Coupling the Vibrant Soundbridge to Cochlea Round Window: Auditory Results in Patients With Mixed Hearing Loss
Coupling the Vibrant Soundbridge to Cochlea Round Window: Auditory Results in Patients With Mixed Hearing Loss
复制标题
DOI：
10.1097/mao.0b013e318180a495
复制
发表时间：
2009-02-01
影响因子：
2.1
通讯作者：
Streitberger, Christian
中科院分区：
文献类型：
--
作者：
Beltrame, Achille M.;Martini, Alessandro;Streitberger, Christian
目的：评估放置在圆窗 (RW) 上的 Vibrant Soundbridge (VBS) 对混合性听力损失患者的功能结果。研究设计：功能性听力的回顾性评估，术后 7 至 9 个月进行测量。设置：两个三级转诊医院中心。受试者：12 名患有与慢性化脓性中耳炎和耳硬化症相关的混合性严重听力损失的个体。干预：通过手术将 VBS 机械效应器放置在近距离与 RW 膜接触，直接驱动内耳液体。主要结果测量：通过纯音测听和语音测听分析功能性听力增益，在安静和噪声中关闭和打开 VBS。结果：我们观察到平均增益为 37.5 dB (0.5-4 kHz)，个体差异较大。总体增益主要归因于气骨间隙恢复，而气导阈值在 2 kHz 时明显进一步平均提高 12 dB。安静条件下的语音接收阈值显示平均增益为 24 dB，而在噪声条件下，它需要比正常听力控制高 7 至 13 dB 的信噪比。所有患者都是 VBS 设备的日常使用者。 结论：对于患有严重至极重度混合性听力损失的个人来说，能够直接驱动耳蜗液的中耳植入物似乎是一个有前途的替代方案。然而，听力恢复的变异性很大，可能反映了与慢性病理结果相关的耳蜗反应性的变异性，也可能反映了 VBS 效应器与 RW 接口方式的变异性。修改 VBS 效应器的形状可以改善与 RW 的机械耦合，以更好地利用设备的放大能力。
Objective: To assess the functional results of the Vibrant Soundbridge (VBS) placed on the round window (RW) in patients with mixed hearing loss.Study Design: Retrospective evaluation of functional hearing, with measurements performed 7 to 9 months postoperatively.Settings: Two tertiary referral hospital centers.Subjects: Twelve individuals with mixed severe hearing loss associated with chronic suppurative otitis media and otosclerosis.Intervention: Surgical placement of the VBS mechanical effector in close contact with the RW membrane to directly drive the inner ear fluids.Main Outcome Measurement: Functional hearing gain as analyzed via pure-tone audiometry and speech audiometry with VBS off and on in quiet and in noise.Results: We observed a mean gain of 37.5 dB (0.5-4 kHz) with wide individual differences. The overall gain is mainly due to the air-bone gap recovery, whereas a further 12-dB mean improvement of air-conducted threshold is evident at 2 kHz. The speech reception threshold in quiet shows a mean gain of 24 dB, whereas in noise, it requires a signal-to-noise ratio 7 to 13 dB greater than normal-hearing controls. All patients are daily users of their VBS device.Conclusion: A middle ear implant capable of directly driving the cochlear fluids seems to be a promising alternative for individuals with a severe to profound mixed hearing loss. However, variability in hearing recovery is great, likely reflecting variability in responsiveness of the cochlea associated with chronic pathologic findings and, possibly, variability in how the VBS effector interfaces with the RW. Modifying the shape of the VBS effector can improve the mechanical coupling to the RW to better exploit the device's amplification power.