Roman Stéphane, Denoyelle Françoise, Farinetti Anne, Garabedian Erea-Noel, Triglia Jean-Michel
Department of Pediatric Otolaryngology and Neck Surgery, Aix Marseille University, Marseille Cedex 05, France.
Int J Pediatr Otorhinolaryngol. 2012 Dec;76(12):1775-8. doi: 10.1016/j.ijporl.2012.08.022. Epub 2012 Sep 15.
Active middle ear implant can be used in children and adolescents with congenital hearing loss. The authors report their experience with the semi implantable Medel Vibrant Soundbridge(®) (VSB) in the audiologic rehabilitation of such patients.
In this retrospective study, audiological and surgical data of 10 children (10.5±4 years) implanted with 12 VSB in 2 tertiary cares ENT Departments were analysed.
Two children with bilateral external auditory canal (EAC) atresia and mixed hearing loss (mean air conduction (AC) thresholds=65dB HL) were bilaterally implanted. Eight children presented with microtia associated with EAC atresia bilaterally (n=3) and unilaterally (n=5). All of them had a conductive hearing loss in the implanted ear (mean (AC) thresholds were 58.75dB HL preoperatively). The Floating Mass Transducer was crimped on the long process of the incus (n=8) or on the suprastructure of the stapes (n=4). There were no intra- or postoperative surgical complications. All the children wore their implants after 5 weeks. Postoperative mean bone conduction (BC) thresholds were unchanged. The mean aided thresholds with VSB (four frequencies warble tones at 0.5, 1, 2 and 4 kHz) were 28dB HL (± 10). Word discrimination threshold in quiet conditions in free field with the VSB unilaterally activated was 50% at 38dB SPL (± 9).
The results indicate that satisfaction of the children and their parents is very encouraging but surgeons should be cautious with this new approach in relation to the pinna reconstruction and to possible risks to inner ear and facial nerve.
有源中耳植入物可用于患有先天性听力损失的儿童和青少年。作者报告了他们使用半植入式Medel Vibrant Soundbridge（®）（VSB）对此类患者进行听力康复的经验。
在这项回顾性研究中，分析了在2个三级护理耳鼻喉科为10名儿童（10.5±4岁）植入12个VSB的听力和手术数据。
2名双侧外耳道闭锁并伴有混合性听力损失（平均气导（AC）阈值 = 65dB HL）的儿童接受了双侧植入。8名儿童表现为双侧（n = 3）和单侧（n = 5）小耳畸形并伴有外耳道闭锁。他们所有植入耳均为传导性听力损失（术前平均（AC）阈值为58.75dB HL）。浮动质量传感器夹在砧骨长突上（n = 8）或镫骨上部结构上（n = 4）。术中及术后均无手术并发症。所有儿童在5周后佩戴了植入物。术后平均骨导（BC）阈值未变。使用VSB时（0.5、1、2和4kHz四个频率的啭音）平均助听阈值为28dB HL（±10）。在自由声场中单侧激活VSB的安静条件下，单词辨别阈值在38dB SPL（±9）时为50%。
结果表明儿童及其家长的满意度非常令人鼓舞，但外科医生在采用这种新方法进行耳廓重建以及应对内耳和面神经可能的风险时应谨慎。
