Daikhes N A, Diab Kh M, Siraeva A R, Tarasova N V, Kondratchikov D S, Machalov A S, Pashchinina O A, Kuznetsov A O, Yusifov K D
Research and Clinical Centre of Otorhinolaryngology, Russian Federal Medico-Biological Agency, Moscow, Russia, 123182.
Vestn Otorinolaringol. 2017;82(6):39-43. doi: 10.17116/otorino201782639-43.
The objective of the present study was the prospective analysis of the results of bilateral cochlear implantation (CI) in the children presenting with bilateral ossification of the cochlea after they had survived meningitis. A total of 15 patients underwent the surgical intervention. In those exhibiting bilateral ossification of the basal cochlear helix over the 5 mm segment (up to first bend of the cochlear turn) and partial ossification of the second helix (in 6 children), the affected portions were removed with the placement of two choleostomies, the lower one (from the ossified membrane of the cochlear window) and the upper one (toward the second helix). Activation of the speech processors of the CI systems was carried out within 4-6 weeks after surgery. The hearing abilities of the children were evaluated in accordance with the 'Estimation of the auditory perception categories', 'Estimation of the child's apprehension capacity', and 'Analysis of speech intelligibility rating' guidelines. In all the children with ossification over less than 5 mm of the basal cochlear helix, it proved possible to introduce the whole intracochlear electrode grid whereas only half of the electrode array was implanted in the cases of overall ossification of the basal helix. The first results obtained by telemetry and surdopedagogical testing gave evidence of the possibility of identifying various sources of non-verbal and speech stimuli in all the treated children at a small (up to 3 meters) distance.
本研究的目的是对患有脑膜炎后出现双侧耳蜗骨化的儿童进行双侧人工耳蜗植入（CI）结果的前瞻性分析。共有15名患者接受了手术干预。对于那些在5毫米节段（直至蜗螺旋管的第一个弯曲处）出现双侧蜗底螺旋骨化且第二个螺旋部分骨化的患者（6名儿童），通过进行两个造瘘术（下部造瘘术从蜗窗的骨化膜开始，上部造瘘术朝向第二个螺旋）切除受影响部分。人工耳蜗系统的言语处理器在术后4 - 6周内开启。根据“听觉感知类别评估”“儿童理解能力评估”和“言语清晰度评分分析”指南对儿童的听力能力进行评估。在所有蜗底螺旋骨化小于5毫米的儿童中，证明有可能植入整个蜗内电极阵列，而在蜗底螺旋完全骨化的情况下，仅植入了一半的电极阵列。通过遥测和听力教学测试获得的初步结果表明，在所有接受治疗的儿童中，在小距离（最多3米）内识别各种非言语和言语刺激源是可能的。
