面神经后入路振动声桥圆窗植入术治疗小耳畸形

The Vibrant Soundbridge Implantation in Round Window via Retro-FaciaI-Nerve Approach in a Patient with Congenital Microtia

目的探讨双侧小耳畸形合并耳道骨性闭锁患者。面神经垂直段后进路振动声桥植入的可行性和术后效果。方法1例双耳先天小耳畸形合并耳道骨性闭锁患者，左耳传导性耳聋，右耳混合性聋，语频区平均骨气导差为55dB。Jahrsdoerfer评分患者左侧为5分。右侧为4分。双侧面神经后进路开放骨性隧道，一期双耳振动声桥圆窗植入。结果双耳面神经后进路振动声桥圆窗植入。术后2．5个月开机使用。声场测听语频区左耳听阈平均40dBHL。右耳平均听阈39dBHL，双耳气导听阈降低15～16dBHL。开放式汉语单声母、韵母言语识别率为98％。结论面神经后进路开放骨性隧道暴露圆窗行振动声桥圆窗植入术治疗小耳畸形，听力改善较为理想。

Objective To explore the feasibility and postoperative outcome of vibrant soundbridge implantation via the retro-facial nerve approach in patients with bilateral microtia and bony aural atresia. Methods A patient with bilateral microtia and bony aural atresia was involved in this study. The patient had conductive deafness in the left ear and mixed deafness in the right ear and the air-bone gap was 55 dB at the speech frequency. The Jahrsdoerfer score of left ear was 5 and that of right ear was 4. The bony tunnel was opened behind the facial nerve and vibrant soundbridges were implanted in round window bilaterally. Results The vibrant soundbridges were implanted bilaterally via the retro-facial nerve approach. The device was switched on 2.5 months after the surgery. The hearing threshold at the speech frequency was 40 dB HL for the left ear and 39 dE} HL for the right ear. The binaural air-conduction thresholds were increased by 15-16 dE} HL. The open-set speech recognition score of Chinese single initial consonants and vowels was 98%. Conclusion After receiving the vibrant soundbridge implantation in round window via the retro-facial nerve approach, the patient with bilateral microtia and bony aural atresia shows obvious improvement in hearing.