Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Otorhinolaryngology and Head and Neck Surgery, Nijmegen, The Netherlands.
Otol Neurotol. 2014 Feb;35(2):221-6. doi: 10.1097/MAO.0000000000000258.
To compare amplification options for patients with mixed hearing loss. Devices tested include percutaneous and transcutaneous bone conductors (BCDs) and middle ear implants with their actuator directly coupled to the cochlea.
Tertiary academic medical center.
Maximum output was studied with simulators. As simulators are lacking for the middle ear implants (the Vibrant Soundbridge [VSB] and the Cochlear's Direct Acoustic Cochlear Stimulator [Codacs]), the maximum output had to be measured in patients (4 and 5 patients, respectively).
The maximum output averaged at 0.5, 1, and 2 kHz was the main outcome measure, which was expressed in dB HL, using appropriate transformation tables.
The maximum output was the highest for the Codacs device and was above the patients' uncomfortable loudness levels. The maximum output of the VSB varied between 65 and 85 dB HL, and that of percutaneous BCD varied between 68 and 80 dB HL depending on the type of device. The transcutaneous BCD, the Sophono device, had the lowest output.
Only with the Codacs device can the complete dynamic range be used. The maximum output of the VSB is lower and variable owing to the coupling to the cochlea. For patients with a sensorineural hearing loss component up to 50 dB HL, a percutaneous BCD forms a good treatment option that is completely independent of the middle ear status. The transcutaneous Sophono BCD is suitable for patients with a (sub-)normal sensorineural hearing loss component of 20 dB or less.
比较混合性听力损失患者的放大选择。测试的设备包括经皮和经皮骨导体（BCDs）以及与耳蜗直接耦合的中耳植入物及其执行器。
三级学术医疗中心。
使用模拟器研究最大输出。由于缺乏中耳植入物（Vibrant Soundbridge [VSB] 和 Cochlear 的直接声学耳蜗刺激器 [Codacs]）的模拟器，因此必须在患者中测量最大输出（分别为 4 名和 5 名患者）。
0.5、1 和 2 kHz 的平均最大输出是主要观察指标，使用适当的转换表以 dB HL 表示。
Codacs 设备的最大输出最高，超过了患者的不适响度水平。VSB 的最大输出在 65 和 85 dB HL 之间变化，而经皮 BCD 的最大输出在 68 和 80 dB HL 之间变化，具体取决于设备类型。Transcutaneous BCD，Sophono 设备的输出最低。
只有 Codacs 设备才能使用完整的动态范围。由于与耳蜗的耦合，VSB 的最大输出较低且可变。对于听力损失成分高达 50 dB HL 的感音神经性听力损失患者，经皮 BCD 是一种完全独立于中耳状态的良好治疗选择。Transcutaneous Sophono BCD 适用于听力损失成分在 20 dB 或更低的（亚）正常感音神经性听力损失患者。
