Perényi Ádám, Jóri József, Csanády Miklós, Rovó László
Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Tisza Lajos krt. 111., 6725.
Orv Hetil. 2019 Jun;160(24):936-943. doi: 10.1556/650.2019.31389.
Early cochlear implantation enables prelingual deaf individuals to become full members of the hearing society. Although early diagnostics are widely accessible and enable early rehabilitation, implant surgery often may be delayed due to a candidate's young age. The authors' objectives were to determine the anatomical parameters of the pediatric and adult temporal bone that are relevant to cochlear implantation and to ascertain the differences between them in order to assess whether the anatomical differences could influence the surgical technique and the timing of surgery. Along with a survey of the literature, findings from the authors own cochlear implantees were assessed with respect to the most relevant dimensions of the internal electronic package, including the stimulating electrode of the cochlear implant, by measuring the squama of the temporal bone, the mastoid cavity and the facial recess on high resolution computed tomographic images. The skull and the overlying soft tissues proved to be thinner and the mastoid cavity was less developed in children than in adults, while no significant changes were noted in the size of the facial recess. It is recommended to choose modern, thin implants that do not require sinking the implant package into a bone bed. Less bone work in infants and children enables excellent visualization of the round window through the underdeveloped mastoid cavity, which makes the procedure less time-consuming and minimally invasive. Indeed, a young age should alert ear surgeons to be cautious, but no higher risk of injury to important structures is predicted for young subjects than those that might occur in adults. Orv Hetil. 2019; 160(24): 936-943.
早期人工耳蜗植入可使语前聋患者成为听力社会的正式成员。尽管早期诊断广泛可用并能实现早期康复，但由于候选患者年龄小，植入手术往往可能会延迟。作者的目的是确定与人工耳蜗植入相关的儿童和成人颞骨的解剖参数，并确定它们之间的差异，以评估解剖差异是否会影响手术技术和手术时机。除了文献综述外，通过在高分辨率计算机断层扫描图像上测量颞骨鳞部、乳突腔和面隐窝，对作者自己的人工耳蜗植入患者的结果进行了评估，涉及内部电子组件的最相关尺寸，包括人工耳蜗的刺激电极。结果发现，儿童的颅骨及覆盖其上的软组织比成人更薄，乳突腔发育程度更低，而面隐窝大小没有明显变化。建议选择不需要将植入组件沉入骨床的现代薄型植入物。婴幼儿和儿童所需的骨操作较少，通过发育不全的乳突腔能很好地观察圆窗，这使得手术耗时更短且创伤最小。确实，患者年龄小应提醒耳科外科医生谨慎操作，但预计年轻患者重要结构受伤的风险并不高于成人。《匈牙利医学周报》。2019年；160(24):936 - 943。
