内耳畸形人工耳蜗植入术:与手术并发症及沟通技巧有关的考虑。

IF 1.3
Recep Karamert, Hakan Tutar, Şenay Altinyay, Mehmet Düzlü, Merve Yildiz, İsmail Akdulum, Mehmet Birol Uğur, Mustafa Çolak, Süleyman Cebeci, Muammer Melih Şahin, Elçin Orçan, Yıldırım Ahmet Bayazit
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引用次数: 7

摘要

导言:畸形耳蜗的植入有一些特殊的挑战,如面神经异常、脑脊液(CSF)泄漏、错误电极插入或面部刺激,并且根据畸形的严重程度,结果可能不同。本研究的目的是评估内耳畸形(IEMs)对人工耳蜗植入手术并发症和结果的影响。方法:为评估IEMs对人工耳蜗(CI)预后的影响,从863例患者中选取流行病学参数相似的2组患者。研究组(IEM患者)和对照组(正常内耳患者)包括25例接受CI治疗并完成至少1年随访的患者。术前和植入后至少1年评估听觉表现、接受和表达语言能力以及言语的产生和使用。观察各组手术并发症类型及翻修手术率。结果:在研究组中,最常见的畸形是孤立的前庭导水管扩大(EVA)(44.8%)。总的来说,IEMs患者在听觉语言技能上有了显著的改善。总的来说,耳蜗正常的患者得分明显高于iem患者(p < 0.05)。对照组的并发症发生率明显低于研究组(p = 0.001),但翻修手术率无显著差异(p = 0.637)。结论:尽管IEMs患者术后表现不同,但仍有可能提高与CIs的沟通技巧。EVA、2型不完全隔区和2型耳蜗发育不全患者在听-语言能力方面表现最好。与耳蜗正常的患者相比,IEMs患者得分较低。脑脊液泄漏(涌出或渗出)是手术中最常见的并发症,在3型不完全分区病例中极有可能发生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cochlear Implantation in Inner Ear Malformations: Considerations Related to Surgical Complications and Communication Skills.

Introduction: There are particular challenges in the implantation of malformed cochleae, such as in cases of facial nerve anomalies, cerebrospinal fluid (CSF) leaks, erroneous electrode insertion, or facial stimulation, and the outcomes may differ depending on the severity of the malformation. The aim of this study was to assess the impact of inner ear malformations (IEMs) on surgical complications and outcomes of cochlear implantation.

Methods: In order to assess the impact of IEMs on cochlear implant (CI) outcomes, 2 groups of patients with similar epidemiological parameters were selected from among 863 patients. Both the study group (patients with an IEM) and control group (patients with a normal inner ear) included 25 patients who received a CI and completed at least 1 year of follow-up. Auditory performance, receptive and expressive language skills, and production and use of speech were evaluated preoperatively and at least 1 year after implantation. Types of surgical complications and rates of revision surgeries were determined in each group.

Results: In the study group, the most common malformation was an isolated enlarged vestibular aqueduct (EVA) (44.8%). Overall, the patients with IEMs showed significant improvement in auditory-verbal skills. In general, the patients who had normal cochleae scored significantly better compared to patients with IEMs (p < 0.05). The complication rate was significantly lower in the control group compared to the study group (p = 0.001), but the rate of revision surgeries did not differ significantly (p = 0.637).

Conclusion: It is possible to improve communication skills with CIs in patients with IEMs despite the variations in postoperative performances. Patients with EVA, incomplete partition type 2, and cochlear hypoplasia type 2 were the best performers in terms of auditory-verbal skills. Patients with IEMs scored poorly compared to patients with normal cochleae. CSF leak (gusher or oozing) was the most common complication during surgery, which is highly likely in cases of incomplete partition type 3.

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