人工耳蜗植入的术前评估与术中处理

目的 总结人工耳蜗植入术前评估和术中处理经验,以提高手术安全性和术后效果。方法 对158例行人工耳蜗植入患者的术前听力学与影像学信息进行评估,与术中术后结果进行比较。结果 158例人工耳蜗植入者,中耳内耳形态正常者116例,中耳内耳有异常改变42例。6例术中出现井喷,除1例井喷术前未预料外,余157例均与术前评估吻合。术后全部患者重新建立了新的听觉,平均纯音听力(声压级)37.6 dB。结论 人工耳蜗植入手术的安全性主要依靠术前影像学评估,使用高分辨率CT指导手术可以降低手术失败率,减少并发症。

Pre-operation evaluation and intra-operation management of cochlear implantation

Objective To summarize pre-operation evaluation experiences in cochlear implantation. Methods Performing auditory evaluation and image analysis seriously in 158 severe hearing loss or total deaf cases before cochlear implantation, comparing their performance with the findings during and post operation. Results Among the total 158 cases, 116 cases with normal structure,42 cases with the abnormal findings of the inner or middle ear. Stapedial gusher happened in 6 cases, 1 case was not predicted before operation. Except 1 case with serious malformation, the findings of other 157 cases in operation were consistent with the pre-operation evaluation. We helped all patients reconstruct auditory conduction with cochlear implantation, and the average hearing level up to 37. 6 dB SPL Conclusions Performing image analysis seriously before operation and planning for operation according to HRCT can do great help to cochlear implantation. The operation under the HRCT instruction has less complications.