Lailach S, Müller C, Lasurashvili N, Seidler H, Zahnert T
Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf-Hals-Chirurgie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
HNO. 2021 Jun;69(6):447-463. doi: 10.1007/s00106-019-00775-2.
In patients with inadequate hearing improvement after tympanoplasty and failure of conventional hearing aid fitting, active hearing implants provide an alternative treatment option. Active middle ear implants function as a vibromechanical bypass of the stiffness and damping effect of a poorly oscillating tympanic membrane and the (reconstructed) ossicular chain. The selection of the hearing system depends on the maximum output levels of the hearing system and the anatomical conditions in mostly multiply operated ears. The development of variable coupling elements for active middle ear implants led to an extension of the indications to include not only purely sensorineural hearing loss but also mixed and conductive hearing loss in patients, as the transducer can now be coupled to the (mobile) stapes or the round window membrane. The article provides an overview of current clinical study results and recommendations on the indications for active hearing implants in patients with chronic otitis media.
对于鼓室成形术后听力改善不足且传统助听器验配失败的患者，有源听力植入物提供了一种替代治疗选择。有源中耳植入物起到振动机械旁路的作用，绕过振动不良的鼓膜和（重建的）听骨链的刚度和阻尼效应。听力系统的选择取决于听力系统的最大输出水平以及大多接受过多次手术的耳朵的解剖状况。有源中耳植入物可变耦合元件的发展使得适应证得以扩展，不仅包括单纯感音神经性听力损失，还包括患者的混合性和传导性听力损失，因为现在换能器可以耦合到（可活动的）镫骨或圆窗膜。本文概述了当前关于慢性中耳炎患者有源听力植入物适应证的临床研究结果及建议。
