【摘要】：目的:總結人工耳蝸植入手術患者耳蝸蝸軸缺失的類型和人工耳蝸植入手術入路的選擇,為掌握人工耳蝸植入手術的適應證提供參考。方法:人工耳蝸植入患者按術前顳骨高分辨CT檢查,將存在的耳蝸蝸軸發(fā)育缺失分為3種類型:1耳蝸發(fā)育不良形成的蝸軸缺失(Mondini畸形);2耳蝸前庭半規(guī)管發(fā)育不良(Common cavity畸形);3內耳道與耳蝸共腔(IP-Ⅲ)畸形。將蝸軸缺失的內耳畸形人工耳蝸植入手術入路分成3種類型:Ⅰ型,常規(guī)面神經(jīng)隱窩入路將圓窗擴大開放入耳蝸內;Ⅱ型,常規(guī)面隱窩入路后鼓岬表面開放入畸形的耳蝸腔內,電極沿側壁擺放;Ⅲ型,乳突側開放外半規(guī)管突入共腔將電極擺放于耳蝸側的腔內骨壁。結果:1246例內耳畸形中耳蝸蝸軸發(fā)育缺失共166例,其中Mondini畸形的215例患者中存在蝸軸缺失135例;Conmon cavity畸形18例,全部存在耳蝸蝸軸缺失;內耳道與耳蝸共腔(IP-Ⅲ)畸形13例,全部存在耳蝸蝸軸缺失。2內耳畸形存在耳蝸蝸軸缺失的人工耳蝸植入手術入路的選擇:Ⅰ型136例,其中Mondini畸形123例,內耳道與耳蝸共腔(IP-Ⅲ)畸形13例;Ⅱ型12例,全部為Mondini畸形存在蝸軸缺失患者;Ⅲ型18例,全部為Conmon cavity畸形。33種內耳畸形人工耳蝸植入術后效果:Mondini畸形聲場測試平均為65dB,單韻母言語識別為95%,單聲母言語識別為25%;Conmon cavity畸形聲場測試平均為80dB,單韻母言語識別為60%,單聲母言語識別為0;內耳道與耳蝸共腔(IP-Ⅲ)畸形聲場測試平均為55dB,單韻母言語識別為100%,單聲母言語識別為45%。結論:耳蝸蝸軸缺失的內耳畸形人工耳蝸植入術后患者聽覺言語識別效果很差,Conmon cavity畸形最差,Mondini畸形次之,內耳道與耳蝸共腔(IP-Ⅲ)畸形較前兩者好。
[Abstract]:Objective: to summarize the types of cochlear axis loss in cochlear implant patients and the choice of cochlear implant approach in order to provide reference for the indication of cochlear implant operation. Methods: cochlear axis defects in cochlear implants were classified into three types according to preoperative high-resolution CT examination of temporal bone: (1) cochlear axis deletion (Mondini malformation) caused by cochlear dysplasia; (2) (Common cavity malformation of vestibular semicircular canal dysplasia of cochlea and 3 malformation of IP- 鈪，

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