Balkany T, Gantz B, Nadol J B
Colorado Otologic Research Center, Denver, CO 80210.
Ann Otol Rhinol Laryngol Suppl. 1988 Sep-Oct;135:3-7. doi: 10.1177/00034894880975s201.
Deposition of bone within the fluid spaces of the cochlea is encountered commonly in cochlear implant candidates and previously has been considered a relative contraindication to the use of multichannel intracochlear electrodes. This contraindication has been based on possible mechanical difficulty with electrode insertion as well as uncertainty about the potential benefit of the multichannel device in the patient. Fifteen profoundly deaf patients with partial ossification of the basal turn of the cochlea received implants with long intracochlear electrodes (11, Nucleus; 1, University of California at San Francisco/Storz; and 3, Symbion/Inneraid). In 11 cases, ossification had been predicted preoperatively by computed tomographic scan. Electrodes were completely inserted in 14 patients, and partial insertion was accomplished in one patient. All patients currently are using their devices and nine of 12 postlingually deaf patients have achieved some degree of open-set speech discrimination. This series demonstrates that in experienced hands, insertion of long multichannel electrodes into partially ossified cochleas is possible and that results are similar to those achieved in patients who have nonossified cochleas.
在人工耳蜗植入候选者中,常见到骨沉积于耳蜗的液腔中,此前这一直被视为使用多通道耳蜗内电极的相对禁忌证。这一禁忌证基于电极插入可能存在的机械困难以及多通道装置对患者潜在益处的不确定性。15名耳蜗底转部分骨化的极重度聋患者接受了长耳蜗内电极植入(11例使用Nucleus;1例使用加利福尼亚大学旧金山分校/斯托兹公司的产品;3例使用Symbion/Inneraid公司的产品)。11例患者术前经计算机断层扫描预测有骨化。14例患者电极完全插入,1例患者部分插入。所有患者目前都在使用他们的装置,12名语后聋患者中有9名获得了一定程度的开放式言语辨别能力。该系列研究表明,在经验丰富的医生手中,将长多通道电极插入部分骨化的耳蜗是可行的,且结果与未骨化耳蜗患者的结果相似。