Kiefer Jan, Arnold Wolfgang, Staudenmaier Rainer
Department of Otolaryngology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
ORL J Otorhinolaryngol Relat Spec. 2006;68(6):378-85. doi: 10.1159/000095282. Epub 2006 Oct 26.
Congenital malformations of the auricle are often combined with atresia of the outer ear canal and malformations of the ossicles, representing aesthetic as well as functional deficits. Optimal treatment should therefore address both aspects equally. This report describes a new approach, combining the reconstruction of the auricle with implantation of an active middle ear hearing aid, stimulating the round window membrane.
A 33-year-old male patient, with bilateral ear microtia, fibrous atresia of the external ear canals and malformation of the ossicles due to Treacher Collins-Franceschetti syndrome was included in the study. In stage one, the cartilage framework of the new auricle, made of autogenous rib cartilage, was fabricated and implanted. During stage two, the auricle was elevated, a retro-auricular sulcus was formed and a Vibrant MED-EL Soundbridge device was implanted. The transducer was coupled to the round window membrane.
Both functional and aesthetical results were favourable. Aided thresholds were between 15 and 30 dB in the frequency range of 0.75-6 kHz, monosyllabic word understanding at 65 dB SPL increased from 0 to 80%.
Combining aesthetic and functional rehabilitation, autogenous reconstruction of a new auricle together with the implantation of an active middle ear hearing aid, coupled to the round window membrane, is a promising new approach.
耳廓先天性畸形常合并外耳道闭锁及听小骨畸形，存在美学和功能缺陷。因此，最佳治疗应兼顾这两个方面。本报告描述了一种新方法，即将耳廓重建与植入有源中耳助听器相结合，刺激圆窗膜。
一名33岁男性患者因特雷彻·柯林斯 - 弗朗切斯科蒂综合征患有双侧小耳畸形、外耳道纤维性闭锁及听小骨畸形，被纳入本研究。第一阶段，制作并植入由自体肋软骨制成的新耳廓软骨支架。第二阶段，掀起耳廓，形成耳后沟，并植入MED-EL Vibrant Soundbridge装置。换能器与圆窗膜相连。
功能和美学效果均良好。在0.75 - 6 kHz频率范围内，助听阈值在15至30 dB之间，在65 dB声压级下单音节词理解率从0%提高到80%。
将美学和功能康复相结合，自体重建新耳廓并植入与圆窗膜相连的有源中耳助听器，是一种有前景的新方法。
