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透明化面神经与鼓索神经对于提高人工耳蜗植入术的安全性研究 被引量:1

Study on the safety of active and adequate exposure of the facial nerve and chorda tympani nerve to improve the safety of cochlear implantation
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摘要 目的 探讨人工耳蜗植入术中主动充分透明化面神经、鼓索神经的可行性和安全性.方法 回顾性分析2011年1月-2015年6月在我科接受人工耳蜗植入手术的患者,术中均主动充分透明化面神经、鼓索神经,最大程度地开放面隐窝.统计面神经高位、面隐窝狭窄、鼓索神经变异的例数,随访术后是否发生面瘫、面神经刺激症、味觉减退.术后1个月开机调试及跟踪随访11个月至5年.结果 614例患者接受人工耳蜗植入术,术中所有患者的面神经和鼓索神经均透明化并完整保留,顺利开放面隐窝后成功植入电极.67例面神经高于水平半规管平面,36例面隐窝狭窄,1例面神经垂直段分叉变异为四支,1例鼓索神经严重变异,横行于面隐窝上中1/2部位.所有患者术后未出现面瘫、面神经刺激症状及味觉异常等并发症.采用此手术方法后,规范化培训住院医师学习、辨认耳显微外科结构的培训时间由原来的5周缩短为2周.结论 人工耳蜗植入术中主动充分透明化面神经、鼓索神经可以安全有效地开放面隐窝,经乳突-后鼓室-面隐窝径路植入电极,可降低患者面瘫、面神经刺激、味觉异常的发生率,从而提高人工耳蜗手术的安全性,同时可以促进规培住院医师学习耳显微外科解剖知识. Objective To probe the safety and feasibility of active and adequate transparent exposure of the facial nerve and chorda tympani nerve during the surgery. Methods A retrospective analysis was performed to all patients who underwent cochlear implantation by transparently exposing the facial nerve and chorda tympani nerve actively and adequately from Jan 2011 to June 2015. During operation, anatomical variations of facial recess, facial and chorda tympani nerve were recorded. All patients had been followed up for 11 months to 5 years postoperatively, and their postoperative complications including facial paralysis, facial nerve irritation and taste impairment were observed. Results A total of 614 patients received artificial cochlear implantation, and the facial nerve and chorda tympani nerve were actively and fully exposed and kept intact during operation. The facial nerves of 67 cases were above the horizontal semicircular canal plane, while narrow facial recess was observed in 36 cases. Serious facial nerve variation was found in one case, and serious chorda tympani nerve variation was found in another. No facial paralysis and facial nerve irritation and abnormal taste occurred after operation. By this surgical method, the time of training resident doctors to identify the mierosurgical structures of ear was shortened from five weeks to two weeks. Conclusions Cochlear implantation with initiative and adequate exposure of facial nerve and the chorda tympani nerve is safe and effective to open facial recess, and can reduce the incidence of facial paralysis, facial nerve stimulation and taste abnormalities and improve the safety of the cochlear implant surgery. It also can promote the residents~ anatomical knowledge of ear microsurgery.
出处 《中国耳鼻咽喉颅底外科杂志》 CAS 2016年第3期213-215,219,共4页 Chinese Journal of Otorhinolaryngology-skull Base Surgery
关键词 面神经 鼓索神经 人工耳蜗植入术 透明化 安全性 Cochlear implantation Ear microsurgery Facial recess Facial nerve Chorda tympani nerve
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