Deveze Arnaud, Rameh Charbel, Sanjuan Mélanie, Lavieille Jean-Pierre, Magnan Jacques
Department of Oto-Rhino-Laryngology and Skull Base Surgery, University Hospital Nord - University La Méditerranée and Assistance Publique Hôpitaux de Marseille, Marseille, France.
Auris Nasus Larynx. 2010 Oct;37(5):631-5. doi: 10.1016/j.anl.2010.01.005. Epub 2010 Feb 18.
Open mastoid cavity rehabilitation should focus on both anatomical and functional aspects. We hereby report the technique and results of a combined strategy to reconstruct the external ear canal using a titanium wall implant and the middle ear using a fully implantable active middle ear device.
A fully implantable active middle ear implant was used to rehabilitate the mixed hearing loss of a 63-year-old woman, and a titanium posterior canal wall prosthesis was used to reconstruct the external ear canal during the same procedure. The middle ear implant was placed directly on the footplate. The auditory results were compared to the preoperative unaided thresholds and to the amplification of a conventional hearing aid.
Following the procedure, there was an anatomically normal external ear canal with a healed tympanic membrane separating the external from the middle ear spaces. The postoperative auditory gains were on average 31.8 dB on pure-tone audiometry, and 20 dB on speech reception threshold. No complications occurred.
The rehabilitation of the external ear canal in an open mastoid cavity allows for clinical follow-up of the patient, and the implantation of an active middle ear implant provides appropriate auditory gains both in pure tones and in speech reception thresholds.
开放乳突腔修复应兼顾解剖和功能两方面。我们在此报告一种联合策略的技术及结果，该策略使用钛壁植入物重建外耳道，并使用完全植入式有源中耳装置修复中耳。
使用完全植入式有源中耳植入物修复一名63岁女性的混合性听力损失，并在同一手术过程中使用钛质后耳道壁假体重建外耳道。中耳植入物直接放置在镫骨足板上。将听觉结果与术前未助听阈值以及传统助听器的放大效果进行比较。
术后，外耳道解剖结构正常，鼓膜愈合，分隔了外耳道和中耳腔。术后纯音听力测试平均听觉增益为31.8 dB，言语接受阈增益为20 dB。未发生并发症。
开放乳突腔中外耳道的修复便于对患者进行临床随访，植入有源中耳植入物可在纯音和言语接受阈方面提供适当的听觉增益。
