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- 郑军主任医师 教授
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医院:
首都医科大学附属北京同仁医院
科室:
耳鼻咽喉科
- 部分性耳聋治疗的术前听力保护
- 作者:郑军|发布时间:2013-06-20|浏览量:1393次
International Center of Hearing and Speech of the Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland. henryk.skarzynski@ifps.org.pl
摘要:
背景:部分性耳聋(PD)是指在影响言语理解的频率中至少某一个频率存在听力损失。目前部分性耳聋的治疗选择(PDT)依赖于术前听力的保存情况,以及随后不同的声刺激或者电刺激,扩展不同辅助听觉装置的适用范围。可能的治疗选择包括单纯的声刺激,助听器或者中耳植入,电刺激和声电联合刺激。
材料/方法:患有不同类型的部分性耳聋的95名患者(63名成人,32名儿童),分别给予不同的电极类型并采用“圆窗植入”到内耳,持续观察至少36个月。
结果:部分性耳聋治疗的扩展给那些戴助听器无效且不满足于普通的人工耳蜗植入的耳聋患者一个新的机会。作者的观察发现97.1%的成人患者(8年的随访观察)术前听力得到了保存,100%的儿童患者(6年的随访观察)术前听力得到了保存。
结论:为了比较来自不同的研究的部分性耳聋治疗结果,作者开发了一套Skarzynski PDT分类系统,用于比较术后结果,包括听力保存的程度以及更为重要的,患者的术后言语理解。
Abstract:
BACKGROUND: Partial deafness (PD) is a condition in which hearing loss occurs in at least 1 frequency critical to speech understanding. Current options for partial deafness treatment (PDT) rely on preoperative hearing preservation, which, along with the use of different means of acoustic and electric stimulation, enable extending the indications for various assistive hearing devices. Possible solutions include acoustic methods only, the use of hearing AIDSor middle ear implants, electric complementation, and a combination of electric and acoustic stimulation.
MATERIAL/METHODS: A total of 95 patients (63 adults, 32 children) with different types of PD were treated using selected types of electrodes and the optimal "round window" approach to the inner ear, with at least 36 months of observation.
RESULTS: The extension of PDT indications created an opportunity for patients with different hearing impairments who obtained no benefit from a hearing aid and did not qualify for standard cochlear implant application. The authors' observations are based on the findings that preservation of preoperative hearing had been achieved in 97.1% of adult patients (8 years' observation) and in 100% of children (6 years' observation). Those results send the important message that PDT is feasible and effective.
CONCLUSIONS: To allow comparison of PDT results from different studies, the authors developed the Skarzynski PDT classification system, which permits the comparison of postoperative results, including the degree of hearing preservation and, more importantly, the patient's understanding of speech after treatment.