Jang Jeong Hun, Park Min-Hyun, Song Jae-Jin, Lee Jun Ho, Oh Seung Ha, Kim Chong-Sun, Chang Sun O
Department of Otorhinolaryngology, Kyungpook National University College of Medicine, Daegu, Korea.
Department of Otorhinolaryngology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
J Korean Med Sci. 2015 Jan;30(1):82-7. doi: 10.3346/jkms.2015.30.1.82. Epub 2014 Dec 23.
This study compared long-term speech performance after cochlear implantation (CI) between surgical strategies in patients with chronic otitis media (COM). Thirty patients with available open-set sentence scores measured more than 2 yr postoperatively were included: 17 who received one-stage surgeries (One-stage group), and the other 13 underwent two-stage surgeries (Two-stage group). Preoperative inflammatory status, intraoperative procedures, postoperative outcomes were compared. Among 17 patients in One-stage group, 12 underwent CI accompanied with the eradication of inflammation; CI without eradicating inflammation was performed on 3 patients; 2 underwent CIs via the transcanal approach. Thirteen patients in Two-stage group received the complete eradication of inflammation as first-stage surgery, and CI was performed as second-stage surgery after a mean interval of 8.2 months. Additional control of inflammation was performed in 2 patients at second-stage surgery for cavity problem and cholesteatoma, respectively. There were 2 cases of electrode exposure as postoperative complication in the two-stage group; new electrode arrays were inserted and covered by local flaps. The open-set sentence scores of Two-stage group were not significantly higher than those of One-stage group at 1, 2, 3, and 5 yr postoperatively. Postoperative long-term speech performance is equivalent when either of two surgical strategies is used to treat appropriately selected candidates.
本研究比较了慢性中耳炎（COM）患者在不同手术策略下人工耳蜗植入（CI）后的长期言语表现。纳入了30例术后2年以上有可用开放式句子得分的患者：17例接受一期手术（一期组），另外13例接受二期手术（二期组）。比较了术前炎症状态、术中操作和术后结果。一期组的17例患者中，12例在植入人工耳蜗的同时进行了炎症根除；3例未根除炎症直接植入人工耳蜗；2例通过耳道入路植入人工耳蜗。二期组的13例患者在一期手术中进行了彻底的炎症根除，在平均间隔8.2个月后进行二期人工耳蜗植入手术。2例患者在二期手术中分别因腔隙问题和胆脂瘤进行了额外的炎症控制。二期组有2例术后并发症为电极暴露；插入了新的电极阵列并用局部皮瓣覆盖。二期组在术后1年、2年、3年和5年时的开放式句子得分并不显著高于一期组。当使用两种手术策略中的任何一种来治疗适当选择的患者时，术后长期言语表现相当。
