Cayé-Thomasen Per, Jensen Jørgen Hedegaard, Bonding Per, Tos Mirko
Department of Otorhinolaryngology, Head and Neck Surgery, Gentofte University Hospital of Copenhagen, Hellerup, Denmark.
Otol Neurotol. 2002 Nov;23(6):904-11. doi: 10.1097/00129492-200211000-00016.
To document the long-term surgical and audiologic results of the implantation of a first-generation semi-implantable hearing aid for mixed hearing loss, consisting of a magnetic partial or total ossicular replacement prosthesis and an electromagnetic driver fitted in the ear canal. The short-term results have previously been published as excellent in both surgical and audiologic terms. To analyze and discuss reasons of treatment failure, as well as future perspectives.
Patient file review, follow-up otomicroscopic examination and audiometry, as well as patient interview. SETTING Tertiary referral center at a University hospital.
Of nine patients operated on, six with a mixed hearing loss after chronic otitis media could be evaluated primarily. Two underwent implantation with a partial and four with a total ossicular replacement prosthesis.
Use of and satisfaction with the hearing aid, apparatus function and integrity, hearing without electromagnetic driver, prostheses containment, drum abnormalities, nonaudiologic ear symptoms, e.g., discharge.
All patients attended follow-up for a mean of 9.5 years after implantation (range 8.8-10 years). No patients used the semi-implantable hearing aid at follow-up. The mean semi-implantable hearing aid using time was 24 months (range 3-60 months). The main reasons for discontinuation of use were problems fitting the electromagnetic driver correctly in the ear canal and prosthesis extrusion or dislocation.
Despite excellent short-term surgical and audiologic results, it is concluded that these first long-term results of the first-generation electromagnetic semi-implantable hearing aids with ossicular replacement prosthesis for mixed hearing loss are disappointing. However, improvements in the surgical approach and in the reshaping, refinement, and overall improvement of the semi-implantable hearing aid could lead to satisfactory treatment of this group of patients.
记录第一代用于混合性听力损失的半植入式助听器植入的长期手术及听力学结果，该助听器由磁性部分或全听骨链置换假体以及安装在耳道内的电磁驱动器组成。此前已发表的短期结果在手术和听力学方面均表现出色。分析并讨论治疗失败的原因以及未来展望。
患者病历回顾、随访耳显微镜检查及听力测定，以及患者访谈。地点：大学医院的三级转诊中心。
在接受手术的9名患者中，6名慢性中耳炎后出现混合性听力损失的患者可作为主要评估对象。2名患者植入了部分听骨链置换假体，4名患者植入了全听骨链置换假体。
助听器的使用情况及满意度、装置功能及完整性、无电磁驱动器时的听力、假体容纳情况、鼓膜异常、非听力学耳部症状，如耳漏。
所有患者在植入后平均随访9.5年（范围8.8 - 10年）。随访时无患者使用半植入式助听器。半植入式助听器的平均使用时间为24个月（范围3 - 60个月）。停用的主要原因是电磁驱动器在耳道内安装不当以及假体挤出或脱位。
尽管短期手术和听力学结果出色，但第一代用于混合性听力损失的带听骨链置换假体的电磁半植入式助听器的这些首次长期结果令人失望。然而，手术方法的改进以及半植入式助听器的重塑、优化和整体改进可能会使该组患者得到满意的治疗。
