Monini Simonetta, Filippi Chiara, Salerno Gerardo, Barbara Maurizio
Otorhinolaryngology Clinic, NESMOS Department, Sapienza University, Rome, Italy.
Front Neurol. 2022 Feb 10;13:834402. doi: 10.3389/fneur.2022.834402. eCollection 2022.
A fully implantable active middle ear device has been proposed and indicated for the rehabilitation of bilateral moderate or moderate-to-severe sensorineural hearing loss, assuming it would overcome the disadvantages of a conventional hearing aid. The indications have further been extended to severe or severe-to-profound forms of hearing loss in the case of an expected limited or null efficacy of hearing aids. While the literature has highlighted several positive aspects of the device, including a better quality of life related to its invisibility, the improvement of auditory and perceptual functions has not been controlled for throughout a long period of follow-up. The present study aimed to verify the behavior of the auditory threshold, especially the bone conduction (BC) component, in the implanted ear in a group of implantees affected by initial bilateral symmetric hearing loss of different severity grades. The BC threshold was assessed preoperatively at activation and at the last follow-up (ranging from 4 to 12 years) in the implanted ear, and preoperatively and at the last follow-up in the contralateral ear, to monitor eventual deteriorated values in both ears over time. The pure tone average (PTA; 250-4,000 Hz), speech reception threshold (SRT) and the maximum word recognition score as a percentage (% WRS) and in dB HL were measured in the implanted ear to verify the efficacy of the device after the first fitting at device activation. A significant worsening of the BC threshold with respect to the baseline threshold was noticed during further follow-up. When comparing the implanted ear with the contralateral ear, a significant worsening of the bone PTA was assessed in the former with respect to the contralateral ear. Despite the worsened hearing found in the implanted ears, the beneficial gains in PTA and speech audiometry observed at the first activation remained constant at the follow-up, thus showing an extension of the efficacy of this device in aiding those with up to the most severe forms of sensorineural hearing loss.
一种完全可植入的有源中耳装置已被提出，并被用于双侧中度或中度至重度感音神经性听力损失的康复治疗，前提是它能克服传统助听器的缺点。在助听器预期效果有限或无效的情况下，该装置的适应症已进一步扩展至重度或重度至极重度听力损失。虽然文献强调了该装置的几个积极方面，包括因其不可见性而带来的更好的生活质量，但在长期随访中，听觉和感知功能的改善情况尚未得到全面控制。本研究旨在验证一组最初患有不同严重程度双侧对称性听力损失的植入者植入耳的听觉阈值行为，尤其是骨传导（BC）成分。在植入耳激活前和最后一次随访（4至12年）时评估BC阈值，同时在对侧耳术前和最后一次随访时评估BC阈值，以监测双耳随时间最终恶化的值。在植入耳中测量纯音平均听阈（PTA；250 - 4000 Hz）、言语接受阈（SRT）以及以百分比（%WRS）和dB HL表示的最大单词识别分数，以验证装置激活首次适配后该装置的疗效。在进一步随访期间，发现BC阈值相对于基线阈值有显著恶化。将植入耳与对侧耳进行比较时，发现植入耳的骨PTA相对于对侧耳有显著恶化。尽管植入耳的听力有所恶化，但在首次激活时观察到的PTA和言语测听的有益改善在随访时保持不变，从而表明该装置在帮助患有最严重形式感音神经性听力损失的患者方面的疗效得到了扩展。
