骨锚式助听器植入手术临床分析  

Clinical application of bone-anchored hearing aid implantation

作　　者：夏寅[1] 张华[1] 龚树生[1] 王丹妮[1] 郑雅丽[1] 李玉玲[1] 董博雅[1] 韩德民[1] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科北京市耳鼻咽喉科研究所耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),100730

出　　处：《中华耳鼻咽喉头颈外科杂志》2013年第8期640-643,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：北京市自然科学基金（7122037）;首都卫生发展科研专项（首发2011-2005-04）

摘　　要：目的通过分析骨锚式助听器（bone—anchoredheatingaid，BAHA）植入患者临床资料，探讨BAHA植人手术的适应证、手术方式及效果。方法回顾性分析16例BAHA植入患者的临床资料，其中男9例，女7例；年龄8～53岁，平均31岁；外中耳畸形9例，慢性化脓性中耳炎术后2例，耳硬化症2例，单侧重度感音神经性聋3例。术前进行纯音测听、言语识别率测试、颞骨CT等评估，术后3个月左右开机时测试助听后的声场纯音听阈和言语识别率。结果术后随访4～16个月，未见明显术后并发症。16例患者术前平均气导听阈（x±s，下同）为（63．2±19．0）dBHL，术后声场下助听听阈为（35．5±10．9）dBHL。术后噪声下言语识别率测试较术前提高了37．0％±31．7％，术后单音节言语识别率测试较术前提高了76．0％±19．7％。结论BAHA是一种临床上安全、有效的人工听觉植入装置，在严格选择适应证的前提下可以在临床推广应用。Objective To discuss the indications, surgery methods and effects of the BAHA implantation by analyzing the patients＇ medical records of bone-anchored hearing aids（BAHA）. Methods Retrospective analyzed the records of 16 patients of BAHA implantation, including nine males and seven females. Their average age was 31 years old （8 -53ys）. Nine of them were congenital ear malformation, two were chronic suppurative otitis media, two were otoselerosis and three were unilateral severe sensorineural deafness. We evaluated their pure tone audiometry （PTA）, speech audiometry and temporal CT before the surgery, and evaluated the aided PTA in soundfield and speech audiometry in sound field. Results These patients received BAHA implantation and installed the speech processor their months later. The average preoperative PTA measurements （PTA at0. 5, 1, 2, 4 kHz） was （63.2 ± 19 0） dB HL and postoperative aided PTA in sound field was （35.5 ± 10.9）dB HL. The average improvement in Heating In Noise Test （HINT） was 37. 0% ±31. 7%. The average improvement in Mandarin Speech Test was 76.0% ± 19.7%. After 4-16 months＇ follow-up, no significant complications were recorded. Conclusion BAHA is a safe and effective bone implantable hearing device.

关 键 词：骨锚式助听器 听觉丧失 耳外科手术 测听法 纯音 测听法 言语 

分 类 号：R764[医药卫生—耳鼻咽喉科]