Lefebvre Philippe P, Gisbert Javier, Cuda Domenico, Tringali Stéphane, Deveze Arnaud
Department of Otorhinolaryngology, CHU de Liège, Liège, Belgium.
Audiol Neurootol. 2016;21(5):333-345. doi: 10.1159/000454666. Epub 2017 Jan 5.
To summarise treatment outcomes compared to surgical and patient variables for a multicentre recipient cohort using a fully implantable active middle ear implant for hearing impairment. To describe the authors' preferred surgical technique to determine microphone placement.
Multicentre retrospective, observational survey.
Five tertiary referral centres.
Carina recipients (66 ears, 62 subjects) using the current Cochlear® Carina® System or the legacy device, the Otologics® Fully Implantable Middle Ear, with a T2 transducer.
Patient file review and routine clinical review. Patient outcomes assessed were satisfaction, daily use and feedback reports at the first fitting and ≥12 months after implantation. Descriptive and statistical analysis of correlations of variables and their influence on outcomes was performed. Independently reported preferred methods for microphone placement are collectively summarised.
The average implant experience was 3.5 years. Satisfaction increased significantly over time (p < 0.05). No correlation with covariates examined was observed. Feedback significantly decreased over time, showing a significant correlation with microphone location, primary motivation, gender, age at implantation, and contralateral hearing aid use (p < 0.05). Patient satisfaction was inversely correlated with reports of system feedback (p < 0.05). The implantable microphone was most commonly on the posterior inferior mastoid line, in 42/66 (65%) cases, correlating with less likelihood for feedback and consistent with author surgical preference.
Carina recipients in this study present as satisfied consistent daily users with very few reports of persistent feedback. As microphone location is an influencing factor, a careful surgical consideration of microphone placement is required. The authors prefer a posterior inferior mastoid line position whenever possible.
总结使用完全植入式有源中耳植入物治疗听力障碍的多中心受者队列的治疗结果，并与手术和患者变量进行比较。描述作者确定麦克风位置的首选手术技术。
多中心回顾性观察性调查。
五个三级转诊中心。
使用当前的科利耳®卡瑞娜®系统或旧款设备Otologics®完全植入式中耳及T2换能器的卡瑞娜植入者（66耳，62名受试者）。
查阅患者病历并进行常规临床检查。评估的患者结局包括初次调试时以及植入后≥12个月时的满意度、日常使用情况和反馈报告。对变量之间的相关性及其对结局的影响进行描述性和统计分析，并汇总独立报告的麦克风放置首选方法。
平均植入经验为3.5年。满意度随时间显著提高（p<0.05）。未观察到与所检查的协变量有相关性。反馈随时间显著减少，与麦克风位置、主要动机、性别、植入时年龄和对侧助听器使用情况显著相关（p<0.05）。患者满意度与系统反馈报告呈负相关（p<0.05）。可植入麦克风最常位于乳突后下线上，42/66（65%）例如此；这与反馈可能性较小相关，且与作者的手术偏好一致。
本研究中的卡瑞娜植入者作为日常使用者满意度较高，很少有持续性反馈报告。由于麦克风位置是一个影响因素，则需要在手术中仔细考虑麦克风放置。作者尽可能倾向于将其置于乳突后下线上。
