Cochlear implantation in healthy and otitis-prone children: A prospective study
Cochlear implantation in healthy and otitis-prone children: A prospective study
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DOI：
10.1097/00005537-200109000-00023
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发表时间：
2001-09-01
期刊：
影响因子：
2.6
通讯作者：
Farah-Sima'an, A
中科院分区：
文献类型：
--
作者：
Luntz, M;Teszler, CB;Farah-Sima'an, A
客观的。评估和比较外科手术的时间，术中发现和中耳炎与不容易发生耳炎的儿童的耳蜗植入的与耳蜗植入的结果。研究设计：前瞻性。方法：转诊植入的儿童被分配给一个易于炎的人群（A组：转诊后首次访问时正常的耳镜）或一个容易发症的组（B组：当前或最近转诊的耳炎史）。使用旨在植入前中耳炎控制的结构化方案对B组患者进行管理。该研究回顾了术前，内和术后数据。结果：在研究的18名儿童中，有8个分配给A组（转介的平均年龄为40.6 mo），为B组10分（平均年龄在转介中，31.6 mo）。为了控制中耳炎，所有容易发症的儿童均接受通风管插入（植入前的各种程序）。只有一个容易发症的儿童需要皮质乳突切除术。从转诊到植入的时间在两组中相似（平均6.6 mo）。高分辨率计算机断层扫描数据显示，在易受一度的大肠炎组中，乳突性气体明显小得多，但是在这一组中，面部凹陷并不小。在植入期间，有10名儿童发炎中耳粘膜。其中七个属于B组。这七个孩子的所有圆形窗户壁细分都被发炎的粘膜抹掉，必须将其除去以进行圆形窗户识别。植入后，只有一个孩子通过通风管排水超过1周。 B组的两个儿童在1周内开发了中耳炎（植入后1年）。没有中耳炎培养基相关的并发症。结论：如果使用结构化方案来控制耳蜗植入前中耳炎，则中耳炎培养基不需要延迟植入。在中耳炎媒体炎的儿童中，圆形窗户的生态位通常被发炎的粘膜遮盖。它的去除是必须识别圆形窗膜的必不可少的。人工耳蜗植入后，中耳炎并不是经常发生的。
Objective. To evaluate and compare the timing of surgery, intraoperative findings, and otitis media-related outcome of cochlear implantation in children who are otitis-prone with their counterparts who are not otitis-prone. Study Design: Prospective. Methods: Children referred for cochlear implantation were assigned to a non-otitis-prone group (group A: normal otoscopy on their first visit after referral) or an otitis-prone group (group B: current or a recent history of otitis media at referral). Group B patients were managed using a structured protocol aimed at preimplantation otitis media control. The study reviewed pre-, intra-, and postoperative data. Results: Of the 18 children studied, 8 were assigned to group A (mean age at referral, 40.6 mo) and 10 to group B (mean age at referral, 31.6 mo). For otitis media control, all otitis-prone children underwent ventilating tube insertion (various numbers of procedures before implantation). Only one otitis-prone child required cortical mastoidectomy also. Time from referral to implantation was similar in the two groups (mean, 6.6 mo). High-resolution computed tomography data showed mastoid pneumatization to be significantly smaller in the otitis-prone group, but the facial recess was not smaller in this group. During implantation, 10 children had inflamed middle ear mucosa. Seven of these belonged to group B. All of these seven children had a round window niche obliterated by the inflamed mucosa, which had to be removed for round window membrane identification. After implantation, only one child had drainage through the ventilating tube for more than 1 week. Two children in group B developed otitis media (1 year postimplantation) that was overcome within 1 week. There were no otitis media-related complications. Conclusions: If a structured protocol is used for the control of otitis media before cochlear implantation, otitis media should not require a delay in implantation. In otitis media-prone children, the round window niche is often obscured by inflamed mucosa. Its removal is mandatory for identification of the round window membrane. After cochlear implantation, otitis media is not a frequent occurrence.