Otology and Cochlear Implant Centre, University of Pisa, Pisa, Italy.
Otol Neurotol. 2009 Oct;30(7):950-5. doi: 10.1097/MAO.0b013e3181b04d35.
An alternative transcanal surgical technique named "exclusive transcanal approach" for Vibrant Soundbridge (VSB) implantation is presented. The surgical steps and our experience in a series of 12 patients are reported.
Retrospective study.
: Tertiary referral center. University hospital.
Twelve patients, 8 women and 4 men, mean age 50 years (range, 41-71 yr), were implanted with the VSB through the exclusive transcanal approach. In 7 patients with moderate sensorineural hearing loss, the floating mass transducer (FMT) was placed on the incus, whereas in 5 patients with a mixed hearing loss for chronic otitis media and/or previous middle ear surgeries, the FMT was placed on the round window.
INTERVENTION(S): Hearing rehabilitation.
MAIN OUTCOME MEASURE(S): Postoperative surgical and anatomic results.
Anatomic results and functional results in patients operated with the FMT on the round window.
The exclusive transcanal approach proved to be faster, simpler, and safer in comparison to the classic surgical technique through the facial recess, reducing the risk of chorda tympani and facial nerve lesions. All the patients and, in particular, those operated placing the FMT on the round window achieved improvements in hearing thresholds and speech perception tests from the use of the VSB. Moreover, after a mean 21-month follow-up (range, 15-32 mo), we did not observe any complication such as tympanic membrane perforations, external ear canal skin lesions, or extrusion of the coil in the external ear canal.
介绍一种名为“经耳道独占式手术入路”的新型经耳道外科手术技术，用于 Vibrant Soundbridge（VSB）植入。报告了手术步骤以及我们在一系列 12 例患者中的经验。
回顾性研究。
三级转诊中心。大学医院。
12 例患者，8 名女性和 4 名男性，平均年龄 50 岁（范围 41-71 岁），通过独占式经耳道入路植入 VSB。在 7 例中度感音神经性听力损失患者中，浮动质量换能器（FMT）置于砧骨上，而在 5 例因慢性中耳炎和/或先前中耳手术导致混合性听力损失的患者中，FMT 置于圆窗上。
听力康复。
术后手术和解剖结果。
FMT 置于圆窗患者的解剖和功能结果。
与经典经面神经隐窝入路相比，经耳道独占式入路更快、更简单、更安全，降低了损伤鼓索神经和面神经的风险。所有患者，特别是那些将 FMT 置于圆窗的患者，使用 VSB 后听力阈值和言语感知测试均得到改善。此外，在平均 21 个月的随访（范围 15-32 个月）后，我们未观察到任何并发症，如鼓膜穿孔、外耳道皮肤损伤或线圈在外耳道内脱出。
