Mignacco Giulia, Salerni Lorenzo, Bindi Ilaria, Monciatti Giovanni, Cerase Alfonso, Mandalà Marco
Otolaryngology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
Neuroimaging, Diagnostic and Functional Neuroradiology Unit, Department of Neurological and Movement Sciences, University of Siena, Siena, Italy.
Front Neurol. 2020 Dec 22;11:581783. doi: 10.3389/fneur.2020.581783. eCollection 2020.
The aim of the present study is to report the outcomes of round window reinforcement surgery performed with the application of a Vibrant Soundbridge middle ear implant (VSB; MED-EL) in a patient with superior semicircular canal dehiscence (SSCD) who presented with recurrent vertigo, Tullio phenomenon, Hennebert's sign, bone conduction hypersensitivity, and bilateral moderate to severe mixed hearing loss. Vestibular evoked myogenic potentials (VEMPs) and high-resolution computed tomography (HRCT) confirmed bilateral superior semicircular canal dehiscence while this was not seen in magnetic resonance imaging. The surgical procedure was performed in the right ear as it had worse vestibular and auditory symptoms, a poorer hearing threshold, and greatly altered HRCT and VEMPs findings. With local-assisted anesthesia, round window reinforcement surgery (plugging) with perichondrium was performed with simultaneous positioning of a VSB on the round window niche. At the one and 3 months follow-up after surgery, VSB-aided hearing threshold in the right ear improved to mild, and loud sounds did not elicit either dizziness or pain in the patient.
本研究的目的是报告在一名患有上半规管裂（SSCD）的患者中应用振动声桥中耳植入物（VSB；MED-EL）进行圆窗强化手术的结果，该患者出现复发性眩晕、图利奥现象、亨内伯特征、骨传导超敏反应以及双侧中度至重度混合性听力损失。前庭诱发肌源性电位（VEMP）和高分辨率计算机断层扫描（HRCT）证实双侧上半规管裂，而磁共振成像未显示此情况。由于右耳前庭和听觉症状更严重、听力阈值更差且HRCT和VEMP结果有显著改变，故在右耳进行手术。在局部辅助麻醉下，用软骨膜进行圆窗强化手术（填塞），同时在圆窗龛上植入VSB。术后1个月和3个月随访时，右耳VSB辅助听力阈值改善至轻度，大声响未引起患者头晕或疼痛。
