人工耳蜗植入"井喷"的判断与术中处理的体会

目的：探讨人工耳蜗植入发生“井喷”的术前判断与术中处理的方法。方法：327例人工耳蜗植入患者术前均行颞骨高分辨CT（HRCT）筛查，并行术前准备及术中处理。结果：11例术前颞骨HRCT显示内耳畸形并发内听道底骨性缺损与耳蜗、前庭相通，术中均有脑脊液喷出，经过术中对植入口的严密封闭，术后未见脑脊液耳鼻漏等并发症的发生。结论：人工耳蜗植入发生“井喷”的原因为内耳与蛛网膜腔有异常开放的通道。术前行颞骨HRCT检查不仅能对内耳畸形的患者作出准确的判断，还能为术中进行正确的处理提供准确的科学依据，从而避免并发症的发生。

Prediction and management about perilymph gusher in cochlear implantation

Objective:To discuss the clinical experience of prediction and management about perilymph gusher in cochlear implantation.Method:Among 327 cases of cochlear implant,eleven recipients were selected by the high resolution computed tomography(HRCT) findings of cochlear malformations and bony fistula on fundus of the internal auditory canal that caused an abnormal connection between subarachnoid and perilymphatic spaces.Result:Perilymph gusher was found in all of these 11 recipients during cochlear implantation and was controlled with muscle tissue seal.Conclusion:The reason of perilymph gushers in cochlear implantation is that abnormal connection between subarachnoid and internal auditory canal.HRCT can be used to assess the possibility of perilymph gusher in surgery.The safe and rapid surgical method of gusher controlling can avoid complication.