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耳蜗植入的手术并发症:一家三级学术中心 25 年回顾性病例分析。

Surgical complications of cochlear implantation: a 25-year retrospective analysis of cases in a tertiary academic center.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, St. Elizabeth's Medical Center, 736 Cambridge St, Brighton, MA, 02135, USA.

Department of Otorhinolaryngology-Head and Neck Surgery (ORL), Pendik Training and Research Hospital, Marmara University Medical Faculty, Mimar Sinan Caddesi No. 41, Fevzi Cakmak Mahallesi, Ust Kaynarca-Pendik, 34899, Istanbul, Turkey.

出版信息

Eur Arch Otorhinolaryngol. 2020 Jul;277(7):1917-1923. doi: 10.1007/s00405-020-05916-w. Epub 2020 Mar 17.

Abstract

PURPOSE

Despite the advances made in cochlear implantation techniques, the associated complication rates are still high. Here, we aimed to analyze cases, with extensive follow-up data, associated with a large sample of patients to identify complications related to cochlear implants and to present our surgical experience and the technique that we used in order to follow surgical rules/medical purpose to avoid any complications.

METHODS

We retrospectively examined cases involving 2597 patients (1342 males; 1255 females; age 1-88 years) who underwent cochlear implantation procedures between November 1995 and July 2019, and we classified complications as minor and major.

RESULTS

The mean age at the time of implantation was 6.48 (Min: 1/Max: 88) years. The cause of deafness was congenital in 76.5% of the patients and acquired in 16.8%. The overall rate of complications in the study was 3.7% (n = 97). The minor and major complication rates were 3.0 and 0.7, respectively. Further, while the most common minor complication we encountered was vertigo, the most common major complication was implant extrusion.

CONCLUSION

Fixing the cochlear implant receiver-stimulator with the bone-recess technique and sealing the posterior tympanotomy site with a piece of muscle in order to follow surgical rules/medical purpose to avoid any complications. Following the insertion of the electrode into the cochlea, the muscle closure of the cochleostomy site or the round window restores the original anatomy and in order to follow surgical rules/medical purpose to avoid any complications. We have developed this highly effective technique with years of experience and have not had a major surgical complication in 5 years.

摘要

目的

尽管耳蜗植入技术取得了进步,但相关并发症发生率仍然较高。在这里,我们旨在分析具有广泛随访数据的病例,这些病例涉及大量患者,以确定与耳蜗植入相关的并发症,并介绍我们的手术经验和技术,以便遵循手术规则/医疗目的,避免任何并发症。

方法

我们回顾性检查了 1995 年 11 月至 2019 年 7 月期间接受耳蜗植入手术的 2597 例患者(1342 例男性;1255 例女性;年龄 1-88 岁)的病例,并将并发症分为轻微和严重。

结果

植入时的平均年龄为 6.48 岁(最小:1/最大:88)。患者耳聋的原因先天性占 76.5%,后天性占 16.8%。研究中并发症的总发生率为 3.7%(n=97)。轻微和严重并发症的发生率分别为 3.0%和 0.7%。此外,我们遇到的最常见的轻微并发症是眩晕,最常见的严重并发症是植入物脱出。

结论

为了遵循手术规则/医疗目的,避免任何并发症,我们采用骨槽技术固定耳蜗植入体接受刺激器,并使用一块肌肉密封后鼓室切开部位。为了遵循手术规则/医疗目的,避免任何并发症,我们在将电极插入耳蜗后,通过耳蜗造口处的肌肉闭合或圆窗修复来恢复原始解剖结构。我们结合多年的经验开发了这种非常有效的技术,并且在 5 年内没有出现重大手术并发症。

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