大前庭水管综合征患者人工耳蜗植入效果分析

摘要

Objective To study the feasibility of the cochlear implantation and effects in the treatment of large vestibular aqueduct syndrome.Methods A total of 37 patients(74 ears)diagnosed with large vestibular aque-duct syndrome received cochlear implants since 2002 at the Renmin Hospital of Wuhan University.We made a retro-spectively analysis of these 37 patients(37 ears).While 37 patients(37 ears)with normal cochlear structures were considered as the control group.After activation,their speech perception at pre-operation and at 3,6,9,12 months affer the operation were evaluated.Their CAP and SIR scores were collected through questionnaires at each assess-ment interva1 .Results In LVAS group,5 patients(5 ears)had serious gusher,while no gusher was abserved in the control group.The two groups of the electrodes were all inserted in the cochlea.No serious complications occurred after implantation in the two groups.The impedance of the electrodes,the T level,C level and the hearing thresholds were similar with the normal group with cochlear implantations.The results had no significant differences when compared with the normal cochlear group (P>0.05).The speech perception ability,CAP and SIR scores were im-proved along with the increase time of implant use.At the same recovery time,the results had no significant differ-ence in the two groups(P>0.05).At the same group,the results between pre-operation and 3,6,9,12 months post-operation after device activation had significant differences (P<0.05).Conclusion Cochlear implants could be performed safely in patients with large vestibular aqueduct syndrome.The primary outcomes for patients with large vestibular aqueduct syndrome were similar to those with normal cochlear structure following the cochlear im-plantation.%目的：分析大前庭水管综合征（large vestibular aqueduct syndrome，LVAS）患者人工耳蜗植入的疗效。方法回顾性分析37例行人工耳蜗植入术的LVAS患者（LVAS组）的临床资料，另选择临床资料相匹配37例耳蜗结构正常的人工耳蜗植入患者作为对照组，分别于人工耳蜗植入术前和术后3、6、9、12个月评估其言语识别率、听觉行为分级（categories of auditory performance，CAP）和言语可懂度分级（speech intelligibility rating， SIR）。结果①37例LVAS患者术中有5例（5耳）出现严重井喷，20例（20耳）耳蜗钻孔后出现外淋巴液不同程度波动，对照组均未出现“井喷”现象；两组电极均成功植入；两组术后均无面瘫、脑脊液漏、脑膜炎等并发症；②开机调试时两组电极阻抗值、电极反应阈值（T值）及最大舒适阈值（C值）差异无统计学意义（P＞0．05），术后3、6、9、12个月两组的言语识别率、CAP、SIR评分均随着康复时间的延长而逐渐提高，在相同的康复时间段，两组之间各项康复指标差异无统计学意义（P＞0．05）；③术中发生“井喷”与未发生“井喷”的LVAS患者之间术后康复效果差异也无统计学意义（P＞0．05）。结论人工耳蜗植入可作为LVAS患者听觉康复的手段，其听觉康复效果与内耳发育正常的人工耳蜗植入患者接近。