结论:我们的数据代表了奥地利最大的人工耳蜗植入项目的经验。总之,人工耳蜗植入是一种安全的手术,与术后并发症发生率低相关。然而,应告知患者可能出现的问题,尤其是因器械故障而再次手术的风险.
目的:评估耳聋的病因,1994年至2003年在维也纳总医院连续进行的所有人工耳蜗植入手术的术中发现和并发症发生率。
方法:包括双侧植入和翻修的所有手术,对164例成人(年龄范围14.5~81岁;平均年龄50.79岁)和128例儿童(年龄范围0.75~14岁;平均年龄5.00岁)进行的342例手术进行了回顾性分析.
结果:耳聋的病因以先天性或进行性为主(66.89%)。300例(87.72%)选择常规乳突切除术,42例(12.28%)选择了动脉上入路。术中,4例(2.53%)发生脑脊液瘘,35例(10.23%)发生耳蜗骨化。三名成人(1.63%)和两名儿童(1.27%)的面神经异常。总并发症发生率为12.2%,主要并发症发生率为4.97%,次要并发症发生率为4.09%。术后无脑膜炎或面神经麻痹病例。一名成人患者(0.54%)发生皮瓣坏死和电极脱位,但没有一个孩子。在一名成年人(0.54%)和一名儿童(0.63%)中发现了胆脂瘤的形成。成人装置故障率为7.07%,儿童为13.92%。
CONCLUSIONS: Our data represent the experience of the largest cochlear implant program in Austria. In conclusion, cochlear implantation is a safe procedure, associated with a low rate of intra- and postoperative complications. Nevertheless, patients should be informed about possible problems and especially about the risk of a reoperation due to device failure.
OBJECTIVE: To evaluate the cause of deafness, the intraoperative findings and the complication rate for all cochlear implant operations performed consecutively between 1994 and 2003 at Vienna General Hospital.
METHODS: Including all surgeries for bilateral implantation and revision, a series of 342 operations performed on 164 adults (age range 14.5-81 years; mean age 50.79 years) and 128 children (age range 0.75-14 years; mean age 5.00 years) was retrospectively analyzed.
RESULTS: The etiology of deafness was predominantly congenital or progressive (66.89%). The routine mastoidectomy approach was chosen in 300 patients (87.72%) and the suprameatal approach in 42 (12.28%). Intraoperatively, 4 children (2.53%) had a cerebrospinal fluid fistula and 35 patients (10.23%) showed cochlear ossification. Three adults (1.63%) and two children (1.27%) had facial nerves with an aberrant course. The overall complication rate was 12.2%, the rate of major complications was 4.97% and the rate of minor complications was 4.09%. There were no cases of either postoperative meningitis or facial nerve palsy. Both flap necrosis and electrode dislocation occurred in one adult patient (0.54%), but in none of the children. Formation of cholesteatoma was found in one adult (0.54%) and one child (0.63%). The rate of device failure was 7.07% for adults and 13.92% for children.