Yan Tao, Zong Fangru, Ma Xiaojie, Xu Xinbo, Chen Weiliang, Song Zhongyi, Han Xiao, Wang Xiaojing, Zhang Hanbing
Department of Otorhinolaryngology, Qilu Hospital of Shandong University, Jinan, China; NHC Key Laboratory of Otorhinolaryngology, Shandong University, Jinan, China.
Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China.
Am J Otolaryngol. 2019 Mar-Apr;40(2):183-186. doi: 10.1016/j.amjoto.2018.12.004. Epub 2018 Dec 8.
The timing of CI for postmeningitic deafness is controversial and differential outcomes have been reported. To review and share our surgical and auditory outcomes.
17 patients with ossified cochleas who received CI were enrolled. Clinical data including the cause of cochlear ossification, preoperative examination, onset of deafness, age at implantation, surgical findings, and relevant auditory outcomes was analysed.
Cochlear ossification was observed in 53% of patients with HRCT, whereas the corresponding value for MRI was 59%. Patients in both stage I and II received complete insertion of the electrode array, however, stage III patients only received partial insertion. 1 patient in stage II received bilateral CI. Hearing tests showed increased average hearing threshold for stage III patients than those in stage I and II (P < 0.05). CAP scores were much lower for stage III patients than those in stage I and II (P < 0.05). Postlingual deafness patients showed higher SIR scores than prelingual deafness children (P < 0.05).
HRCT and MRI have comparable value in predicting the occurrence of ossification in cochleas. We recommend fast surgical intervention in the patients with bilateral profound postmeningitic deafness. If possible, bilateral cochlear implantation is recommended.
脑膜炎后耳聋人工耳蜗植入（CI）的时机存在争议，且已有不同结果的报道。本研究旨在回顾并分享我们的手术及听觉结果。
纳入17例接受人工耳蜗植入的耳蜗骨化患者。分析临床资料，包括耳蜗骨化原因、术前检查、耳聋发病情况、植入年龄、手术发现及相关听觉结果。
HRCT显示53%的患者存在耳蜗骨化，而MRI的相应比例为59%。I期和II期患者均实现电极阵列完全植入，但III期患者仅部分植入。1例II期患者接受双侧人工耳蜗植入。听力测试显示，III期患者的平均听力阈值高于I期和II期患者（P < 0.05）。III期患者的言语接受阈（CAP）评分远低于I期和II期患者（P < 0.05）。语后聋患者的言语识别率（SIR）得分高于语前聋儿童（P < 0.05）。
HRCT和MRI在预测耳蜗骨化发生方面具有相当的价值。我们建议对双侧重度脑膜炎后耳聋患者进行快速手术干预。如有可能，建议双侧人工耳蜗植入。
