Surgical and medical management for complications in 475 consecutive pediatric cochlear implantations
Surgical and medical management for complications in 475 consecutive pediatric cochlear implantations
复制标题
DOI：
10.1016/j.ijporl.2012.12.009
复制
发表时间：
2013-04-01
影响因子：
1.5
通讯作者：
Kara, Karahan
中科院分区：
文献类型：
--
作者：
Tarkan, Ozgur;Tuncer, Ulku;Kara, Karahan
目的：本研究的目的是评估儿童人工耳蜗植入（CI）后发生的并发症，并讨论随访期间发生的翻修手术和医疗干预措施。研究设计：对三级转诊中心连续475例儿童人工耳蜗植入的回顾性研究。方法：对2000年3月至2012年3月期间在我机构接受人工耳蜗植入的患者（n = 475）进行随访（范围，5个月至12年）。对所有并发症进行系统回顾，分析其原因，进行预防和治疗。结果：所有患儿均接受单侧CI。植入时的平均年龄为 3 岁 7 个月（范围从 10 个月到 18 岁）。四十三名患者 (9%) 出现并发症。 21名患者（4.4%）出现严重并发症，包括装置故障（10名患者）、皮瓣坏死（4名患者）、脑膜炎（2名患者）、电极移位（2名患者）、血肿（2名患者）和磁体移位（1名患者）。 22例（4.6%）出现轻微并发症，包括急性中耳炎（5例）、术中对侧耳部压力反应引起的皮损（4例）、皮瓣肿胀（3例）、轻微伤口感染（3例）、短暂性面瘫（2例）、短暂性眩晕（2例）、血肿（1例）、面部刺激（1例）、皮下气肿（1例）。 43 名患者中，有 13 名患者 (30.2%) 因并发症而需要进行再植手术，7 名患者 (16.2%) 需要接受其他修复手术。 1例脑膜炎患者经药物治疗治愈，22例轻微并发症经药物治疗或自然治愈。结论：人工耳蜗植入是一种安全的技术，并发症发生率相对较低。必须进行长期随访，以尽量减少和控制手术并发症。皇冠版权所有 (C) 2012 由 Elsevier Ireland Ltd 出版。保留所有权利。
Objective: The purpose of this study is to assess complications occurring after cochlear implantation (Cl) in children and to discuss revision surgeries and medical interventions occurring during follow-up. Study design: Retrospective study of 475 consecutive pediatric cochlear implantations at a tertiary referral center.Methods: The patients(n = 475) who received cochlear implants in our institution between March 2000 and March 2012 were followed up (range, 5 months-12 years). All complications were systematically reviewed, and their causes were analyzed for prevention and therapy.Results: All children received unilateral CI. Mean age at implantation was 3 years 7 months (ranged from 10 months to 18 years). Forty-three patients (9%) experienced complications. Twenty-one patients (4.4%) had major complications, consisting of device failure (10 patients), flap necrosis (4 patients), meningitis (2 patients), electrode shifting (2 patients), hematoma (2 patients) and magnet migration (1 patient). Twenty-two (4.6%) had minor complications, consisting of acute otitis media (5 patients), skin lesion due to pressure reaction in contralateral ear during surgery (4 patients), flap swelling (3 patients), minor wound infection (3 patients), transient facial paralysis (2 patients), transient vertigo (2 patients), hematoma (1 patient), facial stimulation (1 patient), subcutaneous emphysema (1 patient). Complications led to reimplantation in 13 (30.2%) and other revision surgery in 7 (16.2%) of the 43 patients. One patient with meningitis cured with medical treatment and 22 patients with minor complications cured with either medical treatment or spontaneously.Conclusions: Cochlear implantation is a safe technique in experienced hands with a relatively low complication rate. Long term follow up is mandatory to minimize and control surgical complication. Crown Copyright (C) 2012 Published by Elsevier Ireland Ltd. All rights reserved.