Retrospective Analysis of Cerebrospinal Gushers in Cochlear Implant Surgery: Incidence, Risk Factors, and Outcomes-A Systematic Review and Meta-analysis.

Mohammed Hazazi, Eman Almashharawi, Saleh Alamry, Meshael M Alkusayer, Alwaleed Altimyat, Yazeed Alsalamah
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Abstract

Background: Cerebrospinal fluid (CSF) gusher is a common complication experienced during cochlear implantation in patients with structural deformities in the inner ear. Objectives: This study aimed to investigate the incidence of CSF gusher, risk factors, and outcomes in patients during cochlear implantation. Methods: This systematic review and meta-analysis were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses model. Studies used in the analysis were identified through a comprehensive search in Google Scholar and PubMed. Results: The analysis was performed using 13 retrospective studies. The incidence of CSF gusher was 5% (95% CI: 3%-9%). CSF gusher was more prevalent among patients with inner-ear malformation (IEM) than without IEM odds ratio = 63.01 (95% CI: 9.85-403.11, P < .00001, I2 = 88%). For incomplete partition (IP), CSF gusher in the IP-I group was 48% (95% CI: 25%-71%, I2 = 0%), 19% in IP-II, 86% in IP-III, 40% in the common cavity, 26% in cochlear hypoplasia, and 27% in patients with enlarged vestibula aqueduct. Conclusion: The CSF gusher incidences were determined to be 5%. Patients with IEM are at increased risk of experiencing CSF gusher during cochlear implant surgery. Therefore, precise scanning reports should be produced in preoperational phase to inform proper management techniques to reduce the chances of intraoperative complications, including CSF gusher.

人工耳蜗手术中脑脊液灌注的回顾性分析:发病率、风险因素和结果--系统回顾和 Meta 分析。
背景:脑脊液(CSF)涌出是内耳结构畸形患者在人工耳蜗植入过程中常见的并发症。研究目的本研究旨在调查人工耳蜗植入术中脑脊液涌出的发生率、风险因素和患者的预后。方法本系统综述和荟萃分析以《系统综述和荟萃分析首选报告项目》模型为指导。分析中使用的研究是通过在谷歌学术和 PubMed 上进行全面搜索后确定的。结果分析使用了 13 项回顾性研究。CSF涌液的发生率为5%(95% CI:3%-9%)。有内耳畸形(IEM)的患者比无内耳畸形(IEM)的患者更容易出现 CSF 涌流,几率比 = 63.01 (95% CI: 9.85-403.11, P < .00001, I2 = 88%)。就不完全分隔(IP)而言,IP-I 组的 CSF 涌出率为 48%(95% CI:25%-71%,I2 = 0%),IP-II 组为 19%,IP-III 组为 86%,普通腔为 40%,耳蜗发育不良为 26%,前庭导水管扩大患者为 27%。结论经测定,脑脊液喷涌发生率为 5%。IEM 患者在人工耳蜗植入手术中出现 CSF 涌流的风险增加。因此,应在术前阶段制作精确的扫描报告,以提供正确的管理技术,降低术中并发症(包括 CSF 涌流)的发生几率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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