人类效率的手术交响曲：高容量人工耳蜗植入任务的结构化术中工作流程模型。

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中文摘要

目的： 高容量人道主义人工耳蜗植入（CI）任务需要高度组织化的工作流程以维持效率与安全。本研究描述了在一项大规模CI活动中所使用的术中模型。
方法： 采用描述性观察设计，使用标准化手术方案、结构化轮班分配和数字化协调，评估多个手术室的手术工作流程。分析了手术时间、术中发现、ECAP反应和术后影像学结果。
结果： 三天内共完成142例CI手术（分别为30例、66例和46例）。平均手术时间为57分钟，中位数为46分钟。57.4%的病例术中术野无异常，31.2%发生外淋巴渗液。3例（2.1%）内耳畸形患者出现ECAP反应缺失；所有患者在术后调机时均显示出反应。影像学评估确认所有候选者耳蜗内植入位置正确。
结论： 结构化的术中工作流程使得在短时间内安全高效地完成高手术量成为可能。这一经验为旨在提高手术室效率的中心提供了实践指导，尤其是在高容量或资源有限的环境中。
证据等级： IV。

英文摘要

OBJECTIVE: High-volume humanitarian Cochlear Implant (CI) missions require highly organized workflows to maintain efficiency and safety. This study describes the intraoperative model used during a large-scale CI campaign.
METHODS: A descriptive observational design was used to evaluate operative workflow across multiple operating rooms using standardized surgical protocols, structured shift-based assignments, and digital coordination. Operative times, intraoperative findings, ECAP responses, and postoperative radiologic outcomes were analyzed.
RESULTS: A total of 142 CI surgeries were completed over three days (30-, 66-, and 46-cases). The mean operative time was 57-minutes, with a median of 46-minutes. Unremarkable intraoperative fields were observed in 57.4% of cases, while perilymph oozing occurred in 31.2%. Absent ECAP responses occurred in three patients (2.1%) with inner ear malformations; all demonstrated responses during postoperative fitting. Radiologic assessment confirmed proper intracochlear insertion in all candidates.
CONCLUSION: A structured intraoperative workflow enabled the safe and efficient completion of a high surgical volume within a short timeframe. This experience offers practical guidance for centers aiming to enhance operating room efficiency, particularly in high-volume or resource-limited environments.
LEVEL OF EVIDENCE: IV.