Một intraoperative di động X-ray mạnh mẽ nên xác minh vị trí điện cực trong khi bệnh nhân vẫn còn ngủ. Đầu của bệnh nhân đứng thẳng trên bàn, tốt nhất trước khi ứng dụng mặc quần áo. Xem duy nhất anteroposterior transorbital (nhẹ hơn, thâm nhập) được thực hiện (Hình 9-20). | 246 Surgical Atlas of Pediatric Otolaryngology An intraoperative portable X-ray is strongly advised to verify electrode placement while the patient is still asleep. The patient s head is straightened on the table preferably prior to application of the dressing. A single anteroposterior transorbital view slightly over-penetrated is taken Figure 9 20 . An incorrectly placed or compressed electrode should be discovered in the operating room rather than weeks later when the child is found to be nonstimulable. A gentle mastoid dressing is applied. Figure 9 20 An intraoperative transorbital X-ray is taken to verify electrode position. A Straight electrode. B Peri-modiolar electrode. B A Cochlear Implants 247 Postoperative Care The dressing is removed the morning following surgery. Staples are generally removed in 10 days no specific aftercare is necessary. Ventilation tubes should not be placed in an ear that has received a cochlear implant. Certain sports and activities are best avoided after cochlear implant surgery including wrestling rugby and heading the ball in soccer. Children engaging in contact sports cycling horseback riding etc should always wear protective headgear. MRI must be avoided unless the magnet can be removed as with the Nucleus CI 24 series there is no contraindication to CT scanning. Monopolar cautery should never be used in the vicinity of the cochlear implant or in cases where the implant lies between the active and the ground electrodes. Other forms of radiant energy eg diathermy should also be avoided as well as plastic playground slides while the external hardware is being worn. Complications No deaths or life-threatening surgical complications have been reported after cochlear implantation and the complication rate has decreased over the years Table 9 1 . Complications for children are less than for adults Table 9 2 . Table 9-1 Cochlear implant complications over time for both adults and children Type of complication 1991 N 459 1993 N 2 751 .
