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目的:探讨乙状窦前移小儿人工耳蜗植入术式的选择和术中处理的方法,为特殊情况下的人工耳蜗植入手术的顺利完成提供经验。方法:538例行人工耳蜗植入手术的听力障碍患儿,术前进行的常规听力学与影像学检查,术前通过高分辨率CT判断乙状窦是否前移,行人工耳蜗植入手术中证实分为显著前移和轻度前移。结果:538例通过常规术式进行人工耳蜗植入患儿中,乙状窦轻度前移64例,占11.9%,对常规人工耳蜗植入手术无影响。4例患儿乙状窦显著前移,对常规人工耳蜗植入手术带来困难,占0.74%,通过处理骨性外耳道后壁和切除砧骨顺利完成手术。结论:小儿人工耳蜗植入手术患儿中,乙状窦轻度前移者对手术无影响,显著前移者经过适当手术处理,亦能成功进行手术。
Objective: To investigate the choice of intraoperative cochlear implantation for pediatric sigmoid sinus surgery and the method of intraoperative management for the treatment of cochlear implants in special cases. Methods: 538 pediatric cochlear implants in children with hearing impairment, preoperative routine audiology and imaging studies, preoperative high-resolution CT to determine whether the sigmoid sinus advance cochlear implant surgery Confirmed divided into significant advance and mild advance. Results: Of the 538 children undergoing routine cochlear implantation, the sigmoid sinus was slightly advanced 64 cases (11.9%), which had no effect on conventional cochlear implantation. Four cases of sigmoid sinus in children significantly advanced, the conventional cochlear implant surgery difficult, accounting for 0.74%, by treating the posterior wall of the bony external auditory canal and resection of the anus successfully complete the operation. Conclusion: In pediatric cochlear implants, mildly advanced sigmoid sinus sinus surgery has no effect on the surgery. Significant advancement of those who have undergone appropriate surgical treatment can also be successfully performed.