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脑脊液喷涌与人工耳蜗植入及其相关因素

Cerebrospinal fluid gusher in cochlear implant and its associated factors.

机构信息

Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran.

Cochlear Implant Center, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Acta Otolaryngol. 2020 Aug;140(8):621-625. doi: 10.1080/00016489.2020.1751276. Epub 2020 Apr 24.

Abstract

Cochlear implants (CI) is considered a safe procedure with overall complication rate of 12.5% amongst adult and pediatric population. Cerebrospinal fluid (CSF) gusher is regarded as a common CI intraoperative complication. In this study, we determined the association between probable associated factors and occurrence of intraoperative CSF gusher. In a retrospective survey, 394 patients with severe to profound sensorineural hearing loss who underwent primary cochlear implantation surgery were evaluated. Patients with incomplete electronic or manual file and those with revision, explantation or reimplantation surgery were excluded. three hundred and ninety-four CI patients with a mean age of 8.74 ± 12.21 years were reviewed 49.62% of them were female. CSF gusher developed in 22 patients (5.58%). Patients with CSF gusher had more structural abnormalities in their CT scans' report. Common cavity malformation and Mondini dysplasia were the most common abnormal reports amongst those with intra-operative CSF gusher. In conclusion, cochlea structural abnormalities affect the incidence of CSF gusher in CI recipients. Common cavity malformation and Mondini dysplasia were associated with an increased incidence of CSF gusher. We insist on more precise pre-operative imaging of those with abnormal cochlea structures to provide the needed management.

摘要

人工耳蜗植入术 (CI) 被认为是一种安全的手术,成人和儿童群体的总体并发症发生率为 12.5%。脑脊液 (CSF) 喷涌被认为是 CI 术中常见的并发症。在这项研究中,我们确定了可能相关因素与术中 CSF 喷涌发生之间的关联。在一项回顾性调查中,对 394 名患有严重至极重度感音神经性听力损失并接受初次人工耳蜗植入手术的患者进行了评估。排除了电子或手动档案不完整以及接受修正、取出或再植入手术的患者。对 394 名人工耳蜗植入术患者进行了回顾性研究,平均年龄为 8.74±12.21 岁,其中 49.62%为女性。22 名患者 (5.58%)出现 CSF 喷涌。CSF 喷涌患者的 CT 扫描报告中更常见结构异常。在术中出现 CSF 喷涌的患者中,常见腔畸形和Mondini 发育不良是最常见的异常报告。总之,耳蜗结构异常影响 CI 受者 CSF 喷涌的发生率。常见腔畸形和Mondini 发育不良与 CSF 喷涌发生率增加相关。我们坚持对那些耳蜗结构异常的患者进行更精确的术前成像,以提供必要的治疗。

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