Mondini畸形电子耳蜗植入电极选择与术后效果分析

发布时间：2018-03-18 01:23

  本文选题：耳蜗植入术　切入点：Mondini畸形　出处：《临床耳鼻咽喉头颈外科杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的:探讨Mondini畸形患者采用弯电极进行电子耳蜗植入的手术方法,比较直、弯电极电子耳蜗植入的术后效果。方法:收集进行电子耳蜗手术的Mondini畸形患者,选择植入弯电极的患者9例,另根据植入年龄、康复条件等选择9例直电极植入患者进行配对分组。分析两组Mondini畸形患者术前听力学特征、术中手术特点、术后神经反应遥测(NRT)结果及开机调试结果,随访术后听觉行为分级标准(CAP)和言语可懂度分级标准(SIR)评分,对比分析采用不同电极患者的测试参数及术后康复效果。结果:Mondini畸形患者术前听力均为极重度神经性聋,4例术中出现脑脊液"井喷";直电极组2例出现面肌抽搐,其余无术后面瘫、面肌抽搐、脑脊液漏、脑膜炎等并发症;所有Mondini畸形患者术后均获得听觉,术中电极植入后测试NRT,弯电极组NRT引出率为77.78%,高于直电极组引出率(55.56%)。开机6个月收集编程调试的阈值(T-levels)、最大舒适强度(Clevels)和动态范围,其中平均T值:弯电极组(145.11±10.88)CL,直电极组(168.44±22.45)CL,P0.05;平均C值:弯电极组(182.67±14.65)CL,直电极组(213.00±19.27)CL,P0.05;动态范围:弯电极组(37.56±6.75)CL,直电极组(44.56±18.06)CL,P0.05。随访6个月~4年,CAP平均得分弯电极组为7.28±0.62,直电极组7.22±0.79,P0.05;SIR平均得分弯电极组为4.17±0.56,直电极组4.00±0.71,P0.05。结论:Mondini畸形患者可以根据需要采用弯电极电子耳蜗植入,术后听力言语康复与直电极无显著性差异,优点是刺激电量较小,NRT引出率高,并发症发生率低。
[Abstract]:Objective: To explore the surgical methods in patients with Mondini malformation with curved electrode cochlear implant is straight, curved electrode cochlear implantation effect after operation. Methods: Mondini malformation patients were collected for cochlear implant surgery, 9 cases of patients with curved electrode implantation, the other according to the age of implantation, 9 cases of rehabilitation conditions choose straight electrode implantation in patients with matching packet. Audiological characteristics of deformity patients before two groups of Mondini, the operation characteristics in operation, postoperative neural response telemetry (NRT) results and debugging results, postoperative auditory behavior grading standard (CAP) and speech intelligibility rating criteria (SIR score), comparative analysis of the effect of rehabilitation the test parameters and the patients with different electrodes. Results: Mondini malformation patients preoperative hearing are very severe sensorineural hearing loss, cerebrospinal fluid blowout occurred in 4 patients; straight electrode there were 2 cases with hemifacial spasm, rest 鏃犳湳鍚庨潰鐦，

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