RESUMO
OBJECTIVE: Our purpose was to evaluate the results of Vibrant Soundbridge (VSB) in conductive or mixed hearing loss. MATERIALS AND METHODS: Twenty-five adult patients (29 ears) with a mixed or conductive hearing loss and various etiologies were included in this retrospective study. The preoperative ipsilateral pure tone average was 71 ± 3.0 dB, and the average bone conduction threshold was 42 ± 2.8 dB (n = 29). The transducer was placed on the long apophysis of the incus (n = 16), in the round window (n = 10) or on the stapes (n = 3). RESULTS: No complications were noted. The bone conduction threshold remained unchanged. VSB was activated in all cases. The postoperative pure tone average without VSB was 63 ± 3.9 dB (n = 24) and with VSB in free-field condition 24 ± 2.1 dB (n = 22). CONCLUSIONS: VSB is safe and efficacious for auditory rehabilitation in conductive and mixed hearing losses.
Assuntos
Perda Auditiva Condutiva/cirurgia , Perda Auditiva Condutiva-Neurossensorial Mista/cirurgia , Audição/fisiologia , Prótese Ossicular , Substituição Ossicular , Adulto , Feminino , Seguimentos , Perda Auditiva Condutiva/fisiopatologia , Perda Auditiva Condutiva/reabilitação , Perda Auditiva Condutiva-Neurossensorial Mista/fisiopatologia , Perda Auditiva Condutiva-Neurossensorial Mista/reabilitação , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do TratamentoRESUMO
CONCLUSIONS: The results support bilateral sequential implantation for patients who are not completely satisfied after implantation of one side. OBJECTIVE: To evaluate the benefit of bilateral Vibrant Soundbridge middle ear implantation as compared with unilateral implantation in quiet and noisy environments. METHODS: This was a multicentric and retrospective study of 15 patients with symmetrical sensorineural hearing loss who were implanted sequentially in both ears. The performance of each subject was compared under three conditions: with the right implant activated, with the left implant activated, and with both implants activated. Audiometric tests were compared with self-assessment subjective evaluation by questionnaire. RESULTS: Both qualitative and quantitative assessments demonstrated improvement in speech intelligibility, especially in background noise, but also for low voice intensity in quiet.
Assuntos
Orelha Média/cirurgia , Auxiliares de Audição , Perda Auditiva Bilateral/reabilitação , Perda Auditiva Neurossensorial/reabilitação , Implantação de Prótese , Meio Social , Percepção da Fala , Adulto , Idoso , Audiometria de Tons Puros , Limiar Auditivo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ruído , Satisfação do Paciente , Estudos Retrospectivos , Teste do Limiar de Recepção da FalaRESUMO
OBJECTIVES: To assess audiological performance, satisfaction rate, and side effects of 100 patients who have been using the middle ear implant Vibrant Soundbridge (VSB) for 5 to 8 yr when compared with data collected from 3 to 18 mo postsurgery. DESIGN: Audiological testing and subjective evaluation using self-assessment scales were performed in 77 out of the 100 patients using the VSB for 5 to 8 years. The results were compared to data collected 3 months (audiological testing) and 18 months (self-assessment scales) after surgery. Twenty-three patients have not been evaluated for different reported reasons. RESULTS: Pure-tone hearing thresholds decreased similarly in both implanted and contralateral ears. The satisfaction ratings and the functional gain provided by the VSB remained stable. Speech comprehension in quiet conditions without the VSB decreased from 56 to 37% in 5 to 8 yr, but an 81% score was achieved with the VSB. CONCLUSIONS: This study demonstrates that the performance of the VSB does not deteriorate for more than 5 yr, without adverse effect. These results confirm the safety and the effectiveness of the VSB with a long-term follow-up.
Assuntos
Implante Coclear/instrumentação , Surdez/cirurgia , Som , Vibração , Audiometria de Tons Puros , Limiar Auditivo/fisiologia , Criança , Pré-Escolar , Surdez/diagnóstico , Surdez/epidemiologia , Feminino , Humanos , Masculino , Satisfação Pessoal , Cuidados Pós-Operatórios , Desenho de Prótese , Reoperação/estatística & dados numéricosRESUMO
OBJECTIVES: The present study was aimed to compare gain and speech intelligibility measured in quiet and in noise between the Signia hearing aid and the Vibrant Soundbridge (VSB), both devices using the same sound processing technology. PATIENTS: A prospective longitudinal study was performed. Six patients with a steeply sloping high-frequency hearing loss were selected. INTERVENTION: The protocol comprised 3 months' hearing aid use, VSB implantation, and 3 months' VSB use. MAIN OUTCOME MEASURES: Patient performances were evaluated unaided and aided by audiologic assessments, including free-field thresholds and word recognition tasks in quiet and in noise. RESULTS: Statistical analysis revealed a slight decrease in overall frequencies in pure-tone audiometry after surgery; however, this decrease did not exceed 5 dB and was not different from the changes that occurred in the contralateral nonimplanted ear. The measures of aided and unaided hearing thresholds showed statistically significant larger gains with the VSB than with the hearing aid. In quiet, speech performances were poorer unaided than with either device. Because of ceiling effects, statistically significant higher scores with the VSB than with the hearing aid were only observed at the lowest intensity level. In noise, speech intelligibility was reported to be better with the VSB compared with both unaided and with the hearing aid at 5 signal-to-noise ratios. CONCLUSION: This prospective study demonstrated that direct-drive stimulation provided by the VSB allows better speech performances than acoustic stimulation for rehabilitation of patients with steeply sloping high-frequency hearing losses.
Assuntos
Auxiliares de Audição , Perda Auditiva Neurossensorial/terapia , Vibração , Estimulação Acústica/instrumentação , Adulto , Feminino , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Desenho de Prótese , Índice de Gravidade de DoençaRESUMO
OBJECTIVE: The Vibrant Soundbridge is an active semi-implantable middle ear implant for the rehabilitation of patients with a sensorineural hearing loss who are not able to derive adequate benefit from conventional hearing aids. A retrospective study was performed to assess the overall level of satisfaction of implanted patients and to investigate the potential determinants of postoperative success. STUDY DESIGN: A retrospective survey of audiological data from repeated measures and subjective data from self-assessment scales administered postoperatively was conducted to determine the degree of benefit and satisfaction for Vibrant Soundbridge implantees. SETTING: Twenty-one tertiary referral and teaching hospitals. SUBJECTS: The first 125 VSB implantees implanted in France between August 1997 and May 2001 were included in the study. RESULTS: No clinically significant change was observed for residual hearing postoperatively. Most patients (83%) reported they were either satisfied or very satisfied with the Vibrant Soundbridge. Analysis of correlation revealed a moderate correlation (Pearson coefficient r = 0.59) between the degree of benefit reported via the patient survey and the degree of benefit reported via the Glasgow Benefit Inventory. A moderate correlation (Pearson coefficient r = 0.66) was observed between speech comprehension scores in quiet for the preoperative unaided condition and the postoperative aided Vibrant Soundbridge condition. No correlation was observed between subjective reports of satisfaction postoperatively and performance on preoperative objective tests or patient characteristics. CONCLUSION: The results indicate a high level of satisfaction with the VSB as a treatment of sensorineural hearing impairment in patients with a wide range of characteristics. Preoperative scores for unaided speech comprehension tests in quiet may be a potential indicator of success on aided Vibrant Soundbridge speech comprehension tests postoperatively but do not reflect patient satisfaction with the device reported on self-assessment scales.