马崧刘宏建--人工耳蜗植入术.pptVIP

2011年新技术项目简介 人工耳蜗植入术 河南省人民医院耳鼻喉科 马崧 刘宏建 全聋患者的福音 人工耳蜗又称电子耳蜗，可以替代人耳蜗的功能将环境中的声音信号转换为电信号，刺激耳蜗残存的听神经，从而产生听觉。 目前是全聋患者恢复听觉的惟一有效治疗方法。 体外部分 植入体（手术就是把植入体植入到耳蜗） 耳蜗内的22个电极 一：技术水平 1.耳后切口，分离皮瓣，切开肌骨膜，暴露乳突及骨性外耳道后壁； 2.开放乳突腔； 3.颅骨表面磨出安放植入体的骨床； 4.开放面隐窝，行耳蜗开窗； 5.将植入体安放在骨床内，将电极植入鼓阶，参考电极置于颞部骨膜下； 6.依次缝合肌骨膜、皮下和皮肤。 手术后2-4周开机，开启外部装置，测试并设定各通道的电刺激阈值和最舒适值； 调试完成后到聋儿康复中心进行言语康复训练。 手术操作早期由北京友谊医院的张道行教授指导下完成。 经过半年的合作，现在已经具有自己独立操作该项技术的能力。 术后的开机调试由我科室独立完成。 患儿的言语康复培训由我院和河南省聋儿康复中心协同完成。 六 经济社会效益 该手术的开展方便了河南人民就医，提高了我院在该领域的学术地位，取得了明显的社会效益。 每例患者住院费用平均8000元左右，每一个患者人工耳蜗置入设备15-20万元，为我院创造了明显的经济效益。 * Insertion of the array into the scala tympani Here is a closer view of the cochlea with the electrode array. The array is inserted into the scala tympani through an opening near the round window. Directly stimulating the auditory nerve fibres (spiral ganglion cells which lie in the Rosenthal抯 cannel for the first 25mm of the basilar membrane) introduce spiral ganglion, the input is different from natural sound, different elecron cause diff frequency, eg coustom sound 3D cochlear imaging studies show that as the cochlea抯 spiral continues, the spiral ganglion cells become more remote from the scala tympani. Consequently, electrically stimulating the cochlea beyond the first 25mm results in diffuse stimulation of the underlying spiral ganglion cells, resulting in poor pitch discrimination * Insertion of the array into the scala tympani Here is a closer view of the cochlea with the electrode array. The array is inserted into the scala tympani through an opening near the round window. Directly stimulating the auditory nerve fibres (spiral ganglion cells which lie in the Rosenthal抯 cannel for the first 25mm of the basilar membrane) introduce spiral ganglion, the input is different from natural sound, different elecron cause diff frequency, eg coustom sound 3D cochlear imaging studies show that as the cochlea抯 spiral continues, the spiral ganglion cells become more remote from the scala tympa