Siegert Ralf
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Recklinghausen, Germany.
Adv Otorhinolaryngol. 2011;71:41-46. doi: 10.1159/000323720. Epub 2011 Mar 8.
Patients with air-bone gaps who cannot be corrected successfully by tympanoplasty or with mixed hearing loss may be treated with bone conduction hearing aids. Their disadvantages are the obvious external fixation components or the biological and psychosocial problems of open implants. We have developed new partially implantable bone conduction hearing aid without a percutaneous abutment and have been using them clinically for 4 years. The principle of these bone conduction hearing aids is a magnetic coupling and acoustic transmission between implanted and external magnets. The goal of this study was to evaluate clinical and audiological results.
Magnets are implanted into shallow bone beds in a one step procedure. The skin above the magnets is also reduced to a thickness of 4-5 mm, which reduces the attenuation to less than 10 dB compared to direct bone stimulation. Over 100 patients have been implanted in the last 5 years.
Except for temporary pressure marks in 4%, which healed after careful shimming of the external base plate, there were no other complications.
The holding strength of the external components is equivalent to partially implantable hearing aids and cochlea implants and the hearing improvement is similar to other bone conduction hearing aids. We have found the comfort and safety of this system is significantly improved compared to conventional or percutaneous bone conduction hearing aids.
鼓膜成形术无法成功矫正气骨导差或伴有混合性听力损失的患者,可用骨传导助听器治疗。其缺点是有明显的外部固定部件,或开放式植入体存在生物学及心理社会问题。我们研发了一种新型的无经皮桥基的部分可植入式骨传导助听器,并已临床应用4年。这些骨传导助听器的原理是植入磁体与外部磁体之间的磁耦合和声传输。本研究的目的是评估其临床和听力学结果。
通过一步法将磁体植入浅骨床。磁体上方的皮肤也减薄至4-5毫米厚,与直接骨刺激相比,衰减降低至小于10分贝。在过去5年中,已有100多名患者接受了植入。
除4%的患者出现暂时性压痕,经仔细调整外部基板后愈合外,无其他并发症。
外部部件的固定强度与部分可植入式助听器和人工耳蜗相当,听力改善情况与其他骨传导助听器相似。我们发现,与传统或经皮骨传导助听器相比,该系统的舒适度和安全性有显著提高。