山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (5): 25-28.doi: 10.6040/j.issn.1673-3770.0.2015.180

• 论著 • 上一篇    下一篇

儿童与成人人工耳蜗植入术并发症比较及处理

陈世琴, 胡金旺   

  1. 安徽省第二人民医院耳鼻咽喉头颈外科, 安徽 合肥 230041
  • 收稿日期:2015-05-06 修回日期:2015-09-22 出版日期:2015-10-16 发布日期:2015-10-16
  • 通讯作者: 胡金旺,E-mail:enthjw@163.com E-mail:enthjw@163.com
  • 作者简介:陈世琴,E-mail:shiqinchen526@163.com

Complications of cochlear implantation in children and adults

CHEN Shiqin, HU Jinwang   

  1. Department of Otolaryngology & Head and Neck Surgery, Anhui No.2 Provincial People's Hospital, Hefei 230041, Anhui, China
  • Received:2015-05-06 Revised:2015-09-22 Online:2015-10-16 Published:2015-10-16

摘要: 目的 探讨儿童与成人人工耳蜗植入术并发症的不同特点,总结其处理经验。方法 回顾性分析170例人工耳蜗植入患者的病历资料,根据年龄将其分为儿童组及成人组,分析比较两组人工耳蜗植入术并发症出现的特点及处理经验。结果 170例人工耳蜗电极均一期植入,成功率100%。术后3 d内出现发热患者15例,儿童13例(8.84%),成人2例(8.69%),发热率差异无统计学意义(P>0.05)。内耳发育正常的患者术后出现眩晕21例,儿童10例(10.20%),成人11例(52.38%),儿童术后眩晕率较成人低(P<0.05)。1例成人患者人工耳蜗植入出现术后头皮血肿,予头皮血肿抽吸后痊愈。1例儿童患者人工耳蜗植入术后外耳道口皮肤穿孔,经手术修复痊愈。1例儿童患者人工耳蜗植入术后18个月皮下植入体损坏,行再次人工耳蜗植入术。结论 人工耳蜗植入术后不同并发症的发生在不同年龄阶段表现不一,对人工耳蜗植入术后并发症与年龄的趋向性进行比较分析,为临床工作者对其预见及处理提供相关经验及依据。

关键词: 人工耳蜗植入术, 并发症, 发热, 眩晕

Abstract: Objective To compare the characteristics of complications after cochlear implantation in children and adults, and to explore the management of these complications. Methods A total of 170 cases of cochlear implantation were retrospectively analyzed. These patients were divided into children group (n=147) and adult group (n=63) according to their age. The characteristics of complication and management were summarized. Results The success rate of implantation was 100%. Three days after operation, 13 children (8.84%) and 2 adults (8.69%) developed fever, and there was no significant difference in the incidence of fever between children and adults(P>0.05). Among those with normal inner ear, 10 children (10.20%) and 11 adults (52.38%) had postoperative vertigo, and the incidence of vertigo was lower in children than that in adults (P<0.05). Scalp hematoma occurred in 1 adult and healed after extraction. External ear canal skin perforation was observed in 1 child which was cured with surgical repair. The cochlear implant was damaged 18 months after implantation in 1 child and was re-implanted. Conclusion Different complications may occur in different periods after cochlear implantation in various age groups, which need clinicians' close attention.

Key words: Cochlear implants, Vertigo, Fever, Complications

中图分类号: 

  • R764.35
[1] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华耳鼻咽喉头颈外科学分会, 中国残疾人康复协会听力语言康复专业委员会. 人工耳蜗植入工作指南(2013年, 三亚)[J]. 中华耳鼻咽喉头颈外科杂志, 2013, 49(2):89-92. Journal Editorial Committee of Chinese Journal of Otorhinolaryngology, Head and Neck Surgery, Chinese Medical Association of Otorhinolaryngology, Head and Neck Surgery, Committee of Chinese Disabled Rehabilitation Association and professional Committee of hearing language rehabilitation. Cochlear implant work guide (2013, Sanya)[J]. Chin J Otorhinolaryngol Head Neck Surgery, 2013, 49(2):89-92.
[2] Bhatia K, Gibbin K P, Nikolopoulos T P, et al. Surgical complications and their management in a series of 300 consecutive pediatric cochlear implantations[J]. Otol Neurotol, 2004, 25(5):730-739.
[3] 邱建华, 陈阳, 谭沛, 等. 人工耳蜗植入手术并发症及临床分析[J]. 中华耳科学杂志, 2010, 8(3):235-239. QlU Jianhua, CHEN Yang, TAN Pei, et al. Complications of cochlear implantation and clinical analysis[J]. Chin J Otology, 2010, 8(3):235-239.
[4] Loundon N, Blanchard M, Roger G, et al. Medical and surgical complications in pediatric cochlear implantation[J]. Arch Otolaryngol Head Neck Surg, 2010, 136(1):12-15.
[5] 李玉洁, 张道行. 1396例人工耳蜗植入围手术期并发症的讨论[J]. 临床耳鼻咽喉头颈外科学杂志, 2010, 24(10):433-435. LI Yujie, ZHANG Daoxing. Perioperative complications of 1396 patients with cochlear implantation[J]. J Clin Otorhinolaryngology Head Neck Surgery, 2010, 24(10):433-435.
[6] Merdad M, Crawford M, Gordon K, et al. Unexplained fever after bilateral superficial cervical block in children undergoing cochlear implantation: an observational study[J]. Can J Anaesth, 2012, 59(1):28-33.
[7] Krause E, Louza J P, Wechtenbruch J, et al. Incidence and quality of vertigo symptoms after cochlear implantation[J]. J Laryngol Otol, 2009, 123(3):278-282.
[8] Thierry B, Blanchard M, Leboulanger N, et al. Cochlear implantation and vestibular function in children[J]. Int J Pediatr Otorhinolaryngol, 2015, 79(2):101-104.
[9] Roberts D S, Lin H W, Herrmann B S, et al. Differential cochlear implant outcomes in older adults[J]. Laryngoscope, 2013, 123(8):1952-1956.
[1] 刘冰,李蓓,张莉,陈敏,张杰. 学龄前和学龄期BPV患儿临床特征比较[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 58-60.
[2] 朱梓建,刘强. 眼震方向可转换型外侧半规管良性阵发性位置性眩晕35例临床分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 53-57.
[3] 张汝祥,田昊,马有祥. 鼻内镜鼻窦手术前筛窦颅底高度的CT评估价值[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 75-77.
[4] 侯小兵,任同力,张毅博. 69例梅尼埃病伴耳鸣的发病特点及影响因素[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 37-40.
[5] 鄢慧琴,王豪. 难治性良性阵发性位置性眩晕的临床分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 86-88.
[6] 仇书要,刘大波,钟建文,杨李强. 儿童阻塞性睡眠呼吸暂停低通气综合征等离子[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 34-37.
[7] 李桂芳,王春华,张淑贞. 体位限制对手法复位后良性阵发性位置性眩晕的疗效观察[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 42-45.
[8] 霍红,李五一,王剑,杨大海,金晓峰,田旭,牛燕燕. 等离子辅助悬雍垂腭咽成形术后重度咽狭窄的治疗[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 58-61.
[9] 王海霞,郑金秀,陈曦. 人工耳蜗植入患者MRI检查的若干问题探讨[J]. 山东大学耳鼻喉眼学报, 2017, 31(5): 38-40.
[10] 鞠骏,李进让,邹世桢,贾曼玉. 创伤后良性阵发性位置性眩晕的临床特点及近期疗效研究[J]. 山东大学耳鼻喉眼学报, 2017, 31(5): 57-61.
[11] 祝青萍, 万玉柱. 儿童急性鼻窦炎眶并发症的临床表现及治疗[J]. 山东大学耳鼻喉眼学报, 2017, 31(1): 91-94.
[12] 刘学升,李筱瑜,邓玮. DHM阴性的非典型PSC-BPPV诊断策略探讨[J]. 山东大学耳鼻喉眼学报, 2017, 31(1): 88-90.
[13] 吴博,胡国华. 异物致颈部脓肿三例并文献复习[J]. 山东大学耳鼻喉眼学报, 2017, 31(1): 100-102.
[14] 刘学升,李筱瑜,邓玮. 后半规管良性阵发性位置性眩晕急性发作时的临床表现[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 11-13.
[15] 张运波,习国平,靳红芳,王彩君. 非手术序列化治疗单侧梅尼埃病48例[J]. 山东大学耳鼻喉眼学报, 2016, 30(3): 73-76.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!