J Otolaryngol Head Neck Surg:解剖变量和Lifts系统的使用对设备植入后听力结果的影响研究

2020-08-23 AlexYang MedSci原创

颞骨畸形对经皮主动骨传导装置的植入产生了不同的挑战,如Bonebridge(Med-el,Innsbruck, Austria)。最近,有研究人员描阐释了高分辨率计算机断层扫描(HRCT)在术前评估中

颞骨畸形对经皮主动骨传导装置的植入产生了不同的挑战,如Bonebridge(Med-el,Innsbruck, Austria)。最近,有研究人员描阐释了高分辨率计算机断层扫描(HRCT)在术前评估中的益处,并分析了乳突过程的特征、术中对硬膜或乙状窦的压迫以及Lifts系统的使用是否会导致植入后听觉表现的差异。

研究包括了110例先天性小耳畸形患者,并使用了HRCT和3D模拟软件程序检查了颞骨的结构情况,测量了从外听道到乙状窦的平均前后乳突骨厚度(该测量方法称为 "AP",以下简称AP)。研究人员还测量了植入前和植入后的声场阈值(SFT)、噪声中的语音接收阈值(SRT)和安静中的单词识别得分(WRS),并记录了所有患者的独立变量:乳突类型、是否存在硬膜或乙状窦压迫,以及Lifts系统的使用情况。研究发现,非压迫组的平均AP为16.2±2.3mm,压迫组为13.1±2.9mm(P<0.001)。研究人员分析了按乳突发育、硬膜或乙状窦压迫、使用Lifts系统分组的患者的听力改善情况,发现这些因素相互不影响,且对听力结果没有影响(P > 0.05)。

非压迫组患者展示(A:AP长度;B:基于数千3D模拟位置的BC-FMT骨床准备;C:术前HRCT三维模拟成像;D:具有Lifts的BC-FMT植入)

压迫组患者展示(A:AP长度;B:基于数千3D模拟位置的BC-FMT骨床准备;C:术前HRCT三维模拟成像;D:具有Lifts的BC-FMT植入)

最后,研究人员指出,非压迫组的AP尺寸明显大于压迫组。该发现结合ROC曲线分析显示,AP尺寸是涉及硬膜和乙状窦压迫的可能手术并发症的高精度预测指标。另外,Bonebridge能产生有效而稳定的骨传导,并能改善患者的听力表现。

原始出处:

Jinsong Yang, Chunli Zhao, Yujie Liu et al. The effect of anatomical variables and use of the Lifts system on hearing outcomes after implantation of an active transcutaneous bone conduction device in bilateral congenital conductive hearing loss. J Otolaryngol Head Neck Surg. Aug 2020

 

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    2020-08-27 ms4000002082197205

    标记一下 学习了

    0

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    2020-08-27 ms4000002082197205

    标记一下 学习了

    0

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    2020-08-25 ysjykql
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    2020-08-25 jiyangfei

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