振动声桥在中国的临床应用

A case study of the vibrant soundbridge implantation in China

目的探讨一例中度感音神经性聋患者行振动声桥（MED-EL）植入后的听力变化，进一步了解振动声桥植入的工作原理、手术适应证、手术方法及疗效。方法回顾性分析我国最先开展振动声桥植入的一例患者的临床资料，重点分析其术前和术后听力变化情况，同时结合相关文献，总结振动声桥植入的原理、手术适应证、手术方法及疗效。结果振动声桥植入后短期内听力改善显著，听阈较术前平均下降约20dBHL（言语频率0．5，1，2，4kHz），其中以中高频（1kHz以上）提高为主，无严重的并发症。结论中度一重度感音神经性聋，尤其是高频听力下降为主的患者配戴传统助听器效果不佳时振动声桥植入手术效果良好。振动声桥植入手术是相对安全的，为中国中度一重度感音神经性聋患者提供了一种新的康复办法。

Objective To evaluate the changes of hearing thresholds in a patient with moderate sensorineural hearing loss （SNHL） that received the vibrant soundbridge （VSB, MEDEL） implantation, and to further understand the mechanism, surgical indications and procedures and its effectiveness. Methods The clinical data of a patient implanted with the VSB system in China was retrospectively analyzed. The hearing thresholds of the patient were tested before and after the surgery. Related literature was also reviewed to summarize the mechanism, surgical indications, surgical procedures and curative effect of VSB. Results The hearing of the patient was improved significantly after the VSB implantation, by 20 dB HL （0.5 kHz, 1 kHz, 2 kHz, 4 kHz） on average, mainly at medium and high frequency （more than 1 kHz）. No severe surgical complications occurred. Conclusion The VSB has demonstrated satisfactory effects in patients with moderate or severe SNHL, especially in those who have hearing loss mainly at high frequency and dissatisfactory aided hearing with hearing aids. Moreover, the operation of VSB implantation is a relatively safe surgical procedure. The VSB provides a new rehabilitation option for medium-to-severe SNHL patients in China.