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人工耳蜗植入并发症及发病情况研究:墨尔本耳科研究基金会经验

A Study of Complications and Morbidity Profile in Cochlear Implantation: The MERF Experience.

作者信息

Raghunandhan S, Kameswaran Mohan, Anand Kumar R S, Agarwal Anoop Kumar, Hossain Mohammod Delwar

机构信息

Department of Implant Otology, Madras ENT Research Foundation, MERF, No. 1, 1st Cross Street, Off 2nd Main Road, Raja Annamalai Puram, Chennai, Tamil Nadu 600028 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2014 Jan;66(Suppl 1):161-8. doi: 10.1007/s12070-011-0387-3. Epub 2011 Dec 15.

Abstract

Cochlear implantation (CI) has been established worldwide as the surgical treatment for individuals with bilateral severe to profound hearing loss. This is a safe and standard procedure in the hands of experienced implant surgeons. Complications due to surgery are minimal and are often encountered in cases with congenital anomalies of the temporal bone and inner ear. Complications in CI are related to malfunctioning of the device or the process of wound healing. In most cochlear implant centers, as the surgeon's skill and clinical expertise in managing various cochlear implant cases improves with years of experience, the complication rates in his series ideally come down over time. Over the years, these well experienced clinics become tertiary referral centers for CI, receiving many difficult cases for implantation and hence such centers report data on complications, which become an important reference for many aspiring implant surgeons. Our study, performed in a premier CI centre in Chennai, looks at the various complications which were encountered in a case series of 300 implantees. Retrospective descriptive study with data collected from operative notes, patient questionnaires, auditory habilitation registers and medical records of cochlear implantees operated between, November 2006 to November 2010. A spectrum of major and minor complications, were categorized. Their incidence rates in relation to the demography of the patient profile and various events during surgical procedure were documented and analyzed. Appropriate management protocols were defined. Our management protocols have been highlighted and the relevant literature reviewed. This report of our experience with 300 cochlear implantees, reveals that complication rates at our center are in comparison with reputed centers worldwide. CI is very safe in the long term and provides optimal auditory awareness with speech perception and intelligibility for profoundly deaf individuals giving them an avid opportunity to integrate within the normal society.

摘要

人工耳蜗植入术(CI)已在全球范围内确立为双侧重度至极重度听力损失患者的外科治疗方法。在经验丰富的植入外科医生手中,这是一种安全且标准的手术。手术引起的并发症极少,常见于颞骨和内耳先天性异常的病例。人工耳蜗植入的并发症与设备故障或伤口愈合过程有关。在大多数人工耳蜗植入中心,随着外科医生处理各种人工耳蜗植入病例的技能和临床专业知识随着多年经验的积累而提高,其系列病例中的并发症发生率理想情况下会随着时间下降。多年来,这些经验丰富的诊所成为人工耳蜗植入的三级转诊中心,接收许多困难的植入病例,因此这些中心报告并发症数据,这成为许多有抱负的植入外科医生的重要参考。我们在金奈一家一流的人工耳蜗植入中心进行的研究,观察了300例植入者病例系列中遇到的各种并发症。通过回顾性描述性研究,从2006年11月至2010年11月期间接受手术的人工耳蜗植入者的手术记录、患者问卷、听觉康复登记册和医疗记录中收集数据。对一系列主要和次要并发症进行了分类。记录并分析了它们与患者人口统计学特征和手术过程中各种事件相关的发生率。定义了适当的管理方案。我们突出了我们的管理方案并回顾了相关文献。我们对300例人工耳蜗植入者的经验报告显示,我们中心的并发症发生率与全球知名中心相比情况。从长远来看,人工耳蜗植入非常安全,为极重度聋人提供了最佳的听觉感知、言语感知和可懂度,使他们有极大的机会融入正常社会。

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