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
Abstract Background Malformations of the temporal bone present different challenges to the implantation of a transcutaneous active bone conduction device, such as Bonebridge (Med-el, Innsbruck, Austria). This study aims to describe the benefits of high-resolution computed tomography (HRCT) in preope...
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SAGE Publishing
2020-08-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
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| Online Access: | http://link.springer.com/article/10.1186/s40463-020-00452-3 |
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| author | Jinsong Yang Chunli Zhao Yujie Liu Mengdie Gao Ran Ren Danni Wang Zhigang Huang Shouqin Zhao |
| author_facet | Jinsong Yang Chunli Zhao Yujie Liu Mengdie Gao Ran Ren Danni Wang Zhigang Huang Shouqin Zhao |
| author_sort | Jinsong Yang |
| collection | DOAJ |
| description | Abstract Background Malformations of the temporal bone present different challenges to the implantation of a transcutaneous active bone conduction device, such as Bonebridge (Med-el, Innsbruck, Austria). This study aims to describe the benefits of high-resolution computed tomography (HRCT) in preoperative assessment and to analyze whether characteristics of the mastoid process, intraoperative compression of the dura or sigmoid sinus, and the use of the Lifts system, lead to differences in audiological performance after implantation. Methods We examined 110 cases of congenital microtia. The structure of the temporal bone was examined using HRCT and a 3D simulation software program. The mean anteroposterior mastoid bone thickness from the external auditory canal to the sigmoid sinus was measured (a measurement referred to as “AP”, hereafter). Sound field threshold (SFT), speech reception threshold (SRT) in noise, and word recognition score (WRS) in quiet, before and after implantation, were also measured. Independent variables were recorded in all patients: mastoid type (well pneumatized or poorly pneumatized), the presence of dural or sigmoid sinus compression, and the use of the Lifts system. Results We found that the mean AP in the non-compression group was 16.2 ± 2.3 mm and in the compression group, 13.1 ± 2.9 mm (p < 0.001). We analyzed the hearing improvement of patients grouped by mastoid development, dural or sigmoid sinus compression, and use of the Lifts system, and found that these factors did not interact and that they had no influence on the hearing outcomes (p > 0.05). Conclusions The AP dimension in the non-compression group was significantly larger than that in the compression group. This finding combined with the ROC curve analysis revealed the AP dimension was a high-accuracy predictor of potential surgical complications involving the dura and sigmoid sinus compression. Further analysis revealed that there was no interaction between the chosen variables: mastoid type, dural or sigmoid sinus compression, and the use of the Lifts system, and that all of these factors had no significant impact on hearing performance. Bonebridge was shown to produce effective and stable bone conduction and to improve patients’ hearing performance. |
| format | Article |
| id | doaj-art-7ab0b790b0754f89a5cecea9e7370f02 |
| institution | OA Journals |
| issn | 1916-0216 |
| language | English |
| publishDate | 2020-08-01 |
| publisher | SAGE Publishing |
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| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj-art-7ab0b790b0754f89a5cecea9e7370f022025-08-20T01:47:45ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162020-08-0149111110.1186/s40463-020-00452-3The 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 lossJinsong Yang0Chunli Zhao1Yujie Liu2Mengdie Gao3Ran Ren4Danni Wang5Zhigang Huang6Shouqin Zhao7Department of Otolaryngology and Head and Neck Surgery, Beijing Tong Ren Hospital, Capital Medical UniversityDepartment of Otolaryngology and Head and Neck Surgery, Beijing Tong Ren Hospital, Capital Medical UniversityDepartment of Otolaryngology and Head and Neck Surgery, Beijing Tong Ren Hospital, Capital Medical UniversityDepartment of Otolaryngology and Head and Neck Surgery, Beijing Tong Ren Hospital, Capital Medical UniversityDepartment of Otolaryngology and Head and Neck Surgery, Beijing Tong Ren Hospital, Capital Medical UniversityDepartment of Otolaryngology and Head and Neck Surgery, Beijing Tong Ren Hospital, Capital Medical UniversityDepartment of Otolaryngology and Head and Neck Surgery, Beijing Tong Ren Hospital, Capital Medical UniversityDepartment of Otolaryngology and Head and Neck Surgery, Beijing Tong Ren Hospital, Capital Medical UniversityAbstract Background Malformations of the temporal bone present different challenges to the implantation of a transcutaneous active bone conduction device, such as Bonebridge (Med-el, Innsbruck, Austria). This study aims to describe the benefits of high-resolution computed tomography (HRCT) in preoperative assessment and to analyze whether characteristics of the mastoid process, intraoperative compression of the dura or sigmoid sinus, and the use of the Lifts system, lead to differences in audiological performance after implantation. Methods We examined 110 cases of congenital microtia. The structure of the temporal bone was examined using HRCT and a 3D simulation software program. The mean anteroposterior mastoid bone thickness from the external auditory canal to the sigmoid sinus was measured (a measurement referred to as “AP”, hereafter). Sound field threshold (SFT), speech reception threshold (SRT) in noise, and word recognition score (WRS) in quiet, before and after implantation, were also measured. Independent variables were recorded in all patients: mastoid type (well pneumatized or poorly pneumatized), the presence of dural or sigmoid sinus compression, and the use of the Lifts system. Results We found that the mean AP in the non-compression group was 16.2 ± 2.3 mm and in the compression group, 13.1 ± 2.9 mm (p < 0.001). We analyzed the hearing improvement of patients grouped by mastoid development, dural or sigmoid sinus compression, and use of the Lifts system, and found that these factors did not interact and that they had no influence on the hearing outcomes (p > 0.05). Conclusions The AP dimension in the non-compression group was significantly larger than that in the compression group. This finding combined with the ROC curve analysis revealed the AP dimension was a high-accuracy predictor of potential surgical complications involving the dura and sigmoid sinus compression. Further analysis revealed that there was no interaction between the chosen variables: mastoid type, dural or sigmoid sinus compression, and the use of the Lifts system, and that all of these factors had no significant impact on hearing performance. Bonebridge was shown to produce effective and stable bone conduction and to improve patients’ hearing performance.http://link.springer.com/article/10.1186/s40463-020-00452-33D simulationTranscutaneous bone conduction deviceHearing outcomesPreoperative evaluationCongenital microtiaBonebridge |
| spellingShingle | Jinsong Yang Chunli Zhao Yujie Liu Mengdie Gao Ran Ren Danni Wang Zhigang Huang Shouqin Zhao 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 Journal of Otolaryngology - Head and Neck Surgery 3D simulation Transcutaneous bone conduction device Hearing outcomes Preoperative evaluation Congenital microtia Bonebridge |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | 3D simulation Transcutaneous bone conduction device Hearing outcomes Preoperative evaluation Congenital microtia Bonebridge |
| url | http://link.springer.com/article/10.1186/s40463-020-00452-3 |
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