Implication Of Cochlear Implantation In Patients With Large Vestibular Aqueduct Syndrome

Objective After hearing of patients with large vestibular aqueduct syndrome develops to stable heavy - extremely sensorineural hearing loss, the medicine and otophone are unable to compensate the hearing. In recent years, with the rapidly development of cochlear implantation techniques, It has become the main therapeutic method to cure patients with LAVS. Through analyzing patient's clinical data and the follow-up results in 18 cases with LAVS,this article investigated the safety and the validity of cochlear implantation.Methods Clinical data of 112 cases following cochlear implantation from June 2003 to June 2010 were retrospectively analyzed, before the operation, through HRCT and MRI inspection besides conventional audiology inspections such as acoustic impedance, ABR, ASSR, DPOAE, we screen out clinical data about cochlear implantation of 18 cases with LAVS. Before the operation, we should know whether the patient is accompanying with concurrent internal ear abnormality, how to forecast blowout in the operation and relevant methods of disposition. After the surgery, We should know: Whether there is complication after the operation, and do the follow-up by telephone for these outpatients. Randomly picked out and set up 18 babies following cochlear implantation as the control group, and excluding inner ear malformation. 6 months after the operation, measuring the hearing levels of that two groups with the free sound field pure sound, measuring patient's spoken language recognition rate using "Deaf child with Sun Xibin to be restored to health Sense of hearing Spoken language Appraisal Vocabulary", Analyzing two groups of results using statistical method, find that whether there is differences between two groups, then draw the conclusion.Results1 surgery resultThe 18 LAVS cases successfully finished the surgery,15 cases received complete electrode insertion, 3 cases incomplete insertion in the cochlear, and slight gusher appeared in 5 implantations, serious gusher in one cases. No serious complications occurred in 0.5 ~ 6.5 years after implantation. 4 months after surgery, only one case appeared implants'body which is fixed after compression wrap and anti-SARS therapy to move ahead.2 hearing and spoken language result after cochlear implantationhalf year later ,pure tone sound field audiometry of LAV group is 25 ~ 46dBSPL, with an average of 34.5dBSPL, speech discrimination score is 67% ~88%, with an average of 78.3%; pure tone sound field eudiometry in inner ear normal group is 23~ 48dBSPL, with an average of 31.6dBSPL, speech discrimination score is 69% ~92%, with an average of 81.6%. Through the SPSS 13.0 software, T-test is carries on to the data of two groups, and P >0.05, the difference of two groups shows no statistical significance.3 telephone follow-up resultIn January, we carries on last follow-up visit, 14 cases entered the kindergarten and the ordinary elementary school. 4 examples are still training in the spoken language recovery school, they can exchange normally with the family member and the degree of satisfaction in their family members is superior.Conclusion The risk of cochlear implantation in LAVS patients is larger than in patients with normal inner ear structure. After strict preoperative hearing and imaging evaluation, positive treatment during operation, postoperative regular hearing and speech rehabilitation training, cochlear implantation in patients with large vestibular aqueduct syndrome is safe and effective.