Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
Eur Arch Otorhinolaryngol. 2021 Jan;278(1):31-39. doi: 10.1007/s00405-020-06049-w. Epub 2020 May 24.
This study assessed the safety and sound-localisation ability of the Vibrant Soundbridge (VSB) (Med-EL, Innsbruck, Austria) in patients with unilateral microtia and atresia (MA).
This was a single-centre retrospective research study. Twelve subjects with unilateral conductive hearing loss (UCHL) caused by ipsilateral MA were recruited, each of whom underwent VSB implantation and auricular reconstruction. The bone-conduction (BC) threshold was measured postoperatively, and the accuracy of sound localisation was evaluated at least 6 months after surgery. Horizontal sound-localisation performance was investigated with the VSB activated and inactivated, at varying sound stimuli levels (65, 70 and 75 dB SPL). Localisation benefit was analysed via the mean absolute error (MAE).
There was no statistical difference in mean BC threshold of impaired ears measured preoperatively and postoperatively. When compared with VSB-inactivated condition, the MAE increased significantly in unilateral MA patients in the VSB-activated condition. Besides, sound-localisation performance worsened remarkably when sound was presented at 70 dB SPL and 75 dB SPL. Regarding the side of signal location, the average MAE with the VSB device was much higher than that without the VSB when sound was from the normal-hearing ear. However, no significant difference was observed when sound was located from the impaired ear.
This study demonstrates that in patients with unilateral MA, the VSB device does not affect inner-ear function. Sound-localisation ability is not improved, but deteriorated at follow-up. Our results suggest that the VSB-aided localisation abilities may be related to the thresholds between the ears, plasticity of auditory system and duration of use of VSB.
本研究评估了 Vibrant Soundbridge（VSB）（奥地利因斯布鲁克 Med-EL）在单侧小耳畸形伴闭锁（MA）患者中的安全性和声音定位能力。
这是一项单中心回顾性研究。招募了 12 名单侧传导性听力损失（UCHL）患者，这些患者均因同侧 MA 导致单侧传导性听力损失，他们均接受了 VSB 植入和耳廓重建。术后测量骨导（BC）阈值，并在术后至少 6 个月评估声音定位的准确性。在 VSB 激活和失活的情况下，在不同的声音刺激水平（65、70 和 75dB SPL）下，研究水平声音定位性能。通过平均绝对误差（MAE）分析定位获益。
术前和术后患耳平均 BC 阈值无统计学差异。与 VSB 失活状态相比，VSB 激活状态下单侧 MA 患者的 MAE 显著增加。此外，当声音在 70dB SPL 和 75dB SPL 时，声音定位性能明显恶化。关于信号位置的侧别，当声音来自正常听力耳时，带 VSB 装置的平均 MAE 明显高于不带 VSB 装置的 MAE，但当声音来自听力受损耳时，没有观察到显著差异。
本研究表明，在单侧 MA 患者中，VSB 装置不会影响内耳功能。声音定位能力没有改善，而是在随访中恶化。我们的结果表明，VSB 辅助的定位能力可能与双耳之间的阈值、听觉系统的可塑性和 VSB 的使用时间有关。
