Brito Rubens de, Pozzobom Ventura Luzia Maria, Jorge José Carlos, Oliveira Eduardo Boaventura, Manzoni Lourencone Luiz Fernando
Department of Otolaringology, Hospital De Reabilitacao De Anomalias Craniofaciais (HRAC), Universidade De Sao Paulo, Bauru, Brazil.
J Int Adv Otol. 2016 Dec;12(3):241-246. doi: 10.5152/iao.2016.2532.
To demonstrate the surgical technique and audiological results of a middle ear implant for restoring hearing in patients with bilateral aural atresia and microtia with conductive or mixed hearing loss.
In this prospective study, 12 subjects aged 12 years and older presenting with hearing loss and bilateral congenital aural atresia underwent surgical insertion of a middle ear implant. The patients underwent tympanomastoidectomy with a wide opening of the attic and preservation of the roof of the atresic tympanic bone to expose the middle ear and position the floating mass transducer of the implant.
There were no intraoperative or postoperative complications. The hearing threshold averages in a free field were 53.5 dB preoperatively and 25.6 dB postoperatively. Monosyllabic word recognition averaged 61% preoperatively and 91.3% postoperatively. The average speech perception in quiet conditions during the hearing in noise test improved from 67.11 dB to 45.99 dB, and the signal-to-noise ratio improved from 5.64 to 1.31.
The tested system is an excellent option for auditory rehabilitation of conductive hearing loss due to bilateral ear atresia. The surgery is well structured and safe and provides several alternatives to the surgeon, which is valuable in difficult cases.
展示一种中耳植入物的手术技术及听力学结果,该植入物用于恢复双侧外耳道闭锁及小耳畸形并伴有传导性或混合性听力损失患者的听力。
在这项前瞻性研究中,12名年龄在12岁及以上、患有听力损失及双侧先天性外耳道闭锁的受试者接受了中耳植入物的手术植入。患者接受了鼓室乳突切除术,广泛开放上鼓室并保留闭锁鼓膜骨的顶部,以暴露中耳并放置植入物的浮动质量传感器。
无术中或术后并发症。术前自由声场平均听阈为53.5dB,术后为25.6dB。术前单音节词识别率平均为61%,术后为91.3%。在噪声环境下听力测试中,安静环境下的平均言语感知从67.11dB提高到45.99dB,信噪比从5.64提高到1.31。
所测试的系统是双侧外耳道闭锁所致传导性听力损失听觉康复的极佳选择。该手术结构良好且安全,为外科医生提供了多种选择,这在困难病例中很有价值。