Seiwerth Ingmar, Brylok Antonia, Schwesig René, Rahne Torsten, Fröhlich Laura, Lauenroth Andreas, Hullar Timothy E, Plontke Stefan K
Department of Otorhinolaryngology, Head and Neck Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
Department of Orthopaedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
Front Neurol. 2022 May 11;13:846999. doi: 10.3389/fneur.2022.846999. eCollection 2022.
As audition also seems to contribute to balance control, additionally to visual, proprioceptive, and vestibular information, we hypothesize that hearing rehabilitation with active middle ear and bone conduction implants can influence postural control.
In a prospective explorative study, the impact of hearing rehabilitation with active middle ear [Vibrant Soundbrige (VSB), MED-EL, Innsbruck, Austria] and bone conduction implants [Bonebridge (BB), MED-EL, Innsbruck, Austria] on postural control in adults was examined in three experiments. Vestibulospinal control was measured by cranio-corpography (CCG), trunk sway velocity (°/s) by the Standard Balance Deficit Test (SBDT), and postural stability with a force plate system, each time in best aided (BA) and unaided (UA) condition with frontal-noise presentation (Fastl noise, 65 dB SPL), followed by subjective evaluation, respectively.
In 26 subjects [age 55.0 ± 12.8 years; unilateral VSB/BB: = 15; bilateral VSB/BB: = 3, bimodal (VSB/BB + hearing aid): = 8], CCG-analysis showed no difference between BA and UA conditions for the means of distance, angle of displacement, and angle of rotation, respectively. Trunk sway measurements revealed a relevant increase of sway in standing on foam ( = 0.01, = 0.51) and a relevant sway reduction in walking ( = 0.026, = 0.44, roll plane) in BA condition. Selective postural subsystem analysis revealed a relevant increase of the vestibular component in BA condition ( = 0.017, = 0.47). As measured with the Interactive Balance System (IBS), 42% of the subjects improved stability (ST) in BA condition, 31% showed no difference, and 27% deteriorated, while no difference was seen in comparison of means. Subjectively, 4-7% of participants felt that noise improved their balance, 73-85% felt no difference, and 7-23% reported deterioration by noise. Furthermore, 46-50% reported a better task performance in BA condition; 35-46% felt no difference and 4-15% found the UA situation more helpful.
Subjectively, approximately half of the participants reported a benefit in task performance in BA condition. Objectively, this could only be shown in one mobile SBDT-task. Subsystem analysis of trunk sway provided insights in multisensory reweighting mechanisms.
由于听觉似乎也有助于平衡控制，除视觉、本体感觉和前庭信息外，我们推测有源中耳和骨传导植入物的听力康复可能会影响姿势控制。
在一项前瞻性探索性研究中，通过三个实验研究了有源中耳[振动声桥（VSB），奥地利因斯布鲁克MED-EL公司]和骨传导植入物[骨桥（BB），奥地利因斯布鲁克MED-EL公司]的听力康复对成人姿势控制的影响。通过颅-体描记法（CCG）测量前庭脊髓控制，通过标准平衡缺陷测试（SBDT）测量躯干摆动速度（°/秒），并使用测力板系统测量姿势稳定性，每次均在最佳助听（BA）和未助听（UA）条件下进行额部噪声呈现（Fastl噪声，65 dB SPL），随后分别进行主观评估。
在26名受试者[年龄55.0±12.8岁；单侧VSB/BB：n = 15；双侧VSB/BB：n = 3，双峰（VSB/BB + 助听器）：n = 8]中，CCG分析显示，BA和UA条件下距离均值、位移角度和旋转角度之间无差异。躯干摆动测量显示，在BA条件下，站在泡沫上时摆动有显著增加（P = 0.01，r = 0.51），行走时摆动有显著减少（P = 0.026，r = 0.44，横滚平面）。选择性姿势子系统分析显示，在BA条件下前庭成分有显著增加（P = 0.017，r = 0.47）。使用交互式平衡系统（IBS）测量时，42%的受试者在BA条件下稳定性（ST）得到改善，31%无差异，27%恶化，而均值比较无差异。主观上，4 - 7%的参与者感觉噪声改善了他们的平衡，73 - 85%感觉无差异，7 - 23%报告噪声导致平衡恶化。此外，46 - 50%报告在BA条件下任务表现更好；35 - 46%感觉无差异，4 - 15%发现UA状态更有帮助。
主观上，约一半的参与者报告在BA条件下任务表现有益。客观上，这仅在一项移动SBDT任务中得到体现。躯干摆动的子系统分析为多感官重新加权机制提供了见解。
