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振动声桥在先天性中外耳畸形患者的应用

ISSN号：1672-2922
期刊名称：《中华耳科学杂志》
时间：0
分类：R764.71[医药卫生—耳鼻咽喉科;医药卫生—临床医学]
作者机构：[1]解放军总医院耳鼻咽喉头颈外科解放军总医院耳鼻咽喉研究所,北京100853
相关基金：国家973计划重大科学研究计划干细胞项目（2012CB967900）;国家973计划重大科学问题导向项目（2011CBA01000）; 国家863计划专题项目（2007AA02Z150）; 国家自然科学基金重点项目（30730040）

作者：邹艺辉[1], 李佳楠[1], 陈艾婷[1], 戴朴[1], 韩东一[1], 刘会占[1], 杨仕明[1]

关键词：振动声桥, 先天性畸形, 中外耳, Vibrant Soundbridge （ VSB ）, congenital deformation , middle and outer ears

中文摘要：

目的报道振动声桥在先天性中外耳畸形患者（尤其有特殊情况者）的应用,探索其在该类患者的适应症。方法对4例先天性中外耳畸形患者行振动声桥植入术,均为男性,年龄3-18岁（平均13.5岁）,3例双耳畸形,1例单耳畸形,均为左侧植入,对具有特殊情况者根据具体情况采用相应措施完成手术。手术径路分为经面神经隐窝径路（3例）和面神经后径路（1例）。振动声桥植入方式分为镫骨振动型（2例）和圆窗振动型（2例）。对比开机前后听力与言语测听结果,及日常交流情况进行评估。结果 4例患者均顺利完成手术,无并发症。开机后,听力改善明显,0.25k-4kHz平均纯音或条件反射测听气导听阈改善35dB（开机前69dB/后34dB）,助听后安静环境下65dBSPL语句识别率,双耳畸形者平均为86%（术前0%）,单耳畸形者100%（术前100%）,但噪声环境（-8dBSNR）下为20%（裸耳0%）。结论振动声桥植入是先天性中外耳畸形患者一种良好的听力解决方案,即便有些特殊情况者,亦可以完成手术取得良好效果

英文摘要：

Objective To report application of the Vibrant Soundbridge （VSB） in patients with congenital deformation of the middle and outer ears and investigate its indications for this patient population. Method Four patients with congenital deformation of middle and outer ears underwent VSB implantation. All were male （aged 3-18 years , average 13.5 years） and operated on the left side. , Malformation was bilateral in 3 patients and unilateral in 1 patient. Surgical techniques were modified to accommodate each patient ’ s unique conditions. The middle ear space was approached via the facial recess in 3 patients and through a post-facial nerve route in 1 patient. The VSB implant was connected to either the stapes （2 cases） or the round window （2 cases）. Pure tone and speech audiometry results and daily communication before and after VSB activation were compared. Results The operations were successful in all patients, with no complications. The patient communication level improved significantly after VSB activation. Average air conduction pure tone threshold or conditioned reflex audiometry improved by 35dB in the 0.25-4 kHz range from 69 dB HL before VSB activation to 34 dB HL after. In quiet, the sentence recognition rate at 65 dB SPL went up to 86% from 0% without VSB for patients with bilateral deformation and remained at 100% for the patient with unilateral deformity. However, for the latter patient, the rate improved to 20% from 0% without VSB in noise （-8 dB SNR）. Conclusion VSB is a good solution for improving hearing in patients with congenital deformation of middle and outer ears. Operation can be completed and good results can be achieved even in patients with unique conditions.

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