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耳蜗支架置入术:我的操作方法。

Cochlear stenting: how I do it.

机构信息

P D Hinduja Hospital, Mumbai, India.

出版信息

Eur Arch Otorhinolaryngol. 2010 Jun;267(6):985-7. doi: 10.1007/s00405-010-1222-2. Epub 2010 Mar 7.

DOI:10.1007/s00405-010-1222-2
PMID:20213155
Abstract

Post-meningitis cases with profound sensorineural hearing loss are known to have progressive labyrinthine ossification; such cases need to be implanted early. In our region, often a substantial amount of time is spent procuring the necessary finances for a cochlear implant; therefore, here we describe our technique of maintaining cochlear lumen patency in post-meningitis cases with early ossification, for a complete functional electrode insertion at a later date. This is a descriptive case study of a patient having post-meningitis profound deafness, with imaging studies showing early cochlear ossification, who was rehabilitated with a cochlear implant. At a tertiary referral centre, a 1-year-old child with post-meningitis bilateral profound sensorineural hearing loss was rehabilitated with cochlear implantation. The left cochlea with early ossification was stented with a customised sterile electrode to prevent scalar occlusion; 3 months later the stent was replaced with a commercial Nucleus Contour Advance implant. A complete insertion of the functional electrode array replaced the stent. Categories of auditory performance (CAP) were used to assess the outcome in our case. The pre-operative CAP score was 1 (detects environmental sounds) and the score at 15 months post implant was 6 (understands some spoken words). In post-meningitis cases with progressive cochlear ossification, stenting the cochlear lumen prevents scalar occlusion and ensures a complete insertion of a functional electrode at a later date.

摘要

已知患有脑膜炎后严重感觉神经性听力损失的病例会出现进行性迷路骨化;此类病例需要尽早植入人工耳蜗。在我们所在的地区,通常需要花费大量时间来筹集植入人工耳蜗所需的资金;因此,我们在这里描述了一种技术,即在脑膜炎后早期骨化的病例中,保持耳蜗管腔通畅,以便日后完全插入功能性电极。这是一个关于脑膜炎后重度耳聋患者的病例描述性研究,影像学研究显示其耳蜗早期骨化,通过人工耳蜗植入进行了康复。在一家三级转诊中心,一名 1 岁儿童因脑膜炎导致双侧重度感觉神经性听力损失,通过植入人工耳蜗进行了康复。左侧早期骨化的耳蜗用定制的无菌电极支架撑开,以防止标度阻塞;3 个月后,支架被更换为商业性 Nucleus Contour Advance 植入物。功能性电极阵列的完全插入取代了支架。我们使用听觉性能类别 (CAP) 来评估病例的结果。术前 CAP 评分为 1 (检测环境声音),植入后 15 个月时的评分提高至 6 (理解一些口语单词)。在进行性耳蜗骨化的脑膜炎后病例中,撑开耳蜗管腔可防止标度阻塞,并确保日后完全插入功能性电极。

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引用本文的文献

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Protocol for Evaluation and Management of Hearing Loss After Meningitis.脑膜炎后听力损失的评估与管理方案
Indian J Otolaryngol Head Neck Surg. 2023 Apr;75(Suppl 1):115-120. doi: 10.1007/s12070-022-03277-w. Epub 2022 Nov 28.

本文引用的文献

1
The development of auditory perception in children following cochlear implantation.儿童人工耳蜗植入后听觉感知的发展
Int J Pediatr Otorhinolaryngol. 1999 Oct 5;49 Suppl 1:S189-91. doi: 10.1016/s0165-5876(99)00158-5.
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The pathology of suppurative labyrinthitis.化脓性迷路炎的病理学
Ann Otol Rhinol Laryngol. 1967 Aug;76(3):554-86. doi: 10.1177/000348946707600303.
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Cochlear patency problems in cochlear implantation.人工耳蜗植入中的耳蜗通畅性问题。
Laryngoscope. 1987 Jul;97(7 Pt 1):801-5.