Objective To report use of the Vibrant Soundbridge (VSB) in patients with congenital deformation of the middle and outer ears and investigate its utility in this patient population.Method Four patients with congenital...Objective To report use of the Vibrant Soundbridge (VSB) in patients with congenital deformation of the middle and outer ears and investigate its utility in 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 and needs.The implant site was approached via the facial recess in 3 patients and through a retro-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 capabilities 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 threshold improved by 35 dB in the 0.25-4 kHz range,from 69 dB HL before VSB activation to 34 dB HL after.The sentence recognition rate in quiet 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 an excellent 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 and needs.展开更多
目的探究听觉诱发电位(auditory evoked potential,AEP)检查P1波峰、P1潜伏期与外中耳畸形患儿术后听觉行为分级(CAP)及言语可懂度分级(SIR)的相关性及对听力改善的评估价值。方法选取我院2017年1月~2019年1月外中耳畸形患儿82例,比较...目的探究听觉诱发电位(auditory evoked potential,AEP)检查P1波峰、P1潜伏期与外中耳畸形患儿术后听觉行为分级(CAP)及言语可懂度分级(SIR)的相关性及对听力改善的评估价值。方法选取我院2017年1月~2019年1月外中耳畸形患儿82例,比较术前、术后12个月P1波峰、P1潜伏期、CAP、SIR分级,分析其相关性,采用有意义听觉整合量表(MAIS)评分评价术后12个月患儿听力康复情况,比较患儿临床资料、P1波峰、P1潜伏期,评价P1波峰、P1潜伏期对听力改善的评估价值。结果术后12个月P1波峰低于术前,P1潜伏期短于术前,CAP、SIR分级高于术前(P<0.05);术前、术后12个月P1波峰、P1潜伏期与CAP、SIR分级均呈负相关(P<0.05);不同MAIS评分患儿术前听力损失程度、术前、术后12个月后CAP、SIR分级、P1波峰比较,差异有统计学意义(P<0.05);P1波峰、P1潜伏期联合评估听力改善的曲线下面积(area under the curve,AUC)最大,为0.872,敏感度、特异度分别为74.19%、85.00%。结论P1波峰、P1潜伏期与外中耳畸形患儿术后CAP、SIR分级均存在负相关性,采用AEP检查P1波峰、P1潜伏期在评估人工耳蜗植入术后听力改善方面具有重要价值。展开更多
目的比较纯音听阈法与Jahrsdoerfer评分法对先天性中外耳畸形的评估作用。方法将53例(53耳)行外耳道再造+鼓室探查成形手术的先天性中外耳畸形患者分有、无卵圆窗发育两组,对比其术前在0.5-4k Hz各频率平均纯音听阈(或条件反射测听阈值)...目的比较纯音听阈法与Jahrsdoerfer评分法对先天性中外耳畸形的评估作用。方法将53例(53耳)行外耳道再造+鼓室探查成形手术的先天性中外耳畸形患者分有、无卵圆窗发育两组,对比其术前在0.5-4k Hz各频率平均纯音听阈(或条件反射测听阈值)、Jahrsdoerfer评分及相应平均纯音听阈情况,比较两种方法的差异。结果两组术前平均气导听阈卵圆窗发育组为64.7 d B,无发育组为73.1 d B(P<0.05),且在1k Hz、2k Hz、4k Hz两组有差异(P<0.05)。Jahrsdoerfer评分卵圆窗未发育组7分以下(含)占83.3%,而发育组为35.7%,但评分高低与平均听阈值间无程度梯度关系。结论:纯音听阈法和Jahrsdoerfer评分法均能反映先天性中外耳畸形的畸形程度,但纯音听阈法更简单、直接。Jahrsdoerfer评分高低与纯音听阈水平不能互相进行评估。展开更多
目的分析先天性中外耳畸形患者纯音听力特点。方法回顾性分析213例(253耳)先天性中外耳畸形患者的纯音听力特点。结果纯音测听显示传导性耳聋198耳(78.26%)、混合性耳聋53耳(20.95%)、感音神经性耳聋2耳(0.78%)。将语频段0.5KHz、1k Hz...目的分析先天性中外耳畸形患者纯音听力特点。方法回顾性分析213例(253耳)先天性中外耳畸形患者的纯音听力特点。结果纯音测听显示传导性耳聋198耳(78.26%)、混合性耳聋53耳(20.95%)、感音神经性耳聋2耳(0.78%)。将语频段0.5KHz、1k Hz、2KHz、4k Hz中任一频率未引出骨导或气导听力的患者剔除后余206例(246耳),平均气导阈值进行分析:以中重度耳聋(55d-70d B HL)51.63%(127/246),重度耳聋(71-90d B HL)33.74%(83/246)为主;其中传导性耳聋和混合性耳聋中重度,重度所占比例分别为59.60%(118/198),26.77%(53/198);18.75%(9/48),62.50%(30/48)。在56-80 d B HL范围内传导性耳聋、混合性耳聋所占比例分别为82.83%(164/198)、58.33%(28/48)。对混合性耳聋骨导纯音测听结果分析示:主要在2KHz处骨导听力有下降,占72.92%,平均阈值为30.42±7.84d B HL(10-60 d B HL),结论先天性中外耳畸形患者主要表现为传导性耳聋,以中重度、重度耳聋为主。骨导听力损失主要发生在2KHz,在2KHz处平均骨导听阈有轻度下降。展开更多
文摘Objective To report use of the Vibrant Soundbridge (VSB) in patients with congenital deformation of the middle and outer ears and investigate its utility in 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 and needs.The implant site was approached via the facial recess in 3 patients and through a retro-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 capabilities 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 threshold improved by 35 dB in the 0.25-4 kHz range,from 69 dB HL before VSB activation to 34 dB HL after.The sentence recognition rate in quiet 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 an excellent 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 and needs.
文摘目的探究听觉诱发电位(auditory evoked potential,AEP)检查P1波峰、P1潜伏期与外中耳畸形患儿术后听觉行为分级(CAP)及言语可懂度分级(SIR)的相关性及对听力改善的评估价值。方法选取我院2017年1月~2019年1月外中耳畸形患儿82例,比较术前、术后12个月P1波峰、P1潜伏期、CAP、SIR分级,分析其相关性,采用有意义听觉整合量表(MAIS)评分评价术后12个月患儿听力康复情况,比较患儿临床资料、P1波峰、P1潜伏期,评价P1波峰、P1潜伏期对听力改善的评估价值。结果术后12个月P1波峰低于术前,P1潜伏期短于术前,CAP、SIR分级高于术前(P<0.05);术前、术后12个月P1波峰、P1潜伏期与CAP、SIR分级均呈负相关(P<0.05);不同MAIS评分患儿术前听力损失程度、术前、术后12个月后CAP、SIR分级、P1波峰比较,差异有统计学意义(P<0.05);P1波峰、P1潜伏期联合评估听力改善的曲线下面积(area under the curve,AUC)最大,为0.872,敏感度、特异度分别为74.19%、85.00%。结论P1波峰、P1潜伏期与外中耳畸形患儿术后CAP、SIR分级均存在负相关性,采用AEP检查P1波峰、P1潜伏期在评估人工耳蜗植入术后听力改善方面具有重要价值。
文摘目的比较纯音听阈法与Jahrsdoerfer评分法对先天性中外耳畸形的评估作用。方法将53例(53耳)行外耳道再造+鼓室探查成形手术的先天性中外耳畸形患者分有、无卵圆窗发育两组,对比其术前在0.5-4k Hz各频率平均纯音听阈(或条件反射测听阈值)、Jahrsdoerfer评分及相应平均纯音听阈情况,比较两种方法的差异。结果两组术前平均气导听阈卵圆窗发育组为64.7 d B,无发育组为73.1 d B(P<0.05),且在1k Hz、2k Hz、4k Hz两组有差异(P<0.05)。Jahrsdoerfer评分卵圆窗未发育组7分以下(含)占83.3%,而发育组为35.7%,但评分高低与平均听阈值间无程度梯度关系。结论:纯音听阈法和Jahrsdoerfer评分法均能反映先天性中外耳畸形的畸形程度,但纯音听阈法更简单、直接。Jahrsdoerfer评分高低与纯音听阈水平不能互相进行评估。
文摘目的分析先天性中外耳畸形患者纯音听力特点。方法回顾性分析213例(253耳)先天性中外耳畸形患者的纯音听力特点。结果纯音测听显示传导性耳聋198耳(78.26%)、混合性耳聋53耳(20.95%)、感音神经性耳聋2耳(0.78%)。将语频段0.5KHz、1k Hz、2KHz、4k Hz中任一频率未引出骨导或气导听力的患者剔除后余206例(246耳),平均气导阈值进行分析:以中重度耳聋(55d-70d B HL)51.63%(127/246),重度耳聋(71-90d B HL)33.74%(83/246)为主;其中传导性耳聋和混合性耳聋中重度,重度所占比例分别为59.60%(118/198),26.77%(53/198);18.75%(9/48),62.50%(30/48)。在56-80 d B HL范围内传导性耳聋、混合性耳聋所占比例分别为82.83%(164/198)、58.33%(28/48)。对混合性耳聋骨导纯音测听结果分析示:主要在2KHz处骨导听力有下降,占72.92%,平均阈值为30.42±7.84d B HL(10-60 d B HL),结论先天性中外耳畸形患者主要表现为传导性耳聋,以中重度、重度耳聋为主。骨导听力损失主要发生在2KHz,在2KHz处平均骨导听阈有轻度下降。
