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儿童双侧同期人工耳蜗植入:手术要点

Bilateral, simultaneous cochlear implantation in children: surgical considerations.

作者信息

Migirov Lela, Kronenberg J

机构信息

Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel.

出版信息

J Laryngol Otol. 2009 Aug;123(8):837-9. doi: 10.1017/S0022215109004824. Epub 2009 Mar 3.

Abstract

PROBLEM

The advantages of bilateral, simultaneous cochlear implantation include: the possibility to pre-empt cochlear calcification following meningitis; reduction of the intervention to only one procedure, general anaesthetic and course of clinical care (with obvious benefits for the patient); and greater cost-effectiveness. The disadvantages of such a procedure include: doubling the risk of associated complications; placing the patient on the implanted side during contralateral implantation; the possibility of vestibular alteration simultaneously in both ears; the need for precise planning of symmetrical incisions and implant sites; and longer surgery time.

METHODS

The study cohort included 10 children who underwent bilateral, simultaneous cochlear implantation using the suprameatal approach.

RESULTS

The overall operation time, inclusive of anaesthesia, was approximately three hours in all cases. None of the children had any intra- or post-operative complications.

CONCLUSIONS

From a surgical perspective, bilateral, simultaneous cochlear implantation is a safe procedure. The use of a non-mastoidectomy approach is recommended.

摘要

问题

双侧同期人工耳蜗植入的优点包括:预防脑膜炎后耳蜗钙化的可能性;将干预减少到仅一次手术、全身麻醉和临床护理疗程(对患者有明显益处);以及更高的成本效益。该手术的缺点包括:相关并发症风险加倍;对侧植入时使患者处于植入侧;双耳同时出现前庭改变的可能性;需要精确规划对称切口和植入部位;以及手术时间更长。

方法

研究队列包括10名采用耳道上入路进行双侧同期人工耳蜗植入的儿童。

结果

所有病例中,包括麻醉在内的总手术时间约为三小时。没有儿童出现任何术中或术后并发症。

结论

从手术角度来看,双侧同期人工耳蜗植入是一种安全的手术。建议采用非乳突切除术入路。

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