Rainsbury James W, Williams Blair A, Gulliver Mark, Morris David P
Otol Neurotol. 2015 Feb;36(2):e58-62. doi: 10.1097/MAO.0000000000000695.
To establish whether preoperative assessment using a conventional, percutaneous bone conducting implant (pBCI) processor on a headband accurately represents postoperative performance of a semi-implantable BCI (siBCI).
Retrospective case series.
Tertiary otology unit.
Five patients with chronic otitis media (implanted unilaterally) and one with bilateral congenital ossicular fixation (implanted bilaterally).
INTERVENTION(S): Semi-implantable bone conduction hearing implant.
MAIN OUTCOME MEASURE(S): Functional hearing gain; preoperative (headband) versus postoperative (aided) speech discrimination; unaided bone conduction (BC) versus postoperative (aided) soundfield threshold.
Significant functional gain was seen at all frequencies (one-tailed t test p G 0.01; n = 7). There was a 50 dB improvement in median speech reception threshold (SRT) from 70 dB unaided to 20 dB aided. Compared to the preoperative BC, aided siBCI thresholds were worse at 0.5 kHz, but at frequencies from 1 to 6 kHz, the siBCI closely matched the bone curve ( p G 0.01). The siBCI performed better than both pBCI processors on a headband at 3 to 4 kHz, except 1 kHz ( p G 0.01).
BC thresholds may be a better indicator of implant performance than headband assessment. Candidacy assessment for siBCI implantation that relies on headband testing with pBCI processors should be interpreted with caution because the headband may under-represent the implanted device. This seems to be especially true at 3 kHz and above and may make it difficult for surgeons to conduct accurate informed consent discussions with patients about the realistic anticipated outcomes and benefits of the procedure.
确定使用传统的、经皮骨传导植入物（pBCI）处理器对头带进行术前评估是否能准确反映半植入式骨传导植入物（siBCI）的术后性能。
回顾性病例系列研究。
三级耳科单位。
5例慢性中耳炎患者（单侧植入）和1例双侧先天性听骨固定患者（双侧植入）。
半植入式骨传导听力植入物。
功能性听力增益；术前（头带）与术后（助听）言语辨别率；未助听骨传导（BC）与术后（助听）声场阈值。
在所有频率均观察到显著的功能增益（单尾t检验p≤0.01；n = 7）。言语接受阈值（SRT）中位数从未助听时的70 dB改善到助听时的20 dB。与术前BC相比，助听时siBCI在0.5 kHz处的阈值更差，但在1至6 kHz频率，siBCI与骨导曲线紧密匹配（p≤0.01）。除1 kHz外，siBCI在3至4 kHz时的表现优于头带上的两个pBCI处理器（p≤0.01）。
BC阈值可能比头带评估更能准确反映植入物性能。依赖pBCI处理器对头带进行测试的siBCI植入候选评估应谨慎解读，因为头带可能无法充分反映植入设备的性能。这在3 kHz及以上频率似乎尤其如此，可能会使外科医生难以与患者就手术的实际预期结果和益处进行准确的知情同意讨论。
