ENT Department, University of Verona, Verona, Italy.
Otol Neurotol. 2011 Oct;32(8):1250-5. doi: 10.1097/MAO.0b013e31822e9513.
To evaluate the long-term outcomes of the first 5 infants and 9 children with congenital aural atresia (CAA) who had undergone hearing rehabilitation using the MED-EL Vibrant Soundbridge with intraoperative assistance of electrocochleography (ECoG) for optimal fitting of the floating mass transducer (FMT) on the round window (RW) membrane.
Tertiary referral medical center; retrospective case series.
Infants and children ranging in age from 2 months to 16 years with a moderate-to-severe conductive or mixed hearing loss with CAA. For comparison, the study population was divided into 2 groups: older children (≥5 yr of age; 5 patients) and younger children/infants (<5 yr of age; 9 subjects) who were submitted to different audiologic tests appropriate for their age and general condition.
RW implantation.
Compound action potential threshold and amplitude were assessed as a function of different methods for stabilizing the FMT on the RW. Pure tone audiogram at 0.5, 1, 2, and 4 kHz, free-field speech testing (older children), bone conduction and free-field auditory brainstem response (ABR; younger children and infants), intraoperative and postoperative complications, and FMT displacement or extrusion rate.
Statistically significant differences were observed with ECoG recordings between pre- and post-FMT-RW membrane optimization with fascia and cartilage (p < 0.001). Significant improvements were observed in speech perception and pure-tone and ABR threshold, immediately after surgery and at follow-up intervals (12-65 mo) in children and infants (p < 0.01). No complications or instances of device extrusion were observed.
Infants and children with moderate-to-severe conductive or mixed hearing loss, not suitable or unwilling to accept Bone-Anchored Hearing Aids and who would not tolerate traditional bone and air conduction hearing aids, obtain substantial benefit with the FMT-RW implantation procedure. Intraoperative ECoG is of significant help in achieving the best FMT-RW fitting.
评估 5 名先天性听小骨闭锁（CAA）婴儿和 9 名儿童在接受术中电 Cochleography（ECoG）辅助的 MED-EL Vibrant Soundbridge 听力康复后，使用圆窗（RW）膜上浮动质量换能器（FMT）进行最佳拟合的长期效果。
三级转诊医疗中心；回顾性病例系列。
年龄在 2 个月至 16 岁之间，有中度至重度传导性或混合性听力损失伴 CAA 的婴儿和儿童。为了进行比较，研究人群分为两组：年龄较大的儿童（≥5 岁；5 例）和年龄较小的儿童/婴儿（<5 岁；9 例），他们接受了适合其年龄和一般情况的不同听力学测试。
RW 植入。
作为稳定 FMT 于 RW 的不同方法的函数，评估复合动作电位阈值和振幅。0.5、1、2 和 4 kHz 的纯音听力图、自由场语音测试（大龄儿童）、骨导和自由场听性脑干反应（ABR；年龄较小的儿童和婴儿）、术中及术后并发症、FMT 移位或挤出率。
筋膜和软骨优化前后的 ECoG 记录显示 FMT-RW 膜之间存在统计学上的显著差异（p<0.001）。在手术后和随访期间（12-65 个月），儿童和婴儿的言语感知和纯音及 ABR 阈值均有显著改善（p<0.01）。未观察到并发症或设备挤出。
不适合或不愿接受骨锚式助听器、不能耐受传统骨导和气导助听器的中重度传导性或混合性听力损失的婴儿和儿童，通过 FMT-RW 植入术获得显著益处。术中 ECoG 对获得最佳 FMT-RW 拟合具有重要帮助。
