摘要目的 通过锥形束CT(cone beam computer tomography,CBCT)观察人工耳蜗植入术后电极在耳蜗内的分布情况,为临床应用CBCT评估电极位置提供参考.方法 选取2016年1月至2017年12月在山东大学第二医院耳鼻咽喉头颈外科行人工耳蜗植入的25例(27耳)患儿作为研究对象,其中男15例(17耳),女10例(10耳);年龄0.5～7.0岁,中位年龄1.6岁;单侧植入23例,双侧植入2例.植入体均采用MED-EL标准12对电极阵列.采用CBCT观察电极在耳蜗中的位置,测量电极与蜗轴之间的距离以及植入到耳蜗内的长度.采用SPSS 22.0软件对测量结果进行统计学处理.结果 CBCT可以清楚显示圆窗、卵圆窗、蜗轴、骨蜗管、骨螺旋板、电极等结构.25例(27耳)患者的人工耳蜗电极阵列均完全植入到耳蜗内,其中26耳位于鼓阶内,1耳电极由鼓阶进入到前庭阶内.电极植入耳蜗内长度平均为30.23 mm(95％CI,30.04～30.71 mm);电极与蜗轴之间的距离在第1～4个电极对区间逐渐增大,并在第4个电极对处达到最大值,平均1.10 mm (95％CI,1.02～1.18 mm),之后从第5个电极对开始,逐渐缩小.结论 CBCT可清晰显示人工耳蜗植入后的电极位置信息和耳蜗细微结构,可用于临床人工耳蜗植入后电极位置的精确评估.

abstractsObjective To observe the position of the electrode in the cochlea following cochlear implantation by cone beam computed tomography (CBCT).Methods Twenty-five children who received cochlear implantation and CBCT examinations in the Department of Otorhinolaryngology Head and Neck Surgery from the Second Hospital of Shandong University between January 2016 and December 2017 were selected.There were 15 males (17 ears) and 10 females (10 ears).The age ranged from 0.5 to 7.0 years old,with a median age of 1.6 years.23 patients with unilateral implantation and two patients with bilateral implantation.The implants were all Med-El standard 12-electrode contact arrays.The CBCT was used to determine the position of the electrode in the cochlea,the distance between the electrode contacts and modiolus,and intracochlear insertion length of the electrode arrays.SPSS Statistics,version 22.0 was used for data processing and statistical analysis.Results CBCT images could clearly demonstrate the structure of round window,oval window,modiolus,osseous cochlear duct,osseous spiral lamina,and electrodes.The electrode arrays of all the children were fully implanted into the cochlea.26 of the electrode arrays were located in the scala tympani and one of them was inserted into the scala vestibular.The mean intracochlear insertion length of the electrode arrays was 30.23 (95％CI,30.04-30.71) mm.The distance between the electrode contacts and modiolus gradually increased at the 1-4th electrode contacts and reached the maximum at the 4th electrode contacts with an average of 1.10 mm (95％CI,1.02 to 1.18 mm),and then gradually decreased from the 5th electrode contacts.Conclusions CBCT can clearly show cochlear fine structures and therefore accurately assess the electrode position following cochlear implantation.