Byaruhanga Richard, Roland J Thomas, Buname Gustav, Kakande Emily, Awubwa Michael, Ndorelire Chris, Namwagala Justine
Department of Otolaryngology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
Department of Otolaryngology, Professor and Chair, New York University School of Medicine.
Afr Health Sci. 2015 Dec;15(4):1342-8. doi: 10.4314/ahs.v15i4.38.
Hearing impairment is a significant disability. According to the World Health Organization (WHO), more than 80% of the world's approximately 120 million people with hearing impairment live in developing countries. Cochlear implant is the only therapeutic intervention for those with severe-profound sensorineural hearing loss. We are reporting an interesting case of the very first cochlear implant operation carried out in Uganda. The patient was a 23 year old male whose presenting complaint was inability to hear in the left ear for three and a half years and in the right ear for one year. He had been treated for TB(Tuberculosis) mastoiditis. After the 8 months of treatment, the otorrhea persisted and he underwent a tympanomastoidectomy on the same ear. He reported no familial history of hearing loss. On examination, ENT examination revealed a small pars flaccida retration pocket of the right tympanic membrane with cholesteatoma. The left ear had an intact tympanic membrane. Pure tone audiometry revealed profound sensorineural hearing loss in both ears (see attached PTA results), CT scan of the temporal bone showed normal inner ear anatomy bilaterally and mild sclerotic changes in both mastoid bones. He then had surgery on his right ear which included cochlear implantation. The cochlear implant (CI) was activated on the first postoperative day remotely via internet with the help of the cochlear implant team at New York University Cochlear Implant Center and the patient was immediately able to appreciate some sounds. He received a pneumococcal vaccine on the first postoperative day and was discharged the following day.
听力障碍是一种严重的残疾。根据世界卫生组织(WHO)的数据,全球约1.2亿听力障碍患者中,超过80%生活在发展中国家。人工耳蜗是重度至极重度感音神经性听力损失患者的唯一治疗干预手段。我们报告了乌干达首例人工耳蜗植入手术的一个有趣病例。患者为一名23岁男性,主要诉求是左耳听力丧失三年半,右耳听力丧失一年。他曾接受过结核性乳突炎治疗。经过8个月的治疗,耳漏仍持续存在,随后他在同一耳接受了鼓室乳突切除术。他报告无听力损失家族史。检查时,耳鼻喉科检查发现右鼓膜松弛部有一个小的内陷袋伴胆脂瘤。左耳鼓膜完整。纯音听力测试显示双耳均为重度感音神经性听力损失(见所附PTA结果),颞骨CT扫描显示双侧内耳解剖结构正常,双侧乳突骨有轻度硬化改变。然后他在右耳进行了手术,包括人工耳蜗植入。术后第一天,在纽约大学人工耳蜗中心的人工耳蜗团队的帮助下,通过互联网远程激活了人工耳蜗,患者立即能够听到一些声音。他在术后第一天接种了肺炎球菌疫苗,第二天出院。