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目的:探讨3岁以下人工耳蜗植入患儿乳突气房和面隐窝气房的发育特点及对人工耳蜗植入手术的影响。方法:对32例3岁以下人工耳蜗植入患儿术前通过高分辨CT(HRCT)对乳突气房与面隐窝气房进行发育评估和CT形态的测量,按乳突气房平面高于或低于耳蜗底转平面将植入患儿分为两组(乳突发育成熟组和乳突发育不成熟组),对每组植入患儿各测量值进行统计学分析,用术前的HRCT进行手术定位指导,将术中发现的乳突气房和面隐窝气房形态与术前HRCT评估进行比较。结果:所有病例均有面隐窝气房发育,术中观察乳突气房和面隐窝气房的发育情况与术前HRCT评价相符。乳突发育不成熟组平均月龄为(16.00±5.48)个月,乳突发育成熟组平均月龄为(23.00±6.79)个月,两者比较差异有统计学意义(P<0.05)。3岁以下的植入患儿面隐窝气房发育程度与大龄患儿接近,两者差异无统计学意义(P>0.05)。结论:①术前通过HRCT可以对乳突气化程度和面隐窝气房进行准确的评估,有利于术中面隐窝定位及减少手术并发症发生。②本组月龄在16个月以下的患儿乳突气化不成熟者多见,手术中应注意乳突轮廓化的范围。③本组全部患儿有面隐窝气房发育,3岁以下患儿面隐窝气房体积与大龄患儿比较差异无统计学意义,提示面隐窝气房于出生后就已基本发育成熟。
OBJECTIVE: To investigate the developmental characteristics of airway in mastoid and facial recess in children under 3 years of age with cochlear implants and its effect on cochlear implant surgery. Methods: 32 cases of cochlear implants under 3 years of age were evaluated by high resolution CT (HRCT) before and after surgery. At or below the basal plane of the cochlea, the implanted children were divided into two groups (mature mastoid and mastodermal immature group). Statistical analysis was performed on each measurement of implanted children with Preoperative HRCT guidance for surgical positioning, intraoperative findings mastoid air space and facial recess gastrocenter morphology and preoperative HRCT assessment were compared. Results: The development of facial recessive air chambers was observed in all cases. The observation of the development of mastoid air spaces and facial recessive air chambers during surgery was consistent with preoperative HRCT evaluation. The average age of immature immature group was (16.00 ± 5.48) months, and the average age of mature mastodesis group was (23.00 ± 6.79) months, the difference was statistically significant (P <0.05) . There was no significant difference in the developmental extent of the implants in infants under 3 years of age implanted in children with older children (P> 0.05). Conclusion: ① Preoperative HRCT can be accurate assessment of mastoid gasification degree and facial crypt room, is conducive to intraoperative positioning of crypts and reduce the incidence of complications. ② This group of children under 16 months of age mastoid immature more common, surgery should pay attention to the scope of mastoid contouring. ③ All children in this group have facial recess and stomach development, children under 3 years of age have no significant difference between the size of the recess and the elderly infants, suggesting that the facial crypt infiltration after the birth of the basic development has matured .