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小儿人工耳蜗植入术:术后疼痛和头晕程度轻微。

Pediatric cochlear implantation: associated with minimal postoperative pain and dizziness.

作者信息

Birman Catherine S, Gibson William P R, Elliott Elizabeth J

机构信息

*Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney; †Sydney Children's Hospital Network (Children's Hospital at Westmead); ‡The Sydney Cochlear Implant Centre, NSW; §Department of Linguistics, Faculty of Human Sciences, Macquarie University; and ∥Sydney Medical School, University of Sydney, Australia.

出版信息

Otol Neurotol. 2015 Feb;36(2):220-2. doi: 10.1097/MAO.0000000000000569.

Abstract

OBJECTIVE

To prospectively document the surgical pain, assessing analgesia use as a proxy, and postoperative dizziness in children over the first week after cochlear implantation.

STUDY DESIGN

Prospective.

SETTING

Tertiary referral hospital and cochlear implant program.

PATIENTS

Children aged 0 to 16 years inclusive undergoing cochlear implant surgery, who returned to see the primary surgeon for the postoperative 1-week follow-up appointment.

INTERVENTIONS

One-week postoperative collection of data via direct questioning of parents and children.

MAIN OUTCOME MEASURES

Analgesia use, duration of analgesia use and dizziness (nil, slight, or moderate), type of surgery, and radiologic findings.

RESULTS

Data were available for 61 of 98 children aged 5 months to 15 years. Children underwent first side implant (n = 27), sequential second side implant (n = 15), bilateral simultaneous (n = 16), and explant reimplantation (n = 3). On average, children used paracetamol for only 1.9 days after discharge from the hospital. Longer average paracetamol use was associated with bilateral simultaneous surgery (3.3 d after discharge from the hospital) and also the younger age group of 0 to 12 months (3.2 d). Slight dizziness was reported by 8% of all children at 1 week postsurgery.No child had marked dizziness or unsteadiness. Four children had large vestibular aqueducts on radiology scans, two (50%) of these children has slight unsteadiness at 1 week postoperatively.

CONCLUSION

Our study shows cochlear implant surgery is well tolerated by children. This information enables better counseling of families and children considering cochlear implantation.

摘要

目的

前瞻性记录人工耳蜗植入术后第一周儿童的手术疼痛情况(以镇痛药物使用情况作为替代指标进行评估)以及术后头晕情况。

研究设计

前瞻性研究。

研究地点

三级转诊医院及人工耳蜗植入项目。

研究对象

年龄在0至16岁(含)之间接受人工耳蜗植入手术,并返回找主刀医生进行术后1周随访预约的儿童。

干预措施

术后1周通过直接询问家长和儿童收集数据。

主要观察指标

镇痛药物使用情况、镇痛药物使用时长、头晕情况(无、轻微或中度)、手术类型及影像学检查结果。

结果

98名年龄在5个月至15岁的儿童中,有61名儿童的数据可供分析。儿童接受首次单侧植入(n = 27)、序贯性第二次单侧植入(n = 15)、双侧同时植入(n = 16)以及取出后重新植入(n = 3)。平均而言,儿童出院后仅使用对乙酰氨基酚1.9天。对乙酰氨基酚平均使用时间较长与双侧同时手术(出院后3.3天)以及0至12个月的较年幼年龄组(3.2天)有关。术后1周,8%的儿童报告有轻微头晕。没有儿童出现明显头晕或不稳。4名儿童在放射学扫描中发现有大前庭导水管,其中2名儿童(50%)术后1周有轻微不稳。

结论

我们的研究表明儿童对人工耳蜗植入手术耐受性良好。这些信息有助于为考虑进行人工耳蜗植入的家庭和儿童提供更好的咨询服务。

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