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摘要: 目的:分析人工耳蜗再手术患者的一般特点、耳蜗故障常见原因及再植入手术入路与手术技巧。方法:对39例行人工耳蜗再手术的患者进行回顾性统计分析,对每例再植入患者的耳蜗佩戴时间、故障原因、再手术方法等进行记录。结果:39例行人工耳蜗再手术患者,年龄1~28岁,平均7.8岁,中位年龄5岁。耳蜗故障前佩戴时间从开机即刻到7年,平均2.2年,中位时间1年。再植入者37例,右侧30例,左侧7例。耳蜗再手术原因分别为植入体故障28例,感染5例,电极植入错误3例,面神经刺激症状2例,电极脱出1例。再手术方式取决于首次植入方式,2例胆脂瘤术后经中耳乳突径路行再植入手术,余35例均经面隐窝径路行再植入手术;5例对侧植入,余均为同侧植入。结论:人工耳蜗再植入的原因多样且较复杂,多与外伤或植入体本身故障有关。耳蜗故障后尽早再植入,可以最大限度减小耳蜗骨化及言语发育停滞的影响。再手术方式尽可能循原入路进行耳蜗电极植入。Abstract: Objective: To analyse the characteristics of the revision cochlear implantation (RCI)patients,the cause of the cochlear malfunction,and the choice of RCI operative approach.Method: A total of 39 patients with RCI were enrolled in this study. The cochlear use time, cause of failure and reoperation procedure are recorded and analyzed retrospectively. Result: There were 39 patients accepted cochlear reoperation,the ages ranges from 1 to 28,average age was 7.8 years, median age was 5 years old. The cochlear use time ranges from 1 month to 7 years,average was 2.2 years, median time was 1 year. Thirty-seven patients underwent RCI,30 cases right side and 7 cases left side. The reason of RCI contains device failure (28 cases),infection (5 cases),incorrect electrode implantation (3 cases),facial nerve stimulation (2 cases),and electrode prolapse (1 case).The choice of RCI procedure was dependent on the first operation procedure,contains facial nerve recess approach (35 cases) and mastoid approach (2 cases).Contralateral implantation was performed in 5 cases, the rest were ipsilateral. Conclusion: RCI has a variety causes and the common reason is trauma and device failure,the RCI should be completed as early as possible to avoid the ossified cochlear and hearing or speech stagnation,the electrode implantation through previous approach is the best method.
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Key words:
- cochlear implantation /
- device failure
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