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人工耳蜗取出与重新植入术中电极阵列经耳道入路:我的操作方法

Transmeatal Section of the Array in Cochlear Implant Explantation and Reimplantation: How I Do It.

作者信息

Concheri Stefano, Zanoletti Elisabetta, Franchella Sebastiano

机构信息

Department of Neuroscience, Section of Otorhinolaryngology, University of Padova, Padova, Italy.

出版信息

J Int Adv Otol. 2025 May 20;21(3):1-3. doi: 10.5152/iao.2025.241771.

DOI:10.5152/iao.2025.241771
PMID:40407776
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12128287/
Abstract

BACKGROUND

Cochlear implant explantation and reimplantation (ERI) are rarely required, but the widespread use of implants has made it a procedure that every otologic surgical center must address. Although generally described as safe, ERI presents specific surgical challenges, particularly concerning the replacement of the array.

METHODS

The transmeatal section of the array as the initial step of cochlear implant ERI is proposed and described.

RESULTS

A brief case series did not report any specific complications.

CONCLUSION

The transmeatal section of the array allows for the early and safe removal of the cable portion within the mastoid, enabling the surgeon to address scar tissue and new bone formation without the hindrance of the cable and preventing the premature removal of the array in the cochlea.

摘要

背景

人工耳蜗取出及重新植入术(ERI)很少需要进行,但随着人工耳蜗的广泛使用,这已成为每个耳科手术中心都必须应对的一项操作。尽管通常认为该手术是安全的,但ERI存在特定的手术挑战,尤其是在电极阵列的更换方面。

方法

提出并描述了将电极阵列经耳道切开作为人工耳蜗ERI的第一步。

结果

一个简短的病例系列未报告任何特定并发症。

结论

电极阵列经耳道切开可早期安全地移除乳突内的电缆部分,使外科医生能够处理瘢痕组织和新骨形成,而不受电缆的阻碍,并防止过早取出耳蜗内的电极阵列。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c70b/12128287/6c71ee097aec/jiao-21-3-241771_f003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c70b/12128287/ba1d98905412/jiao-21-3-241771_f001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c70b/12128287/d3ed36a30864/jiao-21-3-241771_f002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c70b/12128287/6c71ee097aec/jiao-21-3-241771_f003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c70b/12128287/ba1d98905412/jiao-21-3-241771_f001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c70b/12128287/d3ed36a30864/jiao-21-3-241771_f002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c70b/12128287/6c71ee097aec/jiao-21-3-241771_f003.jpg

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本文引用的文献

1
Intraoperative Measurement of Insertion Speed in Cochlear Implant Surgery: A Preliminary Experience with Cochlear SmartNav.人工耳蜗植入手术中植入速度的术中测量:使用Cochlear SmartNav的初步经验
Audiol Res. 2024 Feb 22;14(2):227-238. doi: 10.3390/audiolres14020021.
2
Cochlear Reimplantation Rate and Cause: a 22-Year, Single-Center Experience, and a Meta-Analysis and Systematic Review.耳蜗再植入率及原因:22 年单中心经验,以及荟萃分析和系统评价。
Ear Hear. 2023;44(1):43-52. doi: 10.1097/AUD.0000000000001266. Epub 2022 Aug 15.
3
The French National Cochlear Implant Registry (EPIIC): Cochlear explantation and reimplantation.
法国国家人工耳蜗植入登记处(EPIIC):人工耳蜗取出和再植入。
Eur Ann Otorhinolaryngol Head Neck Dis. 2020 Sep;137 Suppl 1:S45-S49. doi: 10.1016/j.anorl.2020.07.006. Epub 2020 Aug 18.
4
Revision cochlear implant surgery in children: Surgical and audiological outcomes.儿童人工耳蜗植入翻修手术:手术及听力学结果
Laryngoscope. 2018 Nov;128(11):2619-2624. doi: 10.1002/lary.27198. Epub 2018 May 4.
5
Cochlear re-implantation: lessons learnt and the way ahead.人工耳蜗再次植入:经验教训与未来方向。
Acta Otolaryngol. 2016 Jun;136(6):564-7. doi: 10.3109/00016489.2015.1136430. Epub 2016 Feb 22.
6
Pediatric cochlear implant revision surgery and reimplantation: an analysis of 957 cases.小儿人工耳蜗翻修手术和再次植入:957例病例分析
Int J Pediatr Otorhinolaryngol. 2014 Oct;78(10):1642-7. doi: 10.1016/j.ijporl.2014.07.013. Epub 2014 Jul 21.
7
Cochlear reimplantations: technical and surgical failures.人工耳蜗再植入:技术及手术失败情况
Acta Otolaryngol. 2009 Apr;129(4):380-4. doi: 10.1080/00016480802552576.
8
Cochlear reimplantation: causes of failure, outcomes, and audiologic performance.人工耳蜗再次植入:失败原因、结果及听力学表现
Laryngoscope. 2007 Jul;117(7):1225-35. doi: 10.1097/MLG.0b013e31805c9a06.
9
Cochlear reimplantation: surgical techniques and functional results.人工耳蜗再植入:手术技术与功能结果
Laryngoscope. 2001 Sep;111(9):1608-13. doi: 10.1097/00005537-200109000-00022.
10
Cochlear reimplantation.
Laryngoscope. 1999 Mar;109(3):351-5. doi: 10.1097/00005537-199903000-00002.