目的:Bonebridge(BB)是一种新设计的经皮骨传导听力植入物。我们描述,第一次,同时植入BB和不同的耳廓重建手术技术治疗耳廓闭锁/狭窄的小骨症患者。
方法:10例单侧或双侧小耳畸形患者同时接受BB植入,同时使用定制的手雕Medpor框架进行全耳廓重建,或使用自体肋软骨框架进行第二阶段耳廓投影。使用(1)纯音平均值(PTA4)评估听觉辅助和非辅助声场,(2)语音接收阈值(SRT),和(3)在65dBSPL的声级下的语音辨别得分(SDS)。
结果:所有患者及其家属对其人工耳的美学结果感到满意,没有要求进一步修改。没有遇到重大并发症。一名患者出现轻微的部分皮肤移植表皮松解症,愈合顺利,另一名患者对BB装置进行了为期三个月的听觉适应。术后,平均辅助PTA4下降35.35dB,而使用BB声音处理器的SRT为54.5dBHL和28dBHL。SDS增加16.4%-65dBSPL。
结论:对于患有耳道闭锁/狭窄的小耳畸形患者,在全耳重建或框架投影期间同时植入BB是可行且安全的。这种方法减少了手术阶段,从而最大限度地减少学校/职业的中断和时间,以全面重建和听觉康复。
OBJECTIVE: The Bonebridge (BB) is a newly designed transcutaneous bone conduction hearing implant. We describe, for the first time, simultaneous BB implantation and different surgical techniques of auricular reconstruction for microtia patients with aural atresia/stenosis.
METHODS: Ten patients with unilateral or bilateral microtia underwent BB implantation combined simultaneously with either total auricular reconstruction using bespoke hand-carved Medpor framework or second stage auricular projection using autologous costal cartilage framework. Auditory aided and unaided sound fields were evaluated using (1) a pure-tone average (PTA4), (2) a speech reception threshold (SRT), and (3) a Speech Discrimination Score (SDS) at a sound level of 65 dB SPL.
RESULTS: All patients and their families were satisfied with the aesthetic outcome of their constructed ears with no requests for further revision. No major complications were encountered. One patient developed minor partial skin graft epidermolysis that healed uneventfully, and another patient had a three month period of auditory acclimatization to the BB device that resolved. Postoperatively, the mean aided PTA4 decreased by 35.35 dB, while the SRT was 54.5 dB HL unaided and 28 dB HL with use of a BB sound processor. The SDS increased by 16.4%-65 dB SPL.
CONCLUSIONS: Simultaneous BB implantation during either total auricular reconstruction or framework projection for microtia patients who have aural atresia/stenosis is feasible and safe. This approach reduces operative stages, thereby minimizing schooling/occupational disruption and time to total microtia reconstruction and auditory rehabilitation.