关键词: 并发症, 内耳畸形, 人工耳蜗植入术, 大前庭导水管综合征

Abstract:

Objective    To investigate common types of inner ear malformation and the surgical complicationsin deaf children with cochlear implants. Methods    The clinical data of 170 cases of cochlear implantation were retrospectively analyzed. The type of 32 patients with bilateral inner ear malformation and the surgical complications were analyzed. Results    ① The proportion of inner ear malformations is higher than other literature reports(32/170;18.8%)； ② In the 32 cases of inner ear malformations, there were 23 cases of large vestibular aqueduct(71.3% of the total number of malformations), 5 cases of large vestibular aqueduct with other innerear deformity  (4 cases complicated by Mondini malformation and 1 case complicated by nondevelopment of lateral semicircular canal), 2 cases of Mondini deformity, and 1 case of mondini deformity complicated by lateral semicircular canal not developing and enlarged vestibular cavity, 1 case CT images of the cochlea was considered “trigeminal shape”; ③ 3 cases had cerebrospinal fluid(CSF)gusher during surgery. 1 case of the cochlea was considered “trigeminal shape” by CT imaging, 1 case of Mondini deformity complicated by lateral semicircular canal not developing and enlarged vestibular cavity, and 1 case of large vestibular aqueduct complicated by Mondini deformity; ④ The patient with cochlea imaging“trigeminalshape”occurred CSF gusher during surgery, and four pairs of electrodes could not be implanted. Hearing recovery was not ideal after surgery; ⑤The patient with Mondini deformity complicated by lateral semicircular canal not developing and enlarged vestibular cavity was followed cerebrospinal fluid leakage, repeated episodes after six months, and was cured after surgical exploration after 1 year. Conclusion    ① The common deformity of cochlear includes large vestibular aqueduct syndrome and the inner ear malformation accompanies. ② Cochlear implantation in these inner ear deformities is not absolutely contraindicate, but serious CSF gusher is common during surgery. And totally electrodes implantation is difficult, cerebrospinal fluid leakage complicated after surgery is often occurred in deformity cochlears. Detailed imaging examination before surgery can reduce the incidence of complications.

Key words: Inner ear malformation, Complication； Large vestibular aquduct syndrome, Cochlear implantation