一名难治性耳鸣患者的人工耳蜗植入术:内窥镜辅助方法的病例报告。

Seung Jae Lee, Jong Dae Lee
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摘要

保留残余听力和前庭功能是人工耳蜗植入术(CI)的关键因素,尤其是对于有低频残余听阈的患者。我们报告了一例接受单侧内窥镜辅助人工耳蜗植入术的患者,该患者在严格的鼓室后切口术后接受了具有挑战性的手术视野。一名 53 岁的男性因 10 年前突发感音神经性听力损失而出现左侧顽固性耳鸣。由于圆窗(RW)的位置异常,远比通常的位置靠后和靠下,阻碍了使用传统 RW 方法插入电极,因此进行了内窥镜辅助 CI。CI 术后 3 个月的纯音测听显示听阈令人满意。此外,左侧耳鸣也有所缓解,主观视觉模拟量表响度和耳鸣障碍量表评分均明显下降。如果有适当的适应症,我们强烈建议在后鼓室切开术后RW可视化不足的病例中,采用内窥镜辅助下的RW方法,而不是传统的骨性耳蜗造口术,以保留低频听阈。
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Cochlear Implantation in a Patient with Intractable Tinnitus: A Case Report of an Endoscope-Assisted Approach.

Preservation of residual hearing and vestibular function is a crucial factor in cochlear implantation (CI), especially in patients with residual low-frequency hearing thresholds. We report a case of a patient who underwent unilateral endoscope-assisted CI with a challenging surgical view following rigorous posterior tympanotomy. A 53-year-old male presented with left-sided intractable tinnitus due to sudden sensorineural hearing loss that had occurred 10 years prior. Due to the abnormal location of the round window (RW), which was far more posterior and inferior than usual and impeded insertion of the electrode using the conventional RW approach, endoscope-assisted CI was performed. Pure-tone audiometry at 3 months after CI revealed satisfactory hearing thresholds. Furthermore, there was alleviation of the left-sided tinnitus, which was indicated by a marked decrease in both the subjective visual analog scale loudness and Tinnitus Handicap Inventory scores. With proper indications, we strongly recommend applying the RW approach with endoscopic assistance over conventional bony cochleostomy for the preservation of low-frequency hearing thresholds in cases where RW visualization is insufficient following posterior tympanotomy.

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