Gerdes Timo, Salcher Rolf Benedikt, Schwab Burkard, Lenarz Thomas, Maier Hannes
Department of Otolaryngology, Medical University Hannover, Hannover, Germany.
Otol Neurotol. 2016 Jul;37(6):685-91. doi: 10.1097/MAO.0000000000001010.
In conductive, mixed hearing losses and single-sided-deafness bone-anchored hearing aids are a well-established treatment. The transcutaneous transmission across the intact skin avoids the percutaneous abutment of a bone-anchored device with the usual risk of infections and requires less care.In this study, the audiological results of the Bonebridge transcutaneous bone conduction implant (MED-EL) are compared to the generally used percutaneous device BP100 (Cochlear Ltd., Sydney, Australia).
Ten patients implanted with the transcutaneous hearing implant were compared to 10 matched patients implanted with a percutaneous device. Tests included pure-tone AC and BC thresholds and unaided and aided sound field thresholds. Speech intelligibility was determined in quiet using the Freiburg monosyllable test and in noise with the Oldenburg sentence test (OLSA) in sound field with speech from the front (S0). The subjective benefit was assessed with the Abbreviated Profile of Hearing Aid Benefit.
In comparison with the unaided condition there was a significant improvement in aided thresholds, word recognition scores (WRS), and speech reception thresholds (SRT) in noise, measured in sound field, for both devices. The comparison of the two devices revealed a minor but not significant difference in functional gain (Bonebridge: PTA = 27.5 dB [mean]; BAHA: PTA = 26.3 dB [mean]). No significant difference between the two devices was found when comparing the improvement in WRSs and SRTs (Bonebridge: improvement WRS = 80% [median], improvement SRT = 6.5 dB SNR [median]; BAHA: improvement WRS = 77.5% [median], BAHA: improvement SRT = 6.9 dB SNR [median]).
Our data show that the transcutaneous bone conduction hearing implant is an audiologically equivalent alternative to percutaneous bone-anchored devices in conductive hearing loss with a minor sensorineural hearing loss component.
在传导性、混合性听力损失及单侧耳聋的治疗中,骨锚式助听器是一种成熟的治疗手段。经完整皮肤的经皮传输避免了骨锚式装置的经皮桥接以及通常与之相关的感染风险,且所需护理较少。在本研究中,对骨桥经皮骨传导植入体(美迪乐公司)与常用的经皮装置BP100(澳大利亚悉尼科利耳有限公司)的听力学结果进行了比较。
将10例植入经皮听力植入体的患者与10例匹配的植入经皮装置的患者进行比较。测试包括纯音气导和骨导阈值以及未佩戴助听器和佩戴助听器时的声场阈值。使用弗莱堡单音节测试在安静环境中测定言语清晰度,在噪声环境中使用奥尔登堡句子测试(OLSA)在声场中从前部(S0)发出言语时测定言语清晰度。使用助听器益处简要概况评估主观获益情况。
与未佩戴助听器的情况相比,两种装置在佩戴助听器后的阈值、单词识别得分(WRS)以及在声场中测定的噪声环境下的言语接受阈值(SRT)均有显著改善。两种装置的比较显示,功能增益存在微小但不显著的差异(骨桥:平均PTA = 27.5 dB;巴哈:平均PTA = 26.3 dB)。在比较WRS和SRT的改善情况时,未发现两种装置之间存在显著差异(骨桥:WRS改善 = 80%[中位数],SRT改善 = 6.5 dB SNR[中位数];巴哈:WRS改善 = 77.5%[中位数],巴哈:SRT改善 = 6.9 dB SNR[中位数])。
我们的数据表明,对于伴有轻度感音神经性听力损失成分的传导性听力损失,经皮骨传导听力植入体在听力学方面等同于经皮骨锚式装置。