微创人工耳蜗植入术及常规人工耳蜗植入术临床比较

摘要

目的：通过微创人工耳蜗植入术与常规人工耳蜗植入术的临床效果比较，探讨微创人工耳蜗植入术的临床优势。方法回顾性分析121例人工耳蜗植入患者，根据人工耳蜗植入术式的不同分为微创人工耳蜗植入术组（微创组）及常规人工耳蜗植入术组（常规组），比较两组患者的手术时间、电极植入情况、手术切口及并发症的不同，分析两种术式之间的特点。结果121例人工耳蜗电极均全植入鼓阶，成功率100%。微创组与常规组的平均手术总时间分别为89.53±12.42分钟、92.30±14.16分钟，电极植入平均用时分别为112.16±16.01秒、117.05±26.90秒，平均电极植入次数分别为1.07±0.26次、1.22±0.49次。两组的手术总时间无明显差别（P>0.05），电极植入用时亦无明显差别（P>0.05)，微创组平均电极植入次数较常规组少(P<0.05)。微创组及常规组的手术切口长度分别为2.53±0.12cm、8.30±0.56cm，微创组的手术切口长度明显小于常规组(P<0.05)。微创组术后未发现皮下血肿及感染，常规组术后出现皮下血肿3例（4.76%），微创组术后皮下血肿率与常规组比较无明显变化(P>0.05)。微创组和常规组的术后眩晕出现率分别为5.88%、21.83%，微创组术后眩晕率低于常规组术后眩晕率（P<0.05）。结论与常规人工耳蜗植入术相比较，微创人工耳蜗植入术在手术时间不增加的前提下，可确保电极位于鼓阶，并具有外形美观，手术切口小，术中创伤小，术后并发症少等优点。%Objective To compare clinical outcomes between minimally invasive cochlear implantation and conven-tional cochlear implantation, and to investigate clinical advantages of minimally invasive cochlear implantation. Methods One hundred and twenty one cases were retrospective analyzed and divided into a minimally invasive group and a conven-tional group based on the type of surgeries they underwent. Surgery time, electrodes insertion time and number of trials, inci-sion size and postoperative complications were compared and analyzed. Results Implantation was successful in all cases. Surgery time was 89.53±12.42 minutes in the minimally invasive group and 92.30±14.16 minutes in the conventional group (P>0.05), and electrode insertion time was 112.16 ± 16.01 seconds and 117.05 ± 26.90 seconds (P>0.05), respectively. Aver-age number of electrodes insertion trials were 1.07±0.26 and 1.22 ± 0.49 for the two groups (P<0.05). The length of incision of the minimally invasive group (2.53±0.12 cm) was shorter than that of the conventional group (8.30 ± 0.56 cm) (P<0.05). Subcutaneous hematoma occurred in 3 cases (4.76%) in the conventional group, but none in the minimally invasive group, although there was no statistically significant difference between the two groups (P>0.05). The rate of postoperative vertigo in the two groups was 5.88%and 21.83%respectively, lower in the minimally invasive group (P<0.05). Conclusions Mini-mally invasive cochlear implantation does not increase surgery time but can ensure insertion of electrode in the scala tym-pani. Its other benefits include better cosmetic appearance, smaller incision, less surgical trauma and lower rates of compli-cations.