Sprinzl Georg Mathias, Schörg Philipp, Edlinger Stefan, Ploder Marlene, Magele Astrid
Department of Otorhinolaryngology, Head & Neck Surgery University Clinic St. Poelten St. Poelten Austria.
Karl Landsteiner University of Health Sciences Krems Austria.
Laryngoscope Investig Otolaryngol. 2022 Jul 6;7(4):1113-1119. doi: 10.1002/lio2.839. eCollection 2022 Aug.
The VIBRANT SOUNDBRIDGE is a widely used active middle ear implant to treat hearing loss. The floating mass transducer is surgically coupled to the ossicles, the round or oval window. A reliable method to monitor the coupling efficiency intraoperatively is highly desired. Research groups have developed several methods, but limitations remain. This study aims to evaluate the clinical feasibility of a new research setup for auditory brainstem response measurement to evaluate the coupling efficiency.
In 14 subjects, the new tool was used to record VSB-evoked ABR thresholds during surgery. The intra-op ABR thresholds were compared to pre-op bone conduction (BC) thresholds and post-op vibrogram thresholds to evaluate the feasibility of the method as a tool to monitor coupling efficiency.
The mean pre-op BC threshold average at 1, 2, and 4 kHz (PTA3) was 47 dB HL, the mean intra-op ABR threshold was 54 dB nHL, and the mean post-op vibrogram PTA3 was 60 dB HLeq. ABR was measurable in all subjects using the new tool. Correlation between pre-op BC thresholds and intra-op ABR thresholds was statistically significant; however, one outlier was present.
Intra-op hearing threshold detection through ABR and direct stimulation of the VSB implant was reliable using this new tool. Despite some individual variability, first results correlate well with pre-op BC and post-op vibrogram thresholds.
VIBRANT SOUNDBRIDGE是一种广泛应用于治疗听力损失的有源中耳植入物。浮动质量传感器通过手术与听小骨、圆窗或卵圆窗相连。非常需要一种可靠的术中监测耦合效率的方法。研究小组已经开发了几种方法，但仍存在局限性。本研究旨在评估一种用于测量听觉脑干反应以评估耦合效率的新研究装置的临床可行性。
在14名受试者中，使用这种新工具在手术期间记录VSB诱发的ABR阈值。将术中ABR阈值与术前骨导（BC）阈值和术后振动图阈值进行比较，以评估该方法作为监测耦合效率工具的可行性。
1、2和4kHz（PTA3）的平均术前BC阈值为47dB HL，平均术中ABR阈值为54dB nHL，平均术后振动图PTA3为60dB HLeq。使用这种新工具在所有受试者中均可测量ABR。术前BC阈值与术中ABR阈值之间的相关性具有统计学意义；然而，存在一个异常值。
使用这种新工具，通过ABR进行术中听力阈值检测以及对VSB植入物进行直接刺激是可靠的。尽管存在一些个体差异，但初步结果与术前BC和术后振动图阈值相关性良好。
