Montandon P B, Boëx C, Pelizzone M
Department of Otolaryngology--Head and Neck Surgery, University Hospital, Geneva, Switzerland.
Am J Otol. 1994 Nov;15(6):748-51.
Extensive ossification of the cochlea is a common finding in patients with total deafness caused by meningitis, labyrinthitis, or otosclerosis. When the cochlea is totally ossified, the prognosis for achieving free-running speech without lip reading is poor. However, subtotal ossification with residual cochlear patency in the upper basal turn, the middle turn, or the apical turn can be maximally exploited by selective insertion of electrodes. Results can be surprisingly adequate in spite of the poor anatomic conditions. Computed tomography and exploratory cochleotomy, in which electrically evoked auditory brainstem responses are elicited and recorded by intracochlear stimulation are good diagnostic indicators of ossification and residual auditory nerve excitability. "Apical cochleostomy" is an adequate procedure to help penetrate the basal turn in retrograde insertion of the cochlear implant electrode array. Results of this study indicate that the surgical technique and placement of the Ineraid electrode array play a major role in the ability of the patient to achieve understanding of free-running speech.
广泛的耳蜗骨化在由脑膜炎、迷路炎或耳硬化症导致全聋的患者中很常见。当耳蜗完全骨化时，不借助唇读实现流畅言语的预后很差。然而，上基底转、中转或顶转存在残余耳蜗通畅的部分骨化情况，可通过选择性插入电极得到最大程度利用。尽管解剖条件不佳，但结果可能出奇地令人满意。计算机断层扫描和探索性耳蜗切开术（通过耳蜗内刺激诱发并记录电诱发听觉脑干反应）是骨化和残余听神经兴奋性的良好诊断指标。“顶转耳蜗造口术”是在逆行插入人工耳蜗电极阵列时帮助穿透基底转的一种合适手术方法。本研究结果表明，Ineraid电极阵列的手术技术和放置在患者实现对流畅言语理解的能力方面起着主要作用。
