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  • Title: [Possible reasons for cerebrospinal fluid gusher in cochlear implantation with inner ear abnormality].
    Author: Sun SP, Lu W, Men XM, Zuo B, Lei YB.
    Journal: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2017 Apr 07; 52(4):283-286. PubMed ID: 28441806.
    Abstract:
    Objective: To discuss the possible reasons for cerebrospinal fluid (CSF) gusher in cochlear implantation (CI) with inner ear abnormality. Method: A retrospective analysis was performed on 340 cases who underwent CI from January 2013 to December 2016 in Division of Otology, Otorhinolaryngology Hospital, the First Affiliated Hospital of Zhengzhou University. Among them, 96 cases had inner ear abnormalities. Imaging examinations were performed on these patients, and classification of inner ear malformation was done according to the results. Results: Among the cases with inner ear abnormality, 9.4% (9/96) suffered from CSF gusher during CI. The inner ear abnormalities were found to be as follows: 3 cases had incomplete partition type Ⅰ; 1 case had incomplete partition type Ⅰ with semicircular canal dysplasia; 1 case had common cavity deformity; 1 case had enlarged vestibular aqueducts and common cavity deformity; 2 cases had Mondini deformity. All of these cases had bony defect in the fundus of the internal acoustic meatus observed on CT scans. Another case was type 1 cochlear aqueduct with round window aplasia. Conclusions: Defects in the modiolus or fundus of the internal acoustic meatus is the main reason for CSF gusher during CI. A patent cochlear aqueduct is another possible reason. 目的： 探讨人工耳蜗植入术(cochlear implantation，CI)中发生脑脊液"井喷"的原因。 方法： 回顾性分析2013年1月至2016年12月于郑州大学第一附属医院耳鼻咽喉科医院耳科行CI的340例患者的临床资料，其中内耳发育畸形96例。对患者行影像学检查并对内耳畸形进行分类。 结果： 96例内耳畸形患者术中发生井喷9例(9.4%)，其中Ⅰ型分隔不全3例，Ⅰ型分隔不全合并半规管发育不良1例，共腔畸形1例，共腔畸形合并前庭导水管扩大1例，Mondini畸形2例，均有内听道底骨质缺损；另有1例为1型耳蜗导水管合并圆窗未发育。 结论： 蜗轴或内听道底骨质缺损是引起CI术中脑脊液井喷的主要原因，耳蜗导水管开放可能是导致术中井喷的另一原因。.
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