Luntz M, Balkany T, Hodges A V, Telischi F F
University of Miami Ear Institute, Fla, USA.
Arch Otolaryngol Head Neck Surg. 1997 Sep;123(9):974-7. doi: 10.1001/archotol.1997.01900090090013.
To describe clinical experiences with multichannel cochlear implantation in children with inner ear malformations, including surgical indications and techniques, imaging findings, and outcomes.
A retrospective review of a series of 10 consecutive cases with a mean follow-up of 29 months, as well as a review of the literature.
Academic referral center.
Ten children who underwent multichannel cochlear implantation for inner ear malformations. High-resolution computed tomographic scans demonstrated a common cavity deformity in 3, an incomplete cochlear partition in 4, and an enlarged vestibule in 1. Two had membranous anomalies as indicated by cerebrospinal fluid gushers at surgery, but the results of imaging were normal.
All subjects received multichannel cochlear implants. Two subjects underwent mastoid obliteration at the time of implantation owing to preoperative recurrent meningitis or chronic otitis media with episodes of clinical mastoiditis.
The 10 subjects were evaluated for electrode insertion and stability and auditory function for up to 7 years.
All 22 electrodes are functional in each child with an incomplete partition, an enlarged vestibule, or a membranous anomaly. Of 3 subjects with common cavities, 2 had full insertion of electrodes and 1 had 16 electrodes inserted. All subjects had speech awareness thresholds detected at 25 dB or better. Three (75%) of the 4 subjects with at least 30 months of experience, including 1 subject with a common cavity, have developed open-set word recognition.
Electrode insertion and hearing results in children with an incomplete partition, an enlarged vestibule, or a membranous anomaly are similar to those in children with normal cochleas. Specific surgical techniques are effective for children with a common cavity, and the results are less certain. Cerebrospinal fluid gushers were encountered frequently but were not difficult to control.
描述内耳畸形儿童多通道人工耳蜗植入的临床经验，包括手术适应症和技术、影像学表现及结果。
对连续10例患者进行回顾性研究，平均随访29个月，并进行文献复习。
学术转诊中心。
10例因内耳畸形接受多通道人工耳蜗植入的儿童。高分辨率计算机断层扫描显示，3例为共同腔畸形，4例为耳蜗隔板不完全，1例为前庭扩大。2例在手术时有脑脊液涌出，提示存在膜性异常，但影像学检查结果正常。
所有研究对象均接受多通道人工耳蜗植入。2例患者因术前反复发生脑膜炎或慢性中耳炎伴临床乳突炎发作，在植入时进行了乳突填塞。
对10例研究对象进行长达7年的电极插入及稳定性和听觉功能评估。
在耳蜗隔板不完全、前庭扩大或存在膜性异常的每个儿童中，所有22个电极均功能正常。在3例共同腔患者中，2例电极完全插入，1例插入了16个电极。所有研究对象的言语察觉阈均在25dB或更低。4例至少有30个月经验的研究对象中，3例（75%），包括1例共同腔患者，已发展出开放式单词识别能力。
耳蜗隔板不完全、前庭扩大或存在膜性异常的儿童，电极插入及听力结果与耳蜗正常的儿童相似。特定的手术技术对共同腔儿童有效，但结果不太确定。脑脊液涌出情况常见，但不难控制。
