Han Dong-yi, Wu Wen-ming, Xi Xin, Huang De-liang, Yang Wei-yan
Department of Otorhinolaryngology-Head and Neck Surgery, PLA General Hospital, Beijing 100853, China.
Zhonghua Er Bi Yan Hou Ke Za Zhi. 2004 Feb;39(2):85-8.
To study surgical difficulty and key of the cochlear implant in patients with congenital malformation of inner ear.
The cochlear implantations were performed in our department from Jan. 2001 to Apr. 2003 for 18 patients with the malformation of inner ear.
In this series, there were 11 cases of large vestibular aqueduct syndrome (LVAS), 3 cases of Waardenberg syndrome, 3 cases of Mondini malformation, and 1 case of Usher syndrome. All 18 patients accepted the Nucleus 24-channel cochlear implantations, including Nucleus straight electrode in 13 cases but Contour implantation in 5 cases of LVAS. During operations, leakage of perilymph but not cerebrospinal fluid (CSF) from the open of scala tympani occurred in 11 cases of LVAS, however, the electrode was inserted successfully. The abnormalities of round window occurred in one of 3 cases of Waardenberg syndrome and 3 cases of Mondini malformation, respectively.
The cochlear implant could be conducted successfully for the LVAS, and the postoperative effect was same as the ones for the deafness persons with normal development of inner ear. However, for the patients with Mondini syndrome and common cavity, it is important to accurately assess the extent of abnormalities in the inner ear and accompanied malformation before operation, and to evaluate the full extent of difficulties of the operation in order to minimize the risk of CSF leakage and meningitis.
探讨内耳先天性畸形患者人工耳蜗植入手术的难度及要点。
回顾性分析2001年1月至2003年4月在我科接受人工耳蜗植入手术的18例内耳畸形患者的临床资料。
18例患者中,大前庭导水管综合征(LVAS)11例,瓦登伯革综合征3例,Mondini畸形3例,Usher综合征1例。18例患者均接受Nucleus 24通道人工耳蜗植入,其中13例植入Nucleus直电极,5例LVAS患者植入Contour电极。手术中,11例LVAS患者鼓阶开放时出现外淋巴漏而非脑脊液漏,但电极均成功植入。3例瓦登伯革综合征患者中有1例出现圆窗异常,3例Mondini畸形患者中也有3例出现圆窗异常。
LVAS患者人工耳蜗植入手术可成功进行,术后效果与内耳发育正常的耳聋患者相同。然而,对于Mondini综合征和共同腔畸形患者,术前准确评估内耳畸形程度及合并畸形情况,充分评估手术难度,以降低脑脊液漏和脑膜炎的发生风险至关重要。