Surgical considerations and safety of cochlear implantation in otitis media with effusion.
Surgical considerations and safety of cochlear implantation in otitis media with effusion.
复制标题
渗出性中耳炎人工耳蜗植入的手术注意事项和安全性。
DOI：
10.1016/j.anl.2017.07.012
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Y. Bayazıt
中科院分区：
文献类型：
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作者：
Raşit Cevizci;A. Dilci;F. Çelenk;R. Karamert;Y. Bayazıt
目的探讨渗出性中耳炎对手术参数、患者安全性、围手术期及术后并发症的影响。年龄12~63个月，平均32个月。根据有无渗出性中耳炎分为渗出性中耳炎组和非渗出性中耳炎组。非中耳炎组785例。非中耳炎组平均手术时间60分钟(28~75分钟)，渗出性中耳炎组平均手术时间90分钟(50~135分钟)(P<0.05)。术中渗出性中耳炎均可见肉芽组织和肿胀的中耳、乳突粘膜。有无渗出性中耳炎两组并发症发生率差异无统计学意义(P>0.05)。105例患者中有5例在人工耳蜗术前置入通气管，不影响人工耳蜗术后的效果。结论渗出性中耳炎不增加人工耳蜗术后的风险，术前不需手术治疗渗出性中耳炎。有渗出性中耳炎的患者手术时间较长。但渗出性中耳炎手术时间较长、出血、圆窗膜显影、清除中耳肉芽及乳突、岩气等困难。
ObjectiveTo evaluate the effects of otitis media with effusion on surgical parameters, patient safety, perioperative and postoperative complications.MethodsTotal 890 children who underwent cochlear implantation between 2006 and 2015 were included. The ages ranged from 12 months to 63 months (mean: 32 months). The patients were divided into two groups according to the presence or absence of otitis media with effusion; otitis media with effusion group and non-otitis media group.ResultsOf 890 children, 105 had otitis media with effusion prior to surgery. In non-otitis media with group, there were 785 children. The average duration of surgery was 60 min (ranged from 28 to 75 min) in non-otitis media group, and 90 min (ranged from 50 to 135 min) in otitis media with effusion group (p < 0.05). Granulation tissue and edematous middle ear and mastoid mucosa were observed in all cases of otitis media with effusion during the surgery. There was no significant difference between the complications of groups with or without otitis media with effusion (p > 0.05). In 5 of 105 patients, there was a ventilation tube inserted before cochlear implantation, which did not change the outcome of implantation.ConclusionThere is no need for surgical treatment for otitis media with effusion before implantation since otitis media with effusion does not increase the risks associated with cochlear implantation. Operation duration is longer in the presence of otitis media with effusion. However, otitis media with effusion leads to intraoperative difficulties like longer operation duration, bleeding, visualization of the round window membrane, cleansing the middle ear granulations as well as mastoid and petrous air cells.