临床医学毕业论文大前庭水管综合征患儿人工耳蜗植入术8例临床分析

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1、XX大学毕业论文大前庭水管综合征患儿人工耳蜗植入术8例临床分析2014年6月25日大前庭水管综合征患儿人工耳蜗植入术8例临床分析【摘要】目的评价大前庭水管综合征患者人工耳蜗植入术的安全性和效果。方法大前庭水管综合征患者8例为内耳畸形组，其中语前聋6例，语后聋2例，以8例耳蜗发育正常的植入者作为对照组,进行手术及术后效果对比。结果8例患者人工耳蜗电极植入顺利,7例耳蜗底冋开窗吋发生井喷，迅速用颛肌筋膜牢固封闭开窗处制止井喷。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,畸形组与对照组术屮和术后并发症差异无显著性意义。术后听阈畸形组多数患者达到3()〜45dBHL,

2、与内耳正常对照组相似，经统计学分析差异无显著性(P0.05),听觉语言康复效果畸形组多数与对照组接近。结论人前庭水管综合征患者在人工耳蜗植入术屮易发生井喷，术屮可控，术后未宙现并发症，所观察患者术后听力及语言康复效果满意，因此，大前庭水管综合征患者行人工耳蜗植入术是安金冇效的。【关键词】而庭水管;畸形;耳蜗植入;听力障碍康复[Abstract]ObjectiveToevaluatetheintraoperativesafeandpost-operativeeffectofcochlearimplantationinchildrenwithlargevestibularaque

3、ductsyndrome.Methods8patientswithlargevestibularaqueductsyndrome(cochlearmalformationgroup)receivedcochlearimplantation.Thepostoperativeeffectof8caseswithcochlearmalformationwerecomparedwith8caseswithnormalcochlea(controlgroup).ResultsViacochleostomypulsatileclearfluidgusheroccurredin7cases

4、,whichwereeasilycontrolledbyquicklyinsertingtheelectrodearrayandsealingthecochleostomywithmuscletissueineachinstance.Theimplantwasinsertedwithoutdifficultyinallpatients>Therehavebeennopost-operativelycomplications,Post-operativehearingthresholdofmostcaseswere30〜45dBHL,whichsimilarwithnormal

5、cochlea.Therewasnostatisticallysignificandifferencebetweenthegroupofmalformationandthecontrolgroup(P0.05)9mostofthemreceivedthesimilarhearingandspeechrecoveringbenefitfromcochlearimplantationopatientswithnormalinnerears.ConclusionDespitepulsatileclearfluidgusherincochlearimplantation,nopost

6、-operativelycomplicationshavebeenfound,andtheoutcomeofthese8patientswithcochlearimplantationwasexcellent.Cochlearimplantationcanbesafelyandeffectivelyperformedinpatientswithprofoundsensorineuralhearinglossassociatedwithlargevestibularaqueductsyndrome【Keywords］Vestibularaqueduct;Abnormalitie

7、s;CochlearImplantation;Rehabilitationofhearingimpaire内耳畸形曾经是人工耳蜗植入的禁忌证,近年来，随着对内耳畸形的解剖学、病理学和病因学研究的深入，此类患者耳蜗植入后效果也越来越受到肯定［l-3］o人前庭水管综合征(largevestibularaqueductsyndrome,LVAS)是较常见的先天性内耳畸形，在儿童感音神经性聋屮,LVAS患者的比率高达13%~14%,男女发病率存在差异，约为1:1,出现进行性阶梯性感音神经性听力下降，最终常发展为