论文部分内容阅读
目的 评价前庭水管扩大综合征患者人工耳蜗植入术的安全性和可行性。方法 1995年 5月 1日～ 2 0 0 2年 6月 1日因双耳重 极重度感音神经性聋在北京协和医院接受人工耳蜗植入术的患者 312例中诊断为双耳前庭水管扩大者 10例 (3 2 % ) ,其中语前聋 7例 ,语后聋 3例。回顾性分析这 10例患者的临床资料。结果 10例患者人工耳蜗电极植入顺利 ,8例耳蜗底回开窗时发生轻度井喷 ,迅速用颞肌筋膜牢固封闭圆窗制止井喷。全部患者术后未出现脑脊液漏、颅内感染、面瘫、中耳炎等并发症。开机 6个月时 8例患者具有开放性言语识别力 ,已进入普通学校 (幼儿园、小学、大学 )就读。另 2例语前聋的幼儿视觉强化测听听阈达 4 0dBHL ,与其他无内耳畸形的全聋儿童术后效果差异无显著性。全聋前语言能力较好的 5例患者术后语言能力明显好于语前聋的患者 ,语言交流基本听不出聋人特有的语音特征。另 5例患者语言均有不同程度的进步。结论 尽管前庭水管扩大患者在人工耳蜗植入术中可能出现井喷 ,但术后未出现并发症且听力 言语康复效果好 ,因此重 极重度聋的前庭水管扩大综合征患者行人工耳蜗植入术是安全可行的
Objective To evaluate the safety and feasibility of cochlear implantation in patients with vestibular aqueduct syndrome. Methods From May 1, 1995 to June 1, 2002, 312 cases of cochlear implants in Beijing Union Hospital were diagnosed as enlarged binocular vestibular aqueduct due to severe sensorineural deafness of both ears 10 cases (32%), including 7 cases of prelingual deafness, 3 cases of deafness after language. The clinical data of 10 patients were retrospectively analyzed. Results 10 cases of cochlear implant electrodes smoothly, 8 cases of cochlear light back to the window when the case of a mild blowout, quickly closed the round window with temporal fascia to stop blowout. All patients did not appear cerebrospinal fluid leakage, intracranial infection, facial paralysis, otitis media and other complications. At 6 months after starting up, 8 patients had open verbal recognition and had attended ordinary schools (kindergartens, elementary schools and universities). The other two cases of preschool children with pre-hearing hearing-enhanced hearing threshold of 40dBHL, and no other deaf children with deaf children no significant difference in postoperative effect. Five patients with good speech ability before deafness had significantly better postoperative language ability than those with prelingual deafness. The language communication basically could not detect the speech features unique to deaf people. The other 5 patients had different degrees of language progress. Conclusions Although blowout may occur during cochlear implantation in patients with enlarged vestibular aqueduct, no postoperative complication is found and hearing and speech rehabilitation is effective. Therefore, cochlear implantation is performed in patients with severe severe deafness with vestibular aqueduct syndrome Safe and feasible