Cevizci Rasit, Dilci Alper, Celenk Fatih, Karamert Recep, Bayazit Yildirim
Department of Otolaryngology and Head & Neck Surgery, Istanbul Medipol University, Istanbul, Turkey.
Department of Otolaryngology and Head & Neck Surgery, Yunus Emre State Hospital, Eskisehir, Turkey.
Auris Nasus Larynx. 2018 Jun;45(3):417-420. doi: 10.1016/j.anl.2017.07.012. Epub 2017 Jul 26.
To evaluate the effects of otitis media with effusion on surgical parameters, patient safety, perioperative and postoperative complications.
Total 890 children who underwent cochlear implantation between 2006 and 2015 were included. The ages ranged from 12 months to 63 months (mean: 32 months). The patients were divided into two groups according to the presence or absence of otitis media with effusion; otitis media with effusion group and non-otitis media group.
Of 890 children, 105 had otitis media with effusion prior to surgery. In non-otitis media with group, there were 785 children. The average duration of surgery was 60min (ranged from 28 to 75min) in non-otitis media group, and 90min (ranged from 50 to 135min) in otitis media with effusion group (p<0.05). Granulation tissue and edematous middle ear and mastoid mucosa were observed in all cases of otitis media with effusion during the surgery. There was no significant difference between the complications of groups with or without otitis media with effusion (p>0.05). In 5 of 105 patients, there was a ventilation tube inserted before cochlear implantation, which did not change the outcome of implantation.
There is no need for surgical treatment for otitis media with effusion before implantation since otitis media with effusion does not increase the risks associated with cochlear implantation. Operation duration is longer in the presence of otitis media with effusion. However, otitis media with effusion leads to intraoperative difficulties like longer operation duration, bleeding, visualization of the round window membrane, cleansing the middle ear granulations as well as mastoid and petrous air cells.
评估中耳积液对手术参数、患者安全性、围手术期及术后并发症的影响。
纳入2006年至2015年间接受人工耳蜗植入的890例儿童。年龄范围为12个月至63个月（平均：32个月）。根据是否存在中耳积液将患者分为两组；中耳积液组和非中耳积液组。
890例儿童中，105例术前有中耳积液。非中耳积液组有785例儿童。非中耳积液组的平均手术时长为60分钟（范围28至75分钟），中耳积液组为90分钟（范围50至135分钟）（p<0.05）。手术中所有中耳积液病例均观察到肉芽组织以及中耳和乳突黏膜水肿。中耳积液组和非中耳积液组的并发症之间无显著差异（p>0.05）。105例患者中有5例在人工耳蜗植入前插入了通气管，这并未改变植入结果。
由于中耳积液不会增加人工耳蜗植入相关风险，因此植入前无需对中耳积液进行手术治疗。存在中耳积液时手术时间更长。然而，中耳积液会导致术中出现困难，如手术时间延长、出血、圆窗膜可视化、清理中耳肉芽以及乳突和岩骨气房。
