Spahn Bjoern, Rak Kristen, Herrmann David P, Cebulla Mario, Engert Jonas, Kurz Anja, Voelker Johannes, Hackenberg Stephan, Müller-Graff Franz-Tassilo
Department of Oto-Rhino-Laryngology, Head and Neck Surgery and the Comprehensive Hearing Center, University Hospital Wuerzburg, Wuerzburg, Germany.
Otol Neurotol. 2025 Aug 1;46(7):821-828. doi: 10.1097/MAO.0000000000004529. Epub 2025 Jun 2.
To determine the optimal coupling efficiency by auditory brainstem response (ABR) in patients with aural atresia undergoing vibroplasty to ensure optimal sound transmission and minimize the need for revision surgery.
Retrospective data analysis.
Tertiary referral center with an established active middle ear implant program.
14 ears of 13 patients with congenital aural malformation receiving active middle ear implant surgery.
Therapeutic surgical treatment for hearing rehabilitation in human subjects.
Intraoperative coupling efficiency as determined by ABR and postoperative audiologic outcomes (sound-field thresholds, speech perception) after active middle ear implantation in patients with congenital aural malformations.
Intraoperative ABR was performed in all patients and revealed thresholds that were not significantly different from preoperative PTA4 bone-conduction thresholds ( p = 0.67). Pearson correlation coefficient r was 0.57. Speech perception improved by 65.0% at 65 dB SPL and by 60.9% at 80 dB SPL. PTA4 Vibrogram thresholds showed stable long-term coupling outcomes (mean, 28.7 ± 8.3 dB HL eq ).
ABR measurement during vibroplasty is applicable in patients with congenital aural malformation. There are often fewer options for coupling the vibratory element of the VSB (floating mass transducer [FMT]) to the ossicular chain or directly to the cochlea in this patients' collective. Confirmation of a stable and valid coupling efficacy during FMT positioning can be of great benefit in malformed middle ears for efficient hearing restoration and to reduce the risk of revision surgery.
通过听觉脑干反应（ABR）确定接受振动成形术的耳闭锁患者的最佳耦合效率，以确保最佳声音传输并尽量减少翻修手术的需求。
回顾性数据分析。
设有活跃中耳植入项目的三级转诊中心。
13例先天性耳部畸形患者的14只耳朵接受了活跃中耳植入手术。
针对人类受试者进行听力康复的治疗性手术治疗。
先天性耳部畸形患者在活跃中耳植入术后，通过ABR确定的术中耦合效率以及术后听力学结果（声场阈值、言语感知）。
所有患者均进行了术中ABR检查，结果显示其阈值与术前PTA4骨导阈值无显著差异（p = 0.67）。皮尔逊相关系数r为0.57。在65 dB SPL时言语感知改善了65.0%，在80 dB SPL时改善了60.9%。PTA4振动图阈值显示出稳定的长期耦合结果（平均，28.7±8.3 dB HL eq）。
振动成形术中的ABR测量适用于先天性耳部畸形患者。在这类患者群体中，将振动声桥（VSB）的振动元件（浮动质量换能器[FMT]）与听骨链或直接与耳蜗耦合的选择通常较少。在FMT定位过程中确认稳定有效的耦合效果，对于畸形中耳实现有效的听力恢复并降低翻修手术风险可能具有很大益处。
