Tringali Stéphane, Pergola Nick, Ferber-Viart Chantal, Truy Eric, Berger Paul, Dubreuil Christian
Service d'Oto-neurochirurgie, Hospices Civils de Lyon, Centre hospitalier Lyon Sud, 69495 Pierre-Bénite Cedex, France.
Int J Pediatr Otorhinolaryngol. 2008 Apr;72(4):513-7. doi: 10.1016/j.ijporl.2007.12.002. Epub 2008 Feb 7.
The objective is to investigate a new therapeutic option for treatment of conductive hearing loss in children with Franceschetti syndrome. A Carina fully implantable device with the MET V transducer for conductive applications was implanted in a 14-year-old male suffering from bilateral conductive hearing loss (mean PTA loss: 70 dB on the right ear and 64 dB on the left ear) secondary to Franceschetti (a.k.a Treacher Collins) syndrome with bilateral agenesis of external ear canal and ossicular malformation. Postoperative unaided PTA was unchanged by the surgical procedure. When the implant was activated, mean PTA was 29 dB improved on the implanted ear. The capacity of the Carina MET ossicular stimulator to provide appropriate gain relative to the degree of hearing loss indicates that the device may be a viable treatment for children with agenesis of external auditory canal and severe malformation of the middle ear. However, these initial results need to be furthered by: (1) additional studies including a greater number of patients to confirm these preliminary results and (2) a long-term follow-up must be carried out to detect possible long-term cochlear adverse effects, in particular on the basilar membrane.
目的是研究一种治疗Franceschetti综合征患儿传导性听力损失的新治疗方案。将带有用于传导应用的MET V换能器的Carina完全植入式装置植入一名14岁男性患者体内,该患者患有双侧传导性听力损失(平均纯音听阈损失:右耳70 dB,左耳64 dB),继发于Franceschetti(又称Treacher Collins)综合征,伴有双侧外耳道发育不全和听骨畸形。术后未佩戴助听器时的纯音听阈未因手术而改变。当植入装置开启时,植入耳的平均纯音听阈提高了29 dB。Carina MET听骨刺激器相对于听力损失程度提供适当增益的能力表明,该装置可能是治疗外耳道发育不全和中耳严重畸形患儿的一种可行方法。然而,这些初步结果需要通过以下方式进一步完善:(1)开展更多研究,纳入更多患者以证实这些初步结果;(2)必须进行长期随访,以检测可能的长期耳蜗不良反应,尤其是对基底膜的影响。