骨传导与中耳植入装置的长期效益与转归:一项14年单中心回顾性对比分析OA
Long-term benefits and outcomes of bone conduction and active middle ear implants:a 14-year single-center retrospective comparative analysis
目的 分析两种不同技术骨传导植入装置与主动式中耳植入装置的长期效益与临床转归,并探讨导致设备转换或废弃的关键因素.方法 回顾性分析解放军总医院第六医学中心于2010年至2024年接受骨导植入(包括骨桥及骨锚式助听器)和中耳植入(以振动声桥为代表)的患者41例.其中29例完成有效随访,男性16例,女性13例;年龄12～53岁,平均年龄(27.28±9.91)岁.将29例患者分为中耳植入组(13例),骨导植入组(16例).通过回顾、电话随访等方式收集并分析标准化的患者数据,并对患者进行主观效益量表评估,评估指标包括助听器效益评估量表和听力设备满意度量表.对术后并发症、设备故障率以及因助听效果不佳或并发症导致的设备转换及移除率进行评估.结果 29例患者的总体随访时间范围为5～14年,中位随访时间11年.两组患者术后均获得较好的听力改善.中耳植入组在背景噪声环境下的改善程度为(36.95±21.11)分,在数值上高于骨导植入组的(23.70±15.00)分.在听力设备满意度量表评估中,骨导植入组的总体满意度平均分为(65.50±4.10)分,中耳植入组为(59.62±10.71)分.两组间的平均得分差异无统计学意义(P＞0.05).然而,骨导植入组在设备整体满意度上评分更稳定,中耳植入组则个体间差异较大.在临床转归方面,中耳植入组因听力持续下降,耦合失效等原因导致的设备更换率为46.2%(6/13);骨导植入组无设备更换,但有3例患者因植入体周围软组织感染而移除设备.在病因构成上,骨导植入组高度集中于畸形与传导性聋,中耳植入组则病因更为复杂(含30.8%感音神经性聋),两组病因构成差异具有统计学意义(P＜0.05).结论 骨导植入装置在经典适应证人群中表现出更稳定的长期疗效和高满意度;主动式中耳植入装置的长期效果和转归高度依赖于更精准的病因学与听力学适应证选择.
Objective To report long-term benefits and clinical outcomes of two distinct technologies--bone conduction implants(BCIs)and active middle ear implants(AMEIs),as well as key factors leading to device explantation or conversion.Methods Data from 41 patients who underwent auditory implantation at the Sixth Medical Center of Chinese PLA General Hospital between January 2010 and December 2024,including bone conduction implants(Bonebridge and BAHA)and middle ear implants(Vibrant Soundbridge),were retrospectively analyzed.Effective follow-ups were completed in 29 cases(16 males and 13 females,aged 12 to 53 years[mean=27.28±9.91 years]).Thirteen of the 29 patients received AMEI and 16 received BCI.Clinical data were collected through chart review and telephone follow-up.Subjective benefits were assessed using the abbreviated profile of hearing aid benefit and the satisfaction with amplification in daily life scales.Postoperative complications,rates of device failure and device explantation/conversion were evaluated.Results The overall follow-up duration in the 29 patients ranged from 5 to 14 years(median=11 years).Hearing improvement was recorded with both types of implant.Subjective benefits in background noise(BN)were 36.95±21.11 with AMEI,numerically higher than that with BCI(23.70±15.00).Mean score for global satisfaction in the Satisfaction with Amplification in Daily Life questionnaire was 65.50±4.10 with BCI group and 59.62±10.71 with AMEI(P＞0.05).However,the global satisfaction score was more consistent with BCI,while showing greater inter-individual variability with AMEI.The rate of device conversion was 46.2%(6/13)with AMEI,mainly due to progressive hearing loss or coupling failure,and none with BCI although the device was removed in 3 patients due to local infection.Conditions treated with BCI included mostly microtia/atresia and conductive hearing loss,whereas those treated with AMEI covered a different and broader range of diseases including sensorineural hearing loss(30.8%)(P＜0.05).Conclusions Bone conduction implants demonstrate consistent long-term efficacy and high patient satisfaction within their classic indication population.Conversely,the long-term outcomes and clinical prognosis of active middle ear implants are highly dependent on precise and rigorous selection of etiological and audiological indications.
庄博翔;汪蓉;陈云鹤;王淑为;康烁烁;杨仕明;李佳楠
解放军总医院第六医学中心耳鼻咽喉头颈外科医学部 听觉与平衡觉全国重点实验室 耳鼻喉疾病国家临床医学研究中心,北京 100048解放军总医院第六医学中心耳鼻咽喉头颈外科医学部 听觉与平衡觉全国重点实验室 耳鼻喉疾病国家临床医学研究中心,北京 100048解放军总医院第六医学中心耳鼻咽喉头颈外科医学部 听觉与平衡觉全国重点实验室 耳鼻喉疾病国家临床医学研究中心,北京 100048解放军总医院第六医学中心耳鼻咽喉头颈外科医学部 听觉与平衡觉全国重点实验室 耳鼻喉疾病国家临床医学研究中心,北京 100048解放军总医院第六医学中心耳鼻咽喉头颈外科医学部 听觉与平衡觉全国重点实验室 耳鼻喉疾病国家临床医学研究中心,北京 100048解放军总医院第六医学中心耳鼻咽喉头颈外科医学部 听觉与平衡觉全国重点实验室 耳鼻喉疾病国家临床医学研究中心,北京 100048解放军总医院第六医学中心耳鼻咽喉头颈外科医学部 听觉与平衡觉全国重点实验室 耳鼻喉疾病国家临床医学研究中心,北京 100048
骨传导植入中耳植入并发症长期转归
bone conduction implantationmiddle ear implantationcomplicationslong-term outcomes
《中华耳科学杂志》 2026 (8)
733-739,7
国家重点研发计划项目(2021YFF0702302)
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