Koro Eleonor, Werner Mimmi
Department of Clinical Sciences, Otorhinolaryngology, Umeå University, Umeå, Sweden.
Department of Clinical Sciences, Otorhinolaryngology, Umeå University, Umeå, Sweden,
Audiol Neurootol. 2019;24(4):197-205. doi: 10.1159/000502052. Epub 2019 Sep 9.
A bone conducting implant is a treatment option for individuals with conductive or mixed hearing loss (CHL, MHL) who do not tolerate regular hearing aids, and for individuals with single-sided deafness (SSD). An active bone conducting implant (ABCI) was introduced in 2012 with indication in CHL, MHL, and SSD, and it is still the only ABCI available. With complete implantation of the active transducer and consequent intact skin, a decrease in infections, skin overgrowth, and implant losses, all common disadvantages with earlier passive bone conducting implants, could be expected. Our Ear, Nose and Throat Department, a secondary care center for otosurgery that covers a population of approximately 365,000 inhabitants, was approved to implant ABCIs in 2012.
Our aim was to conduct an evaluation of audiological and subjective outcomes after ABCIs.
A cohort study with retrospective and prospective data collection was performed.The first 20 consecutive patients operated with an ABCI were asked for informed consent. The main outcome measures werepure tone and speech audiometry and the Glasgow Benefit Inventory (GBI).
Seventeen patients accepted to participate and 15 were able to complete all parts. Six patients had CHL or MHL. In this group the pure tone audiometry tests are comparable with an average functional hearing gain of 29.8 dB HL. With bilateral hearing, the mean Word Recognition Score (WRS) in noise was 35.7% unaided and 62.7% aided. Ten patients had the indication SSD. With the hearing ear blocked, the pure tone average was >101 dB HL, compared to 29.3 dB HL in sound field aided. With bilateral hearing, the mean WRS in noise was 59.7% unaided and 72.8% aided. The mean of the total GBI score was 42.1 in the group with CHL or MHL and 20.6 in the group with SSD.
The patients benefit from their implants in terms of quality of life, and there is a substantial hearing gain from the implant for patients with conductive or MHL. Patients with SSD benefit less from the implant than other diagnoses but the positive outcomes are comparable to other options for this group.
骨传导植入物是不耐受常规助听器的传导性或混合性听力损失（CHL、MHL）患者以及单侧耳聋（SSD）患者的一种治疗选择。有源骨传导植入物（ABCI）于2012年推出，适用于CHL、MHL和SSD患者，并且它仍然是唯一可用的ABCI。随着有源换能器的完全植入以及随之而来的完整皮肤，预计感染、皮肤过度生长和植入物丢失等情况会减少，而这些都是早期被动骨传导植入物常见的缺点。我们的耳鼻喉科是一家耳外科二级护理中心，覆盖约36.5万居民，于2012年被批准植入ABCI。
我们的目的是对ABCI植入后的听力学和主观结果进行评估。
进行了一项回顾性和前瞻性数据收集的队列研究。连续20例接受ABCI手术的患者被要求签署知情同意书。主要结局指标是纯音和言语测听以及格拉斯哥获益量表（GBI）。
17例患者同意参与，15例能够完成所有部分。6例患者患有CHL或MHL。在该组中，纯音测听测试结果具有可比性，平均功能性听力增益为29.8 dB HL。双耳听力时，噪声环境下的平均单词识别得分（WRS）在未佩戴助听器时为35.7%，佩戴助听器时为62.7%。10例患者有SSD指征。患侧耳堵塞时，纯音平均值>101 dB HL，而在声场佩戴助听器时为29.3 dB HL。双耳听力时，噪声环境下的平均WRS在未佩戴助听器时为59.7%，佩戴助听器时为72.8%。CHL或MHL组的GBI总分平均值为42.1，SSD组为20.6。
患者在生活质量方面从植入物中获益，对于传导性或MHL患者，植入物带来了显著的听力改善。SSD患者从植入物中获得的益处少于其他诊断患者，但积极结果与该组的其他选择相当。
