Casserly P, Friedland P L, Atlas M D
Department of Otolaryngology - Head Neck and Skull Base Surgery,Sir Charles Gairdner Hospital,Perth,Australia.
J Laryngol Otol. 2016 Jul;130 Suppl 4:S35-40. doi: 10.1017/S0022215116000979.
Subtotal petrosectomy combined with cochlear implantation is a procedure required in specific situations.
A retrospective review of all cases of subtotal petrosectomy in cochlear implant surgery over a five-year period was performed. The indications, complications and outcomes for this procedure are outlined.
Sixteen patients underwent cochlear implantation in combination with subtotal petrosectomy and blind sac closure of the external auditory meatus from 2008 to 2013. Seventy-five per cent of these were completed as a two-stage procedure and 25 per cent as a single-stage procedure. The most common indications for the procedure were chronic otitis media, previous radical cavity, and for surgical access in challenging anatomy or in drill-out procedures. Mastoids were obliterated with fat or musculoperiosteal flaps. The complication rate relating to blind sac closure was 6 per cent. Cochlear implants were successfully placed in all cases and there was no incidence of device failure.
For patients with chronic suppurative otitis media or existing mastoid cavities, subtotal petrosectomy with blind sac closure of the external auditory canal, closure of the eustachian tube, and cavity obliteration is an effective technique to facilitate safe cochlear implantation.
部分岩骨切除术联合人工耳蜗植入术是特定情况下所需的一种手术。
对五年期间人工耳蜗植入手术中所有部分岩骨切除术病例进行回顾性研究。概述了该手术的适应症、并发症及结果。
2008年至2013年，16例患者接受了部分岩骨切除术联合人工耳蜗植入术及外耳道盲袋封闭术。其中75%为两阶段手术，25%为单阶段手术。该手术最常见的适应症为慢性中耳炎、既往根治性术腔，以及用于解剖结构复杂或钻孔手术时的手术入路。乳突用脂肪或肌骨膜瓣填塞。外耳道盲袋封闭术的并发症发生率为6%。所有病例人工耳蜗均成功植入，未发生设备故障。
对于慢性化脓性中耳炎或现有乳突腔的患者，部分岩骨切除术联合外耳道盲袋封闭术、咽鼓管封闭术及术腔填塞术是促进安全人工耳蜗植入的有效技术。
