Petersen Hannes, Walshe Peter, Glynn Fergal, McMahon Rosemary, Fitzgerald Conall, Thapa Jyoti, Simoes-Franklin Cristina, Viani Laura
a National Cochlear Implant Programme, Beaumont Hospital , Dublin , Ireland.
b Trinity Centre for Bioengineering, Trinity College Dublin , Ireland.
Cochlear Implants Int. 2018 Nov;19(6):297-306. doi: 10.1080/14670100.2018.1513386. Epub 2018 Aug 29.
Cochlear implantation (CI) is considered an effective and relatively safe procedure for patients with severe-profound hearing loss. However, severe complications are reported in several studies. The purpose of this study was to report the frequency and management of major complications following CI surgery at the National CI Programme (NCIP) in Ireland.
Major complications were defined according to the classification of Hansen et al. 2010. The medical records of 1017 patients undergoing CI between 1995 and 2016 were analyzed retrospectively for major complications. In addition, radiological and intraoperative findings as well as therapeutic management of all patients with a major complication were reviewed.
Altogether, 1017 patients underwent 1266 CI surgeries. The median follow-up of all CI surgeries was 44 months. The total number of major complications identified was 21 which corresponds to an overall rate of 1.7%. The majority of major complication (71%) occurred at least one week after surgery. The most common major complications were internal receiver/stimulator protrusion and migration (6/21), followed by migration of the electrode array (4/21) and recurrent otitis media requiring re-implantation (4/21). All patients with major complications required additional surgery, with reimplantation necessary in 19 patients (90%).
CI surgery is a safe surgical procedure for hearing rehabilitation associated with a low rate of severe complications. However, major complications can occur many years after surgery, making revision surgery necessary.
Long-term follow-up is necessary for the early identification of complications to facilitate appropriate care.
对于重度至极重度听力损失患者，人工耳蜗植入术（CI）被认为是一种有效且相对安全的手术。然而，多项研究报告了严重并发症。本研究的目的是报告爱尔兰国家人工耳蜗植入计划（NCIP）中人工耳蜗植入术后主要并发症的发生率及处理情况。
主要并发症根据汉森等人2010年的分类进行定义。回顾性分析了1995年至2016年间1017例接受人工耳蜗植入术患者的病历，以确定主要并发症。此外，还回顾了所有发生主要并发症患者的影像学和术中检查结果以及治疗处理情况。
共有1017例患者接受了1266次人工耳蜗植入手术。所有人工耳蜗植入手术的中位随访时间为44个月。确定的主要并发症总数为21例，总体发生率为1.7%。大多数主要并发症（71%）发生在术后至少一周。最常见的主要并发症是内置接收器/刺激器突出和移位（6/21），其次是电极阵列移位（4/21）以及需要再次植入的复发性中耳炎（4/21）。所有发生主要并发症的患者均需要额外手术，19例患者（90%）需要再次植入。
人工耳蜗植入手术是一种安全的听力康复手术，严重并发症发生率较低。然而，主要并发症可能在术后多年发生，因此需要进行翻修手术。
有必要进行长期随访，以便早期发现并发症，从而促进适当的治疗。
