Luetje Charles M, Brown Sandra A, Cullen Robert D
The Otologic Center, Olathe, KS 66061, USA.
Ear Nose Throat J. 2010 Sep;89(9):E9-E14. doi: 10.1177/014556131008900903.
We conducted a retrospective descriptive study of a series of 31 consecutively presenting patients who had been implanted with the Vibrant Soundbridge middle ear hearing device. All implantations had been performed by the senior author. Three of these patients had undergone bilateral implantation, and 4 others had undergone subsequent explantation and reimplantation in response to known or suspected device failure, giving us a total of 34 ears and 38 implants. Our goal was to ascertain short- and long-term outcomes as measured by conventional audiometry (pure-tone average at 1 to 6 kHz) and long-term benefit as defined by the use or nonuse of the device. We found that at the initial activation session 2 months postoperatively, the average hearing thresholds were within 3 dB of the preoperative thresholds in all 34 ears and all 38 implants. The mean short-term gain at activation in the 38 implants was 28.1 dB. Nineteen patients (20 ears) were available for long-term evaluation, with the length of follow-up ranging from less than 1 year to 11 years (mean: 7.3). Of these 20 ears, 9 demonstrated further gain (mean: 10.8 dB) despite any natural hearing deterioration; of the remaining 11 ears, gain was unchanged in 2, diminished in 7 (mean: -3.6 dB), and gain data were unavailable in 2. In the final analysis, there were 20 user ears and 10 nonuser ears; 4 ears were lost to all follow-up. We conclude that direct-drive hearing with the Vibrant Soundbridge middle ear hearing device is beneficial and provides sustained audiometric gain. Factors that have a significant impact on patient use or nonuse include difficulty in obtaining audiologic support and the direct and indirect costs of the device. Without audiologic or financial support, some patients may choose to become nonusers and to either switch to conventional hearing aid amplification or become apathetic about hearing improvement.
我们对一系列连续就诊的31例植入了振动声桥中耳听力装置的患者进行了回顾性描述性研究。所有植入手术均由资深作者完成。其中3例患者接受了双侧植入，另外4例患者因已知或疑似装置故障接受了后续的取出和重新植入，因此我们共研究了34只耳朵和38枚植入物。我们的目标是通过传统听力测定法（1至6 kHz的纯音平均听阈）确定短期和长期结果，并根据装置的使用与否来定义长期获益情况。我们发现，术后2个月的初次激活时，所有34只耳朵和38枚植入物的平均听力阈值均在术前阈值的3 dB范围内。38枚植入物激活时的平均短期增益为28.1 dB。19例患者（20只耳朵）可进行长期评估，随访时间从不到1年至11年不等（平均：7.3年）。在这20只耳朵中，9只显示出进一步的增益（平均：10.8 dB），尽管存在自然听力下降；其余11只耳朵中，2只增益无变化，7只增益降低（平均：-3.6 dB），2只无法获得增益数据。最终分析时，有20只耳朵使用了该装置，10只耳朵未使用；4只耳朵失访。我们得出结论，振动声桥中耳听力装置的直接驱动听力有益，并能提供持续的听力测定增益。对患者使用或不使用该装置有重大影响的因素包括获得听力支持的困难程度以及该装置的直接和间接成本。如果没有听力或经济支持，一些患者可能会选择不使用该装置，转而使用传统助听器放大或对听力改善变得冷漠。
