Powell H R F, Pai I, Ghulam H, Jiang D
Hearing Implant Centre,Guy's and St Thomas' NHS Foundation Trust,London,UK.
J Laryngol Otol. 2018 May;132(5):457-460. doi: 10.1017/S0022215118000105.
To report a novel management strategy for mixed hearing loss in advanced otosclerosis.
A 50-year-old male was referred to St Thomas' Hearing Implant Centre with otosclerosis; he was no longer able to wear conventional hearing aids because of recurrent otitis externa. The patient underwent short process incus vibroplasty (using the Med-El Vibrant Soundbridge device), followed at a suitable interval (six weeks) by stapes surgery. The main outcome measures were: pure tone audiometry, functional gain and monosyllabic word recognition scores.
Post-operative pure tone audiometry showed a reduction of the mean air-bone gap from 55 dB HL to 20 dB HL. The residual mixed hearing loss was rehabilitated with the Vibrant Soundbridge, with an average device gain of 32 dB. The monosyllabic word recognition scores in quiet at 65 dB improved from 37 to 100 per cent when using the Vibrant Soundbridge at six months after switch-on of the device.
Stapedotomy in conjunction with incus short process vibroplasty (i.e. inner-ear vibroplasty) is a safe and promising procedure for managing advanced otosclerosis with mixed hearing loss in selected patients.
报告一种针对晚期耳硬化症混合性听力损失的新型治疗策略。
一名50岁男性因耳硬化症被转诊至圣托马斯听力植入中心；由于复发性外耳道炎，他已无法佩戴传统助听器。该患者接受了砧骨短突振动成形术（使用美敦力Vibrant Soundbridge装置），并在适当间隔（六周）后进行了镫骨手术。主要观察指标为：纯音听力测定、功能增益和单音节词识别得分。
术后纯音听力测定显示平均气骨导间距从55 dB HL降至20 dB HL。残余的混合性听力损失通过Vibrant Soundbridge得到改善，装置平均增益为32 dB。在开启装置六个月后使用Vibrant Soundbridge时，安静环境下65 dB处的单音节词识别得分从37%提高到了100%。
镫骨切除术联合砧骨短突振动成形术（即内耳振动成形术）是一种安全且有前景的治疗方法，可用于治疗特定患者的晚期耳硬化症合并混合性听力损失。
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