人工耳蜗植入手术并发症-张绍兴.pptVIP

In addition to the reprogramming of electrodes, administration of botulinum toxin is also useful, although repeated injections during every 3 to 6 months are required. Poor response of the auditory nerve Intraoperative monitoring such as the electrically driven auditory brainstem response or neural response telemetry can confirm central nervous system integrity, including the auditory nerve. We had poor or negligible responses in a few cases (7 of 315, 2.5%). It occurred in some congenitally deaf children or in post-lingually deaf adults with an ossified cochlea. Because the subjective threshold is lower than the objective one, some of the patients with this problem had good speech recognition over time, but others recognized only environmental sounds. This unsolved problem became the major reason for abandoning CI in later cases. Although preoperative assessment with magnetic resonance imaging is useful for detecting whether the auditory nerve is aplastic, poor response of the auditory nerve often occurs even in patients with a normally shaped auditory nerve. Reimplantation on the contralateral side or the use of auditory brainstem implant can be a treatment option. Electrode extrusion This complication includes gradual slipping out of the electrode from the cochlea (Figure 5), or electrode lead extrusion from the tympanic membrane or from the external ear canal. A plain x-ray of the electrode in the cochlea. The electrode was originally located in 3/4 of cochlear basal turn, but it slipped out 2 years after surgery. It may occur a few years after CI surgery, but fixation of the electrode array into the split made at the buttress portion may prevent it. If the external bony canal has become thin during the facial recess approach, it should be repaired with cartilage or bone pate. Device migration Apart from electrode extrusion, migration of the implant body toward the auricle tends to occur in the initial several cases. (ie, receiver-stimulator of the Nucleus?