Cabbarzade Cavid, Sennaroglu Levent, Süslü Nilda
Cochlear Implants Int. 2015 Jul;16(4):233-6. doi: 10.1179/1754762813Y.0000000048. Epub 2014 Jul 1.
Intraoperative cerebrospinal fluid (CSF) leakages from the cochleostomy site - known as gushers - are a serious complication of cochlear implantation surgery in cases of congenital deafness. They occur as the result of abnormal communication between CSF in the internal auditory canal and perilymph in the cochlea. Gushers are well recognized as occurring in a proportion of cases in which there is a clearly visible congenital malformation of the cochlea. In this report, we describe two cases in which pre-operative computed tomography (CT) scanning of the cochlea was initially reported as normal but gushers occurred during cochlear implant surgery. In both cases, more detailed review of the CT scans (peroperatively in the first case, pre-operatively in the second case) showed a defect at the cochlear base, in the absence of any other cochlear malformation. The aim of this paper is to draw attention to the risk of missing this abnormality and to encourage careful inspection of the cochlear base on CT scans in all cases, even when the rest of the cochlear appears normal.
在先天性耳聋患者的人工耳蜗植入手术中，来自蜗窗造瘘部位的术中脑脊液漏（即所谓的“喷射性脑脊液漏”）是一种严重的并发症。它们是由于内耳道内的脑脊液与耳蜗内的外淋巴之间存在异常连通而发生的。喷射性脑脊液漏在一部分耳蜗存在明显可见先天性畸形的病例中很常见。在本报告中，我们描述了两例病例，其中耳蜗的术前计算机断层扫描（CT）最初报告为正常，但在人工耳蜗植入手术期间出现了喷射性脑脊液漏。在这两例病例中，对CT扫描进行更详细的复查（第一例在术中，第二例在术前）显示，在没有任何其他耳蜗畸形的情况下，耳蜗底部存在缺陷。本文的目的是提请注意漏诊这种异常的风险，并鼓励在所有病例中仔细检查CT扫描上的耳蜗底部，即使耳蜗的其他部分看起来正常。
