Hao Qing-Qing, Yan Yan, Ren Wei, Xu Guang-Yu, Liu Ri-Yuan, Li Jia-Nan, Sun Li, Jiao Qing-Shan, Zhao Hui, Yang Shi-Ming
Department of Otolaryngology Head & Neck Surgery, PLA General Hospital, Beijing, 100853, China.
Department of Otolaryngology Head & Neck Surgery, Hainan Branch of PLA General Hospital, Sanya, 572000, China.
J Otol. 2015 Sep;10(3):125-129. doi: 10.1016/j.joto.2015.11.004. Epub 2015 Nov 17.
To investigate surgical indications, operative techniques, complications and auditory and speech rehabilitation for cochlear implant (CI) in children with otitis media with effusion (OME).
This is a retrospective review of records of 24children with bilateral profound sensorineural hearing loss and OME who were implanted during January 2011 to November 2014 in the Department of Otorhinolaryngology and Head and Neck Surgery at the PLA Hospital, using one-stage implantation via the facial recess approach and round window insertion. The incus was removed in 8 cases during the implantation procedure. Local infiltration of dexamethasone and adrenaline in the middle ear was also performed. Postoperative complications were examined. Preoperative and postoperative questionnaires including Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR), and the Meaningful Auditory Integration Scale (MAIS) were collected.
All electrodes were implanted successfully without any immediate or delayed complications. Inflammatory changes of middle ear mucosa with effusion were noted in all implanted ears. The scores of post-implant CAP and SIR increased significantly in all 24 cases (t = -25.95 and -14.09, respectively for CAP and SIR, p < 0.05).
One-stage CI via the facial recess approach with round window insertion is safe and effective in cochlear implant candidates with OME, as seen in the 24 children in our study who achieved improved auditory performance and speech intelligibility after CI.
探讨分泌性中耳炎(OME)患儿人工耳蜗植入(CI)的手术适应证、手术技巧、并发症以及听觉和言语康复情况。
回顾性分析2011年1月至2014年11月在解放军总医院耳鼻咽喉头颈外科接受双侧极重度感音神经性听力损失且患有OME的24例患儿的病历资料,采用经面隐窝入路和圆窗插入法进行一期植入。8例患儿在植入过程中切除了砧骨。术中还在中耳局部浸润地塞米松和肾上腺素。观察术后并发症。收集术前和术后的问卷,包括听觉表现分类(CAP)、言语清晰度评分(SIR)和有意义听觉整合量表(MAIS)。
所有电极均成功植入,无任何即刻或延迟并发症。所有植入耳均出现中耳黏膜积液的炎性改变。24例患儿植入后CAP和SIR评分均显著提高(CAP和SIR的t值分别为-25.95和-14.09,p<0.05)。
如本研究中的24例患儿所示,经面隐窝入路和圆窗插入法进行一期人工耳蜗植入对OME患儿人工耳蜗植入候选人安全有效,这些患儿在人工耳蜗植入后听觉表现和言语清晰度均有所改善。