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[儿童和成人群体人工耳蜗植入手术的并发症]

[Complications of cochlear implant surgery in children and adults].

作者信息

Kempf H G, Tempel S, Johann K, Lenarz T

机构信息

HNO-Klinik der Medizinischen Hochschule Hannover.

出版信息

Laryngorhinootologie. 1999 Oct;78(10):529-37. doi: 10.1055/s-1999-8753.

Abstract

BACKGROUND

In a retrospective analysis we evaluated the complication rate in 697 patients after cochlear implantation between 1985 and 1995 (366 children, 331 adults; 604 Nucleus, 50 Clarion and 42 other implants).

RESULTS

Intraoperatively in 74 cases (10.6%) total or partial cochlear obliteration was found, a CSF gusher occurred in 7 cases. Minor complications such as seroma (8 adults), wound infections (14 patients), emphysema, and swelling were successfully treated with conservative methods and drugs. Seven (2.1%) adults showed facial nerve palsy postoperatively with incomplete recovery only in 2 of them (0.6%). No permanent facial nerve palsy was observed in children. Cholesteatoma developed in 18 adults (5.4%), which was treated by revision surgery.

CONCLUSIONS

In conclusion, cochlear implant surgery is a safe procedure with a low complication rate. However, Cochlear implantation should be performed by well experienced ear surgeons who can properly handle intraoperative and postoperative problems. The patients should be informed about the typical risks of ear surgery including implant removal due to infection or technical defects, facial nerve palsy, vertigo and, especially in adults, increased tinnitus.

摘要

背景

在一项回顾性分析中,我们评估了1985年至1995年间697例人工耳蜗植入术后的并发症发生率(366例儿童,331例成人;604例使用Nucleus植入体,50例使用Clarion植入体,42例使用其他植入体)。

结果

术中发现74例(10.6%)出现全部或部分耳蜗闭塞,7例出现脑脊液喷射。轻微并发症如血清肿(8例成人)、伤口感染(14例患者)、气肿和肿胀通过保守方法和药物成功治疗。7例(2.1%)成人术后出现面神经麻痹,其中仅2例(0.6%)恢复不完全。儿童未观察到永久性面神经麻痹。18例成人(5.4%)发生胆脂瘤,通过翻修手术治疗。

结论

总之,人工耳蜗植入手术是一种安全的手术,并发症发生率低。然而,人工耳蜗植入应由经验丰富的耳科外科医生进行,他们能够妥善处理术中及术后问题。应告知患者耳部手术的典型风险,包括因感染或技术缺陷而取出植入体、面神经麻痹、眩晕,尤其是在成人中,耳鸣加重。

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