Lescanne Emmanuel, Al Zahrani Musaed, Bakhos David, Robier Alain, Morinière Sylvain
CHRU de Tours (Centre d'implant cochléaire des Service d'ORL et chirurgie cervico-faciale et Service de chirurgie pédiatrique de la tête et du cou), 37044 Tours, France.
Int J Pediatr Otorhinolaryngol. 2011 Oct;75(10):1221-4. doi: 10.1016/j.ijporl.2011.07.003. Epub 2011 Aug 2.
To report devices failures and postoperative or medical complications after cochlear implantation in children and to discuss revision surgeries and medical interventions occurring during follow-up.
In this retrospective study in a tertiary referral pediatric hospital, we included a consecutive sample of children younger than 15 years old who received implants between January 1994 and June 2010. All complications and treatments were systematically reviewed.
One hundred and forty children were included in this study. Four children received bilateral cochlear implantation. Mean age at implantation was 43.6 months (age ranged from 11 months to 15 years). Overall, 74 children were boys (52.1%) and 35 children (25%) received implants before the age of two. Inner ear malformations were found in 19 children (13.5%), while 18 children (12.9%) experienced complications: cochlear reimplantations (n=8), other revision surgeries (n=3) and medical treatment (n=7). Excluding device failures, 13 children (9.2%) experienced complications. Postoperative infection was the principal cause of these complications (10 cases). Four children younger than 2 years at implantation suffered complication postoperatively. In these children, there was no statistically significant increase in complications compared to older children (P>0.05). Complete electrode insertion was achieved in 7 of the 8 reimplanted children.
Cochlear implantation could be considered a safe and reliable rehabilitation for deafened young children. Reimplantation was feasible and complete electrode insertion was achievable. Long-term follow up was mandatory to minimize and control surgical complication.
报告儿童人工耳蜗植入后的设备故障、术后或医疗并发症,并讨论随访期间发生的翻修手术和医疗干预措施。
在一家三级转诊儿科医院进行的这项回顾性研究中,我们纳入了1994年1月至2010年6月期间接受植入的15岁以下儿童的连续样本。对所有并发症和治疗进行了系统回顾。
本研究纳入了140名儿童。4名儿童接受了双侧人工耳蜗植入。植入时的平均年龄为43.6个月(年龄范围为11个月至15岁)。总体而言,74名儿童为男孩(52.1%),35名儿童(25%)在两岁前接受了植入。19名儿童(13.5%)发现内耳畸形,18名儿童(12.9%)出现并发症:人工耳蜗再次植入(n=8)、其他翻修手术(n=3)和药物治疗(n=7)。排除设备故障,13名儿童(9.2%)出现并发症。术后感染是这些并发症的主要原因(10例)。4名植入时年龄小于2岁的儿童术后出现并发症。与年龄较大的儿童相比,这些儿童的并发症没有统计学上的显著增加(P>0.05)。8名再次植入的儿童中有7名实现了电极完全插入。
人工耳蜗植入可被认为是对失聪幼儿安全可靠的康复方法。再次植入是可行的,并且可以实现电极完全插入。必须进行长期随访以尽量减少和控制手术并发症。