Article record

“不让任何人掉队”：人道主义环境下区域麻醉下的耳蜗植入——病例系列

'Leave no one behind': cochlear implantation under regional anaesthesia in a humanitarian setting - a case series.

临床研究耳科IF 5.8Q1

文献信息

PMID	42723539
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Isra Aljazeeri 查看其他 6 位作者 Mohammad F Alzahrani；Roa Talal Halawani；Hazem Ibrahim Shoukry；Ahmad M Aldhafeeri；Ibrahim Shami；Abdulrahman Hagr
作者单位	Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia. 查看其他 8 条单位信息 Department of Research, King Abdullah Ear Specialist Center (KAESC), King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.；Department of Otorhinolaryngology, Aljaber Ophthalmology and Otolaryngology Specialized Hospital, Ahsa Health Cluster, Ministry of Health, Saudi Arabia.；Research Department, Cochlear Implant Specialized Centers, Ministry of Health, Riyadh, Saudi Arabia.；College of Medicine, King Saud University, Riyadh, Saudi Arabia.；Cochlear Implant Center, Ohud General Hospital, Madinah Health Cluster, Madinah, Saudi Arabia.；Anesthesia Department, Ohud General Hospital, Madinah Health Cluster, Madinah, Saudi Arabia.；Hafr Albaten Cochlear Implant Center, Hafr Albaten Health Cluster, Hafr Albaten, Saudi Arabia.；King Fahad Medical City, Ministry of Health, Riyadh, Saudi Arabia.
期刊	Journal of global health
SCI 分区	Q1
IF	5.8
研究类型	临床研究 · 临床
所属专科	耳科

中文摘要

背景： 耳蜗植入（CI）是重度至极重度听力损失的标准治疗方法。虽然传统上在全身麻醉（GA）下进行，但在低资源环境下的人道主义任务中，GA带来了显著的后勤和安全挑战，常常将具有复杂医学合并症的患者排除在外。区域麻醉（RA）提供了一种实用的替代方案，可避免GA相关风险、缩短手术时间，并允许治疗原本不符合条件的患者，从而坚持“不让任何人掉队”的人道主义原则。因此，本研究的目的是报告在人道主义任务期间于区域麻醉下进行耳蜗植入的可行性、安全性和结局，并实施早期激活方案。
方法： 本病例系列包括八名患者（年龄范围20-66岁），分别为巴勒斯坦、索马里和塞内加尔国籍，他们在2025年4月和12月于约旦（服务巴勒斯坦患者）、肯尼亚（服务索马里患者）和塞内加尔（服务塞内加尔患者）开展的人道主义任务期间接受了区域麻醉下的耳蜗植入。
结果： 所有八例手术均在区域麻醉下成功完成，未转为全身麻醉。多样化的病例组合包括医学复杂患者和具有挑战性的手术解剖结构。所有病例均实现了早期激活。
结论： 区域麻醉使无法接受全身麻醉的医学复杂患者——包括插管失败或高心脏风险者——能够接受耳蜗植入，同时允许术中或术后即刻激活，确保在人道主义任务中不让任何人掉队。早期激活方案在资源有限环境中可实现，并具有后勤效率。

英文摘要

BACKGROUND: Cochlear implantation (CI) is the standard of care for severe-to-profound hearing loss. While traditionally performed under general anaesthesia (GA), GA poses significant logistical and safety challenges during humanitarian missions in low-resource settings, often excluding patients with complex medical comorbidities. Regional anaesthesia (RA) offers a practical alternative that avoids GA-related risks, reduces operative time, and allows treatment for otherwise ineligible patients, upholding the humanitarian principle of 'leaving no one behind'. Therefore, the objective of the study is to report the feasibility, safety, and outcomes of cochlear implantation performed under regional anaesthesia during humanitarian missions, with the implementation of early activation protocols.
METHODS: This case series includes eight patients (age range 20-66 years) of Palestinian, Somali, and Senegalese nationality who underwent cochlear implantation under regional anaesthesia during humanitarian missions conducted in Jordan (serving Palestinian patients), Kenya (serving Somali patients), and Senegal (serving Senegalese patients) in April and December 2025.
RESULTS: All eight procedures were successfully completed under regional anaesthesia without conversion to general anaesthesia. The diverse case mix included medically complex patients and challenging surgical anatomy. Early activation was achieved in all cases.
CONCLUSIONS: Regional anaesthesia enables cochlear implantation in medically complex patients who cannot undergo general anaesthesia - including those with failed intubation or high cardiac risk - while allowing intraoperative or immediate postoperative activation, ensuring no one is left behind in humanitarian missions. Early activation protocols are achievable with logistical efficiency in resource-limited environments.