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感音神经性听力损失患者行镫骨成形术后的长期安全性及生活质量:短/长砧骨突耦合器

Long-Term Safety and Quality of Life after Vibroplasty in Sensorineural Hearing Loss: Short/Long Incus Process Coupler.

作者信息

Edlinger Stefan Herwig, Hasenzagl Martin, Schoerg Philipp, Muck Stefanie, Magele Astrid, Sprinzl Georg Mathias

机构信息

Department of Otorhinolaryngology, University Hospital St. Pölten, St. Poelten, Austria.

Karl Landsteiner University of Health Sciences, Krems, Austria.

出版信息

Audiol Neurootol. 2022;27(2):175-183. doi: 10.1159/000516144. Epub 2021 May 27.

Abstract

OBJECTIVE

The study shows the long-term effectiveness, safety, and quality of life after Vibrant Soundbridge (VSB) implantation in sensorineural hearing loss (SNHL) using the short process coupler (SP) or the long process coupler (LP).

METHODS

This retrospective study evaluated 77 VSB cases. Follow-up (F/U) time-dependent objective measurements (audiological outcomes), subjective data collection (quality-of-life questionnaire), and safety measures are presented.

RESULTS

Sixty-two ears were included in the analysis with up to 116 months of postsurgical F/U data (mean 32.15 ± 37.97 months LP and SP coupler). Fifty-three ears (13 bilateral cases) received the LP coupler and 9 subjects the SP coupler. The post-operative bone conduction thresholds remained stable and, in both groups, <10 dB. The benefit in word recognition scores measured at 65 dB SPL and 80 dB SPL showed no significant difference between the couplers (p = 0.559 and p = 0.088, respectively). The functional gain was not significantly different (p > 0.05) with a mean of 20.91 ± 9.77 and 17.19 ± 5.75 for LP and SP coupler, respectively. The utility score deciphered from the Assessment of Quality-of-life Questionnaire-8 dimensions revealed a mean score of 0.75 ± 0.16 which is not significantly different to the age- and sex-matched healthy control group with 0.81 ± 0.02 (p = 0.3547).

CONCLUSION

The Incus Vibroplasty utilizing both couplers is a safe and effective method to treat mild-to-severe SNHL. Both fixation methods of the floating mass transducer exhibit good clinical and audiological outcomes with high patient quality of life. The SP coupling method can be a good alternative when the long process is anatomically inaccessible, or the approach is limited due to anatomical reasons.

摘要

目的

本研究展示了使用短突耦合器(SP)或长突耦合器(LP)植入振动声桥(VSB)治疗感音神经性听力损失(SNHL)后的长期有效性、安全性及生活质量。

方法

本回顾性研究评估了77例VSB病例。呈现了随访(F/U)时间依赖性客观测量(听力学结果)、主观数据收集(生活质量问卷)及安全措施。

结果

分析纳入了62只耳,有长达116个月的术后F/U数据(LP和SP耦合器平均为32.15±37.97个月)。53只耳(13例双侧病例)接受了LP耦合器,9例受试者接受了SP耦合器。术后骨导阈值保持稳定,两组均<10 dB。在65 dB SPL和80 dB SPL测量的单词识别分数的获益在耦合器之间无显著差异(分别为p = 0.559和p = 0.088)。功能增益无显著差异(p>0.05),LP和SP耦合器的平均值分别为20.91±9.77和17.19±5.75。从生活质量问卷-8维度评估中解读出的效用分数显示平均分为0.75±0.16,与年龄和性别匹配的健康对照组平均分0.81±0.02无显著差异(p = 0.3547)。

结论

使用两种耦合器的砧骨振动成形术是治疗轻至重度SNHL的安全有效方法。浮动质量换能器的两种固定方法均显示出良好的临床和听力学结果,患者生活质量高。当长突在解剖学上无法触及或因解剖学原因入路受限,SP耦合方法可能是一个不错的选择。

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