Sun S P, Lu W, Men X M, Zuo B, Lei Y B
Division of Otology, Otorhinolaryngology Hospital, the First Affiliated Hospital of Zhengzhou University, Henan 450052, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Apr 7;52(4):283-286. doi: 10.3760/cma.j.issn.1673-0860.2017.04.009.
To discuss the possible reasons for cerebrospinal fluid (CSF) gusher in cochlear implantation (CI) with inner ear abnormality. A retrospective analysis was performed on 340 cases who underwent CI from January 2013 to December 2016 in Division of Otology, Otorhinolaryngology Hospital, the First Affiliated Hospital of Zhengzhou University. Among them, 96 cases had inner ear abnormalities. Imaging examinations were performed on these patients, and classification of inner ear malformation was done according to the results. Among the cases with inner ear abnormality, 9.4% (9/96) suffered from CSF gusher during CI. The inner ear abnormalities were found to be as follows: 3 cases had incomplete partition type Ⅰ; 1 case had incomplete partition type Ⅰ with semicircular canal dysplasia; 1 case had common cavity deformity; 1 case had enlarged vestibular aqueducts and common cavity deformity; 2 cases had Mondini deformity. All of these cases had bony defect in the fundus of the internal acoustic meatus observed on CT scans. Another case was type 1 cochlear aqueduct with round window aplasia. Defects in the modiolus or fundus of the internal acoustic meatus is the main reason for CSF gusher during CI. A patent cochlear aqueduct is another possible reason.
探讨内耳异常的人工耳蜗植入（CI）术中出现脑脊液（CSF）喷射的可能原因。对2013年1月至2016年12月在郑州大学第一附属医院耳鼻咽喉医院耳科接受CI手术的340例患者进行回顾性分析。其中96例存在内耳异常。对这些患者进行了影像学检查，并根据结果对内耳畸形进行分类。在内耳异常的病例中，9.4%（9/96）在CI术中发生了CSF喷射。发现内耳异常情况如下：3例为Ⅰ型不完全分隔；1例为Ⅰ型不完全分隔伴半规管发育异常；1例为共同腔畸形；1例为前庭导水管扩大伴共同腔畸形；2例为Mondini畸形。所有这些病例在CT扫描中均观察到内耳道底部存在骨质缺损。另1例为1型耳蜗导水管伴圆窗发育不全。蜗轴或内耳道底部的缺损是CI术中CSF喷射的主要原因。耳蜗导水管通畅是另一个可能原因。
