Application of retrosigmoid sinus approach in Bonebridge implantation

Abstract

Background

Bonebridge is an suitable option for conductive hearing loss, however, the traditional approach cannot accomplished a satisfying implantation for patients with congenital malformation or radical mastoidectomy.

Objectives

To evaluate the clinical application of retrosigmoid sinus approach in Bonebridge implantation and postoperative evaluation.

Materials and methods

11 patients who underwent retrosigmoid sinus approach Bonebridge implantation from March 2016 to September 2019 were retrospectively analyzed, including 6 males and 5 females, aged 12–54 years old (30.6 in average). Among them, 4 cases had undergone bilateral radical mastoidectomy, 6 cases had bilateral congenital aural atresia or stenosis, and 1 case had unilateral congenital aural atresia.

Results

All patients underwent Bonebridge implantation through retrosigmoid sinus approach according to the preoperative image reconstruction and plan. There was no surgical injury of sigmoid sinus or cerebrospinal fluid leakage during the operation. The aided threshold obtained an increase of 32.32 dB HL; the speech recognition rates of bisyllabic words, monosyllabic words and sentence were 79.6%, 67.8% and 75.0%, respectively. After 11–53 months of follow-up, the hearing effect was stable and no long-term complications occurred.

Conclusion

The retrosigmoid sinus approach is an effective surgical approach for patients with congenital ear deformities or radical cavity after mastoidectomy.

Chinese abstract

背景：骨桥是传导性听力损失的合适选择, 但是, 对于先天性畸形或根治性乳突切除术的患者, 用传统方法进行的植入无法达到令人满意的效果。

目的：评价乙状窦后入路在骨桥植入术中的临床应用及术后评估。

材料与方法：回顾性分析了2016年3月至2019年9月行乙状窦后入路骨桥植入术的11例患者, 其中男6例, 女5例, 年龄12-54岁（平均30.6岁）。其中有行双侧乳突根治术4例, 双侧先天性耳道闭锁或狭窄6例, 单侧先天性耳道闭锁1例。

结果：所有患者均根据术前图像重建和计划, 通过乙状窦后入路进行了骨桥植入术。术中无乙状窦外科手术损伤或脑脊液漏。辅助阈值增加了32.32 dB HL；双音节单词, 单音节单词和句子的语音识别率分别为79.6％、67.8％和75.0％。随访11-53个月后, 听力效果稳定并且未发生长期并发症。

结论：乙状窦后入路是治疗先天性耳畸形或乳突切除术后根腔的有效方法.

Keywords:

• Bone-conduction
• hearing implantation
• surgical approach
• congenital aural atresia
• hearing result

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the General Programs of Beijing Municipal Science and Technology Commission under Grant no. Z171100001017079.