Kasemsuwan Lalida, Cheewaruangroj Wichit, Tungkeeratichai Jumroon, Bhongmakapat Thongchai, Thawin Cheamchit, Lertsukprasert Krisna, Tiravanitchakul Rattinan, Dara Rada, Laothamatas Jiraporn
Department of Otolaryngology, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand.
J Med Assoc Thai. 2010 Dec;93(12):1399-405.
To review the cochlear implant program in Ramathibodi Hospital and share experience of cochlear implantation emphasized on clinical and surgical outcomes.
Retrospective review of 143 ears (140 patients) operated with cochlear implant between 1995 and 2009. The demographic data including etiology of deafness and findings from temporal bone CTscans were reviewed. The authors' experience with cochlear implant surgery in terms of patient selection, patient advisory clinic, necessary equipment, pre- and postoperative evaluations, surgical techniques and complications were discussed.
Most congenital origin was unknown etiology and congenital rubella was the most common known cause. From the CT scans of congenital deafness, vestibular aqueduct dilatation was the most common and found in 29.31% while Mondini malformation was shown to be 16.37%. The authors' surgical technique of using the pocket method and designed bony ridge at cortical mastoid rim had helped stabilizing the implant and electrode fancoil. During the last two years, no complication or revision surgery was detected.
Cochlear implant surgery in both children and adults can result in good surgical outcome and fewer complications under experienced surgeons and a good team.
回顾拉玛蒂博迪医院的人工耳蜗植入项目,并分享人工耳蜗植入的经验,重点关注临床和手术结果。
对1995年至2009年间接受人工耳蜗植入手术的143耳(140例患者)进行回顾性研究。回顾了人口统计学数据,包括耳聋病因和颞骨CT扫描结果。讨论了作者在人工耳蜗植入手术方面的经验,包括患者选择、患者咨询门诊、必要设备、术前和术后评估、手术技术及并发症。
大多数先天性耳聋病因不明,先天性风疹是最常见的已知病因。在先天性耳聋的CT扫描中,前庭导水管扩张最为常见,占29.31%,而Mondini畸形占16.37%。作者采用的袋状法手术技术以及在乳突皮质边缘设计的骨嵴有助于稳定植入物和电极扇形线圈。在过去两年中,未发现并发症或翻修手术。
在经验丰富的外科医生和优秀团队的操作下,儿童和成人的人工耳蜗植入手术均可取得良好的手术效果且并发症较少。