Results of a prospective surgical audit of bilateral paediatric cochlear implantation in the UK.
Results of a prospective surgical audit of bilateral paediatric cochlear implantation in the UK.
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DOI：
10.1179/1754762813y.0000000041
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发表时间：
2014-09-01
影响因子：
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通讯作者：
O'Donoghue, Gerard M
中科院分区：
文献类型：
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作者：
Broomfield, Stephen J;Murphy, John;O'Donoghue, Gerard M
目的：自2009年获得批准以来，双侧同时人工耳蜗植入（CI）一直是英国符合CI标准的儿童的标准治疗。其目的是报告手术结果的双边CI在UK.METHODS：2010年1月至2011年12月，14个英国CI中心前瞻性收集数据：人口统计学，病因学，使用成像，设备类型，手术时间，使用术中电生理，住院时间，术后并发症。436例双侧同时，394例双侧连续，131例单侧。大多数（85%）是先天性耳聋。获得性耳聋最常见的原因是脑膜炎和巨细胞病毒感染。先天性耳聋双侧同时CI的中位年龄为2.2岁，平均手术时间为4.5小时。6.3%的手术为日间手术。8例（2.0%）计划双侧CI患者接受了单侧手术。总体重大并发症发生率为1.6%（0.9%，不包括器械失效），包括感染引起的复发（0.2%）、脑脊液漏（0.2%）和脑膜炎（0.1%）。无永久性面神经麻痹和死亡。62例（6.5%）即刻轻微并发症包括12例（1.3%）有明显前庭损伤的儿童。并发症发生率是相似的双边CI相比，顺序和单边CI，并与其他已发表的series.CONCLUSION：这种前瞻性的多中心审计提供的证据表明，双边儿科CI是一个安全的程序在英国，从而认可其作为一个主要的治疗干预儿童耳聋的作用。
OBJECTIVES: Since being approved in 2009, bilateral simultaneous cochlear implantation (CI) has been the standard treatment for children in the UK who meet the criteria for CI. The aim was to report surgical outcomes of bilateral CI in the UK.METHODS: Between January 2010 and December 2011, 14 UK CI centres collected data prospectively: demographics, aetiology, use of imaging, device type, surgery duration, use of intra-operative electrophysiology, length of stay, and post-operative complications.RESULTS: 1397 CI procedures in 961 CI recipients were included; 436 bilateral simultaneous, 394 bilateral sequential, and 131 unilateral. The majority (85%) were congenitally deaf. The commonest causes of acquired deafness were meningitis and cytomegalovirus infection. The median age for congenitally deaf bilateral simultaneous CI was 2.2 years, mean surgical duration 4.5 hours. 6.3% surgeries were day case procedures. Eight cases (2.0%) of planned bilateral CI had unilateral surgery. The overall major complication rate was 1.6% (0.9% excluding device failures), including explantation due to infection (0.2%), cerebrospinal fluid leak (0.2%), and meningitis (0.1%). There were no permanent facial nerve palsies and no deaths. Sixty-two (6.5%) immediate minor complications included 12 (1.3%) children with significant vestibular impairment. The complication rate was similar following bilateral CI compared to sequential and unilateral CI, and is comparable to other published series.CONCLUSION: This prospective multi-centre audit provides evidence that bilateral paediatric CI is a safe procedure in the UK, thus endorsing its role as a major therapeutic intervention in childhood deafness.