Lee Hyun-Jin, Lee Jeon Mi, Choi Jae Young, Jung Jinsei
*Department of Otorhinolaryngology, Gyeongsang National University Changwon Hospital, Changwon †Department of Otorhinolaryngology, Inje University College of Medicine, Ilsan Paik Hospital, Goyang ‡Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.
Otol Neurotol. 2017 Oct;38(9):1246-1250. doi: 10.1097/MAO.0000000000001537.
The study investigated improvements in maximal speech intelligibility after Vibrant Soundbridge (VSB) implantation and analyzed the effect of the hearing loss pattern on maximal speech intelligibility represented by a phonetically balanced word score (PBmax). The effect of middle ear implants on PBmax has not been evaluated yet.
Study.
Tertiary academic medical center.
PATIENTS/INTERVENTIONS: Sixty patients who underwent VSB from December 2011 to January 2016 were retrospectively reviewed. All the patients had hearing aids preoperatively.
Pure-tone and speech audiometry were checked with and without hearing aids and then with the VSB. The patients were divided into two groups: flat and down-sloping type of hearing loss. PBmax score was evaluated at the most comfortable listening level before and after VSB implantation and compared with scores with/without HA.
PBmax for both conventional HA and VSB were significantly higher compared with the unaided condition. The improvement in speech recognition was significantly better using VSB than using HA (p = 0.003). However, there was no significant difference in the improvement provided by VSB and HA in patients with a flat hearing loss. Patients with a down-sloping audiogram showed significantly better improvement with VSB than with HA (p = 0.003). Moreover, patients with greater preoperative high-frequency hearing loss had greater improvement in PBmax after VSB implantation.
Speech intelligibility can be significantly improved by VSB implantation, especially in patients with a down-sloping hearing loss. This finding can help select patients who will benefit most from VSB implantation.
本研究调查了植入振动声桥（VSB）后最大言语清晰度的改善情况，并分析了听力损失模式对以语音平衡词得分（PBmax）表示的最大言语清晰度的影响。中耳植入物对PBmax的影响尚未得到评估。
研究。
三级学术医疗中心。
患者/干预措施：回顾性分析了2011年12月至2016年1月期间接受VSB植入的60例患者。所有患者术前均佩戴助听器。
在佩戴和不佩戴助听器以及佩戴VSB的情况下进行纯音和言语测听。患者分为两组：平坦型和下降型听力损失。在VSB植入前后，于最舒适聆听水平评估PBmax得分，并与佩戴/不佩戴助听器时的得分进行比较。
与未佩戴助听器的情况相比，传统助听器和VSB的PBmax均显著更高。使用VSB时言语识别的改善明显优于使用助听器（p = 0.003）。然而，平坦型听力损失患者中，VSB和助听器所带来的改善没有显著差异。下降型听力图的患者使用VSB时的改善明显优于使用助听器（p = 0.003）。此外，术前高频听力损失越严重的患者，VSB植入后PBmax的改善越大。
植入VSB可显著提高言语清晰度，尤其是在下降型听力损失患者中。这一发现有助于选择最能从VSB植入中获益的患者。
