人工耳蜗植入背景下的脑深部电刺激：病例报告与文献综述
Deep Brain Stimulation in the Setting of Cochlear Implants: Case Report and Literature Review.
作者信息
Buell Thomas J, Ksendzovsky Alexander, Shah Binit B, Kesser Bradley W, Elias W Jeffrey
机构信息
Department of Neurosurgery, University of Virginia, Charlottesville, Va., USA.
出版信息
Stereotact Funct Neurosurg. 2015;93(4):245-9. doi: 10.1159/000380824. Epub 2015 May 21.
BACKGROUND/AIMS: As technology continues to advance for our aging population, an increasing number of deep brain stimulation (DBS) candidates will have preexisting implanted electrical devices. In this article, we discuss safe and successful DBS in a patient with Parkinson's disease (PD) and bilateral cochlear implants.
METHODS
A 70-year-old male with PD and bilateral cochlear implants underwent successful microelectrode-guided DBS implantation into bilateral subthalamic nuclei (STN). The patient's cochlear implant magnets were removed and replaced in the outpatient clinic for preoperative MRI and stereotactic targeting. The cochlear implants were turned off intraoperatively for STN microelectrode recordings.
RESULTS
Precise, MRI-guided stereotactic DBS implantation was possible. Intraoperative high-fidelity microelectrode recordings confirmed STN neurons with the cochlear implants turned off. These recordings were not possible with active cochlear implant devices. Our literature review describes the other approaches/techniques that have been used to manage DBS surgery in the setting of cochlear implants.
CONCLUSIONS
Despite the risk of electrical interference between implanted medical devices, DBS and cochlear implants may be safe and compatible in the same patient if necessary precautions are taken.
背景/目的：随着技术不断进步以满足老龄化人口的需求，越来越多的脑深部电刺激（DBS）候选者将预先植入电子设备。在本文中，我们讨论了一名患有帕金森病（PD）且双侧植入人工耳蜗的患者进行安全且成功的DBS治疗的情况。
方法
一名70岁患有PD且双侧植入人工耳蜗的男性患者成功接受了微电极引导下的双侧丘脑底核（STN）DBS植入术。患者的人工耳蜗磁铁在门诊被移除并更换，以便进行术前MRI和立体定向靶向定位。术中关闭人工耳蜗以进行STN微电极记录。
结果
精确的、MRI引导的立体定向DBS植入是可行的。术中在关闭人工耳蜗的情况下通过高保真微电极记录确认了STN神经元。在人工耳蜗设备开启时无法进行这些记录。我们的文献综述描述了在植入人工耳蜗的情况下用于管理DBS手术的其他方法/技术。
结论
尽管植入的医疗设备之间存在电干扰风险，但如果采取必要的预防措施，DBS和人工耳蜗在同一患者中可能是安全且兼容的。
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