Piché M, Côté M, Philippon D, Laflamme N, Bussières R
Rev Laryngol Otol Rhinol (Bord). 2014;135(4-5):175-80.
We conducted a retrospective case review of patients with mastoid cavity and active or inactive chronic otitis media (COM) who underwent cochlear implantation and ear obliteration in a single-stage procedure. The objectives of this review are to assess the rates of complications and postoperative infections and to evaluate post-implantation audiologic performance.
All patients with COM and mastoid cavity, associated or not with active disease, who undergo cochlear implantation and obliteration of the ear as a single-stage procedure from November 2004 to April 2013, were included in the review. All the complications were recorded. Open-set sentence scores were used to evaluate the audiologic gain after implantation.
Twenty-seven patients were included in our review: Ten with active COM and seventeen with inactive COM. Overall, nine patients (9/27) presented post-operative complications (7/9 were minor): three were amongst active COM patients (30%) as compared to six amongst inactive COM patients (35%), which included the two major complications. A mean gain of 55.9% on open-set sentence scores was obtained after cochlear implantation.
We found that complications rate of the one-stage cochlear implantation was higher in patients with COM than in global implant population, but most complications were minors and there was no statistical difference between active and inactive COM. In addition, these patients had audiologic scores similar to those found in patients with normal temporal bone anatomy.
Cochlear implantation performed as a one-stage procedure could be considered as an option of treatment to avoid staging in patients with active and inactive COM. Although these patients need a regular follow-up, they present good post-implantation audiometric scores.
我们对患有乳突腔以及活动性或非活动性慢性中耳炎(COM)且接受了单阶段人工耳蜗植入和耳闭塞术的患者进行了回顾性病例分析。本分析的目的是评估并发症和术后感染的发生率,并评估植入后的听力学表现。
纳入2004年11月至2013年4月期间接受单阶段人工耳蜗植入和耳闭塞术的所有患有COM和乳突腔、无论是否伴有活动性疾病的患者。记录所有并发症。使用开放式句子得分评估植入后的听力学增益。
我们的分析纳入了27例患者:10例患有活动性COM,17例患有非活动性COM。总体而言,9例患者(9/27)出现术后并发症(7/9为轻微并发症):活动性COM患者中有3例(30%),非活动性COM患者中有6例(35%),其中包括2例主要并发症。人工耳蜗植入后开放式句子得分平均提高了55.9%。
我们发现,COM患者单阶段人工耳蜗植入的并发症发生率高于总体植入人群,但大多数并发症为轻微并发症,活动性和非活动性COM之间无统计学差异。此外,这些患者的听力学得分与颞骨解剖结构正常的患者相似。
对于患有活动性和非活动性COM的患者,单阶段人工耳蜗植入可被视为一种避免分期的治疗选择。尽管这些患者需要定期随访,但他们植入后的听力测试得分良好。