Congenital malformation of the inner ear and pediatric cochlear implantation
Congenital malformation of the inner ear and pediatric cochlear implantation
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DOI：
10.1097/00129492-200405000-00019
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发表时间：
2004-05-01
影响因子：
2.1
通讯作者：
Leeuw, RL
中科院分区：
文献类型：
--
作者：
Mylanus, EAM;Rotteveel, LJC;Leeuw, RL
目的：为了研究手术方面和性能的结果，人工耳蜗植入在儿童畸形innerears.Study设计：临床和听力评价13 patients.Methods：患者的数据有关手术，术后随访，和植入前和植入后听力从人工耳蜗中心的数据库中获得和评价。背景：三级转诊中心。患者：患者有各种内耳畸形和深度听力损失。结果：1例复发性脑膜炎患者出现严重耳蜗畸形（共同腔）。1例耳蜗位置异常并伴有中耳疾病的患者，术中哭时难以找到鼓阶。在两名患者中遇到了脑脊液喷射器，另一名患者遇到了异常的面神经，这并没有导致任何并发症。轻度耳蜗畸形（如不完全分隔）的患者在言语感知测试中表现良好。即使有共同腔畸形的儿童在植入后1年也有一定的开放式语言知觉。从本研究的患者和关于内耳畸形（包括重度耳蜗畸形）儿童人工耳蜗植入的文献综述中的患者来看，迷走面神经的发生率为17%，如果回顾患有严重耳蜗畸形（如共同腔或严重耳蜗发育不全）的儿童的手术结果，则该比例增加到27%。在后一种患者中，言语感知的结果各不相同。虽然人工耳蜗植入的结果可能是有希望的，因为在我们的病人与一个共同的腔，在术前咨询的孩子的父母必须被告知，结果是不确定的。
Objectives: To study the surgical aspects and performance outcome of cochlear implantation in children with malformed inner ears.Study Design: Clinical and audiometric evaluation in 13 patients.Methods: Patient data concerning surgery, postoperative follow-up, and pre- and postimplantation audiometry were obtained from the cochlear implant center's database and evaluated. A review of the literature has been included.Setting: Tertiary referral center.Patients: The patients had a variety of inner ear malformations and profound hearing loss. One patient with recurrent meningitis had a severe cochlear malformation (common cavity).Results: Major complications did not occur. In one patient with an abnormal position of the cochlea and concurring middle ear disease, it was difficult to find the scala tympani during sur,cry. A cerebrospinal fluid gusher was encountered in two patients and an aberrant facial nerve in another, which did not lead to any complications. The patients with mild cochlear malformation such as an incomplete partition demonstrated a good performance in speech perception tests. Even the child with the common cavity deformity had some open-set speech perception 1 year after implantation.Conclusions: Viewing the patients from this study and patients from a review of the literature concerning cochlear implantation in children with malformed inner ears including severe cochlear malformations, the occurrence of an aberrant facial nerve was 17%, which increases to 27% if one reviews the surgical findings in children with severe malformed cochleae such as a common cavity or a severe cochlear hypoplasia. In the latter patients, results in speech perception vary. Although the result of cochlear implantation may be promising, as in our patient with a common cavity, during preoperative counseling the child's parents must be informed that the result is uncertain.