【摘要】 目的探讨伴分泌性中耳炎的极重度聋患者一期行人工耳蜗植入术的可行性及术后听觉言语康复效果,并总结其护理体会。方法对11例伴分泌性中耳炎的极重度聋儿童一期行人工耳蜗植入,术中彻底清除中耳乳突病变黏膜,建立通畅引流后植入人工耳蜗电极,结合围手术期药物治疗、护理、听觉言语康复训练,术后定期随访,评估人工耳蜗植入后听觉与言语康复效果。结果 11例患儿均一期完成单耳人工耳蜗植入,其中右耳8例,左耳3例;植入人工耳蜗型号:Nucleus 24CA 7例,Clarion AB 90K1例,Med el Combi 40+2例,pulsar 1例,术中电极神经遥测均引出神经反应动作电位;术后一月开机,正常调机后均获得满意的主观听性反应,助听下0.25~4kHz声场听阈为20~45dB HL;术后随访13~60个月,11例患儿人工耳蜗工作状态正常,分泌性中耳炎均痊愈;术后听觉言语康复效果满意,11例均进入普通幼儿园或小学学习。结论伴有分泌性中耳炎的极重度聋患者术前做好充分准备后可尽早行人工耳蜗植入,围手术期合理的治疗、护理及术后听觉言语康复有利于获得良好效果。更多还原

【Abstract】 Objective To study the feasibility and rehabilitation outcomes of one-stage cochlear implantation(CI)in profound deaf children with secretory otitis media(SOM).Methods A total of 11profound deaf children with soal receired one-soage unilateral cochlear implantation with a follow-up period from 13~60months.Inflamed mucosa in the mastoid as well as exudates were removed radical1y at the time of implantation for adequate drainage of the middle ear.After the sugery,the patients were followed up and the hearing and rehabilitating outcomes were eveluated.Results All 11patients were successfully operated with 8cases in the right ear and 3cases in the left ear.Among them,7cases were nucleus 24CA,1case losa clarion AB 90K,2cases were medel combi 40+ and 1case was pulsar.All patients were successfully operated.No infectious complications occurred.No recurrence of secretory otitis media was observed.After initial stimulation and post regular fitting,the status of the implantable devices were all stable.All the implantees had satisfied hearing and entered normal kindergartens or schools. Conclusion Profound deaf pediatric patients with SOM are not an absolute contraindication for CI.With sufticient pre-operation preparontion,proper trentment and nursing.Cochlear implantation should be condnote as early as possible better rehabilitation performance.更多还原