTING: Tertiary referral care. PATIENTS: Five subjects were fitted with an auditory brainstem implant in our department because of the poor results achieved with cochlear implants. Two were children, one with bilateral cochlear nerve aplasia and one suffering from auditory neuropathy. Three were adults with complete cochlear ossification. INTERVENTION: A retrosigmoid approach was used in all subjects. Electrically evoked auditory brainstem responses and neural response telemetry were used to monitor electrode positioning. RESULTS: No complications were observed due to implantation surgery or related to activation or long-term use of the auditory brainstem implant. Auditory sensations were induced in all patients with varying numbers of electrodes (from 9-16). In all three adults, the cochlear implant did not allow either word/sentence discrimination or speech tracking, whereas the auditory brainstem implant permitted discrimination of two- or three-syllable words with scores from 85 to 100%. In the two adults with a follow-up of 5 and 6 months after auditory brainstem implant activation, the open-set sentence recognition scores (auditory-only mode) were 70% and 100%, respectively, and the speech-tracking scores were 27 and 40 words/min, respectively. One patient with a follow-up of only 3 months scored 0% in both sentence recognition and speech tracking. The two children who had achieved no hearing ability with the cochlear implant were already able to detect sounds and words as early as 2 months after activation of the auditory brainstem implant and are showing progressive improvement in their performance. CONCLUSION: Auditory brainstem implantation may be a very powerful rehabilitative treatment after cochlear implant failure. The possibility of using the auditory brainstem implant as first-choice therapy in some categories of deaf patients (e.g., subjects with auditory neuropathy or cochlear ossification) who are currently treated with cochlear implantation is discussed.     

Cochlear implantation in children with inner ear malformation and postoperative performance

Cochlear implantation in children with cochlear malformation is on the rise. However, only one case has been reported in Japan. The objective of this paper is to report the authors' experiences with cochlear implants in children with cochlear malformations and, to investigate the morphological classification of cochlear malformation, surgical procedure, complications, and speech perceptions after implantation. Five children (6 ears, including 1 Usher's syndrome and 1 CHARGE association) with congenital inner ear malformations were implanted with multichannel cochlear implants (Nucleus Mini 22 device) between 1994 and 1998. Malformations included common cavity deformity 2, and incomplete partition 4. On the other hand, 4 cases with incomplete partition deformity underwent cochlear implantation by the transmastoid facial recess approach, 2 patients with common cavity deformity received implantation by the transmastoid labyrinthotomy approach. Complications such as facial twitching, cerebrospinal fluid (CSF) gusger, and flap-related problems were encountered. Facial twitching occurred in 1 of 2 patients with common cavity where the electrode array extended into the internal auditory canal. CSF gusher was encountered in 1 of 4 patients with incomplete partition, and revision surgery was performed one week later. One patient had delayed cochlear implant infection and a split pericranial flap was used to cover the defect in the skin flap. Within 6 months, however, the revised pedestal site broke down because of recurrent flap infection. Finally, the cochlear implant was explanted, and the patient underwent a new cochlear implantation in the contralateral ear. All the patients had satisfactory speech reception and word acquisition, but still poor phonetic expression.     

Long-term complications after cochlear implantation

Objective

Cochlear implantation has become an effective treatment for many profoundly deaf patients. As with any surgical procedure, a proportion of patients suffer postoperative complications. The aim of this study was to analyze long-term postoperative complications in patients with cochlear implants with a view to improve clinical interventions and propose a consensus for reporting complications.

Methods

A total of 406 cases received cochlear implants between December 1985 and April 2007 at Tokyo Medical University (TMU) Hospital. We retrospectively reviewed case notes from 366 patients who had undergone cochlear implantation (215 adults and 151 children) after excluding 40 patients of re-implantation including 13 cases implanted initially at other hospitals. Life-threatening, major and minor complications were examined retrospectively.

Results

Major complications occurred following cochlear implantation in 32 patients (8.7%) who had received their initial implant at TMU Hospital. Revision surgery was required for 30 patients. The mean age at implantation was 33 years 6 months (range, 1 year 9 months to 83 years; median, 37 years). The main etiology of deafness was unknown or progressive (113, 52.6%) in adults and congenital (132, 87.4%) in children. The cause of deafness was meningitis in 41 cases (11.2%), and 26 cases (7.1%) were diagnosed with idiopathic sudden deafness.Flap-related problems (including middle ear infection and/or flap necrosis) developed in 13 cases (3.6%), with 12 cases (7 adults, 5 children) requiring re-implantation. Electrode slip-out occurred in 8 patients (7 adults, 1 child). All adult cases in whom electrodes slipped out underwent implantation before 1994, while the child (1 pediatric case) was operated in 2003. All cases required re-implantation and most cochlear implantations were performed using the modified split-bridge technique after 1997. Six patients (4 adults, 2 children) experienced device failure. Four patients experienced electrode problems. Non-surgical major complications included 1 patient with permanent facial nerve paralysis as a result of thermal injury in 1995.The total number of minor medical and surgical complications was 27, representing 7.4% of all operations.

Conclusion

Many cases of major complications, including electrode problems and facial paralysis, excluding traumatic device failure were considered avoidable by strict operative and postoperative procedures. Some cases of flap infection and traumatic device failure may not be able to be avoided completely, and every possible care should be taken by implant patients and others involved.     

Controversial points in cochlear implantation for patients with cochlear otosclerosis

Most cases of otosclerosis show pathological changes only around the oval window. On the other hand, it is known that cavernous changes extending to the cochlea induce progressive sensorineural deafness. Three patients with severe bilateral deafness and severe cochlear otosclerosis as diagnosed by CT underwent cochlear implantation. The postoperative hearing abilities were satisfactory in two of the three patients at one year after the operation. However, one patient with advanced otosclerosis suffered from the complication of facial nerve stimulation two months later after the cochlear implantation. His available cochlear implant electrodes gradually decreased due to the facial nerve stimulation and at last the cochlear implant was no longer beneficial for reacquisition of his hearing ability. His CT densitometry revealed marked degradation of the CT value in the cochlear basal turn circumference in comparison with that in other patients showing good courses after the cochlear implantation. In conclusion, a cochlear implant operation is valuable in patients with severe sensorineural deafness with cochlear otosclerosis. However, we should cautious in performing cochlear implantation in patients with severe demineralization of the cochlear optic capsule.     

1068例人工耳蜗植入临床经验的总结

目的通过对10年共1068例人工耳蜗植入手术的总结,为深入开展人工耳蜗植入的临床工作提供经验。方法截至2008年2月,对1068例重度以上耳聋患者植入了多导人工耳蜗,其中包括澳大利亚Nucleus678例、奥地利Medel309例、美国AB81例,其中双侧植入2例,Nucleus和Medel各1例。结果①手术成功率：1068例人工耳蜗植入手术均一次成功,手术成功率100％。②手术并发症：术中面神经电钻灼伤2例,术后1～3个月完全恢复;术后伤口水肿和血肿自行恢复15例。③术后问题：术后1个月出现分泌性中耳炎鼓膜穿孔治疗5个月痊愈1例,肥胖体形线圈固定困难3例,术后耳鸣加重5例,术后伤口感染植入体裸露进行转移肌瓣修复5例,术后外伤植入体损坏二次更换3例,原因不清植入体不工作二次更换2例,期望值达不到患者要求取出2例。④术后效果：声场测听〈45dB、汉语言语识别率〉70％共758例,占71％;声场测听〉45dB、汉语言语识别率〈70％共310例,占29％。结论①1068例人工耳蜗植入术后信息反馈显示：本组人工耳蜗植入手术的成功率达到100％,与国内外平均水平相比有显著的优势。②手术并发症较少而且未发生严重并发症,但是麻醉的风险仍不能忽视,尤其是气道痉挛问题。③术后听觉言语康复问题较多,主要是一些患者术后的听觉言语康复效果差而在术前无法进行准确评估。④目前一些特殊的人工耳蜗植入患者,如耳蜗内听道畸形、听神经病、脑瘫、自闭症、弱智、年龄较大术前昕觉言语基础较差者等,术后听觉言语康复效果不佳。     

Our experience with split electrode array implant for obliterated cochlea

To study the outcomes of split electrode array cochlear implantation in ossified cochlea using the CAP scoring system. Retrospective case study. Tertiary referral center. Six cochleae in three adult and three pediatric patients with ossification. Intervention(s): All Patients underwent cochlear implantation with a split electrode array system. Major outcome parameter(s): Number of electrodes inserted during surgery, number of functioning electrodes on follow-up and auditory performance evaluation using the CAP score-Category of Auditory Perception [TSC Revised Version, based on Nottingham CI Program, 1995]. Six patients (three children and three adults) had insertion of split electrode array system. The mean number of electrodes inserted were 18.3 (range 15-21) and functioning electrodes at follow-up were mean of 14.3 (range 7-21). Auditory performance was measured using CAP score at 1?year post implant follow up, mean score in children was six and that in adult was eight. One pt had facial nerve twitching which was corrected by switching off the concerned electrode. No complications in sort of facial palsy or vestibular disorder were observed. Patients of ossified cochlea having profound deafness do well with split electrode array cochlear implantation as evaluated with CAP scoring system. The split electrode array results in more number of electrodes within the cochlear lumen. Retro graded apical array insertion has less chances of facial nerve stimulation as it is placed away from the nerve.     

中耳炎性病变患者的人工耳蜗植入

目的探讨伴中耳炎性病变的患者进行人工耳蜗植入的适应证、手术方法和术后并发症的发生情况。方法对1995年5月至2006年2月完成的866例人工耳蜗植入术的临床资料进行回顾性分析。术前或术中发现伴中耳乳突炎性病变患者共41例，其中男17例，女24例，年龄1岁3个月-38岁，平均10岁2个月；左耳人工耳蜗植入18例，右耳植入23例，均为单侧植入。其中慢性分泌性中耳炎13例，隐蔽性中耳炎18例，中耳炎后遗症鼓膜穿孔1例，双侧胆脂瘤中耳炎2例，中耳乳突肉芽肿7例。中耳炎性病变伴内耳、中耳畸形7例。对于双侧胆脂瘤中耳炎乳突根治术后患者，设计采用了带蒂翻转帽状腱膜法保护植入电极和面神经。结果41例患者经 Ⅰ期或分期手术，术后随访时间5个月至6年11个月，平均未发现耳部炎性并发症，装置工作良好。结论慢性非化脓性中耳炎、中耳乳突肉芽肿、中耳炎后遗症伴鼓膜穿孔者可采用Ⅰ期或分期方法行人工耳蜗植入。胆脂瘤中耳炎在彻底去除病变基础上可分期行人工耳蜗植入术。对于乳突根治术后没有足够组织覆盖保护植入电极的病例，可采用带蒂翻转帽状腱膜方法。存在活动性中耳乳突炎症者为手术禁忌证。中耳炎性病变患者人工耳蜗术后应长期随访。     

语前聋患儿国产人工耳蜗植入效果分析

目的 观察语前聋患儿植入诺尔康-晨星人工耳蜗(Nurotron-Venus cochlear implant,Nurotron-Venus CI)后的听觉言语发育情况及其安全性和稳定性.方法 回顾性分析郑州大学第一附属医院行Nurotron-Venus CI植入的78例语前聋患儿的临床资料,患儿植入年龄为13~96月,按植入年龄将患儿分为 A组(13~24月,16 例)、B 组(25~36月,13 例)、C组(37~48月,16 例)、D 组(49~72月,18 例)、 E 组(73~96月,15 例);在患儿术前及开机后1、3、6、12个月采用有意义听觉整合量表(meaningful auditory integration scale,MAIS)(C、D、E组)、婴幼儿有意义听觉整合量表(infant-toddler meaningful auditory integration scale,IT-MAIS )(A、B组)进行听觉能力评估,开机后1、3、6、12个月使用有意义言语使用量表(meaningful use of speech scale,MUSS)进行言语能力评估.术后行X线耳蜗平片检查明确电极位置及形态,定期随访了解术后相关并发症及佩戴人工耳蜗时间和使用情况.结果 所有患儿术前及开机后1、3、6、12月IT-MAIS或MAIS得分分别为1.67±1.19、6.60±5.12、11.86±5.44、17.41±5.04、22.87±5.46分,术后1、3、6、12月MUSS得分分别为5.01±3.26、8.38±3.58、11.88±3.88、16.58±4.95分,随着植入时间延长得分不断上升(均P<0.05);不同年龄组IT-MAIS或MAIS得分比较:术前A组低于C、D、E组,开机后1、3月A、B组低于E组,开机后6月A组低于C、D、E组,B组低于E组(均为P<0.05);不同年龄组MUSS得分比较:开机后1月B组低于E组,开机后3月A、B、C组低于E组,开机后6月A组低于C、D、E组,B组低于E组,开机后1年A组低于C、D、E组(均为P<0.05).所有患儿在开机后1、3、6、12月MUSS与IT-MAIS或MAIS得分相关系数分别为0.918、0.808、0.881、0.756(均为P<0.05),两者呈正相关.78例患儿术后耳蜗位X线平片均显示电极位置正常,形态良好;2例患儿出现处理器故障,其余CI整体工作状态良好.结论 语前聋患儿国产人工耳蜗植入后1年内,所有患儿的听觉言语能力随时间延长不断提高;小龄组患儿听觉言语得分在术后早期低于大龄患儿;听觉能力在开机后12月时已无差异,但小龄组患儿的言语能力仍低于大龄患儿;听觉整合能力越强,言语使用能力越强;Nurotron-Venus CI安全、效果可靠.