Resultados auditivos del sistema activo de conducción ósea Bonebridge(R) en hipoacusias conductivas o mixtas / Hearing outcomes of the active bone conduction system Bonebridge(R) in conductive or mixed hearing loss

Objetivo: El implante activo de conducción ósea transcutáneo Bonebridge(R) está indicado en pacientes con hipoacusia conductiva/mixta bilateral o en casos de hipoacusia neurosensorial unilateral, mostrando resultados auditivos similares a otros dispositivos percutáneos de conducción ósea pero con menor tasa de complicaciones. El objetivo del siguiente trabajo ha sido analizar los resultados auditivos en una serie de 26 pacientes con hipoacusia conductiva/mixta tratados con Bonebridge(R). Métodos: Veintiséis de un total de 30 pacientes implantados con Bonebridge(R) entre octubre 2012 y mayo 2017 fueron incluidos en el estudio. Se compararon los umbrales de vía aérea a las frecuencias 500, 1.000, 2.000, 3.000 y 4.000 Hz, umbral de reconocimiento verbal 50% y el porcentaje de aciertos a 50 dB sin y con el implante. Resultados: El umbral tonal medio en campo libre con el dispositivo en funcionamiento fue de 34,91 dB, obteniendo unas ganancias medias de 33,46 dB. La SRT 50% media con el implante fue de 34,33 dB mientras que sin él nadie alcanzaba el 50% de aciertos a una intensidad de hasta 50 dB. Con respecto al porcentaje de aciertos a 50 dB, mejoró desde un 11% sin implante a un 85% con el mismo. Entre las complicaciones solo se observó un caso de extrusión del dispositivo en una paciente con antecedentes de 2 ritidoplastias previas. Conclusiones: Los resultados audiológicos obtenidos en nuestro estudio son similares a los publicados en la literatura. Bonebridge(R) representa una excelente alternativa en el tratamiento de la hipoacusia conductiva/mixta, pero con una tasa menor de complicaciones

Objective: The active transcutaneous bone conduction implant Bonebridge®, is indicated for patients affected by bilateral conductive/mixed hearing loss or unilateral sensorineural hearing loss, showing hearing outcomes similar to other percutaneous bone conduction implants, but with a lower rate of complications. The aim of this study was to analyze the hearing outcomes in a series of 26 patients affected by conductive or mixed hearing loss and treated with Bonebridge(R). Methods: 26 of 30 patients implanted with Bonebridge(R) between October 2012 and May 2017, were included in the study. We compared the air conduction thresholds at the frequencies 500, 1000, 2000, 3000, 4000Hz, the SRT50% and the percentage of correct answers at an intensity of 50dB with and without the implant. Results: "Pure tone average" with the implant was 34.91 dB showing an average gain of 33.46 dB. Average SRT 50% with the implant was 34.33 dB, whereas before the surgery no patient achieved 50% of correct answers at a sound intensity of 50dB. The percentage of correct answers at 50dB changed from 11% without the implant to 85% with it. We only observed one complication consisting of an extrusion of the implant in a patient with a history of 2 previous rhytidectomies. Conclusions: The hearing outcomes obtained in our study are similar to those published in the literature. Bonebridge(R) represents an excellent alternative in the treatment of conductive or mixed hearing loss, and with a lower rate of complications

Hearing outcomes of the active bone conduction system Bonebridge® in conductive or mixed hearing loss. / Resultados auditivos del sistema activo de conducción ósea Bonebridge® en hipoacusias conductivas o mixtas.

OBJECTIVE: The active transcutaneous bone conduction implant Bonebridge®, is indicated for patients affected by bilateral conductive/mixed hearing loss or unilateral sensorineural hearing loss, showing hearing outcomes similar to other percutaneous bone conduction implants, but with a lower rate of complications. The aim of this study was to analyze the hearing outcomes in a series of 26 patients affected by conductive or mixed hearing loss and treated with Bonebridge®. METHODS: 26 of 30 patients implanted with Bonebridge® between October 2012 and May 2017, were included in the study. We compared the air conduction thresholds at the frequencies 500, 1000, 2000, 3000, 4000Hz, the SRT50% and the percentage of correct answers at an intensity of 50dB with and without the implant. RESULTS: "Pure tone average" with the implant was 34.91dB showing an average gain of 33.46dB. Average SRT 50% with the implant was 34.33dB, whereas before the surgery no patient achieved 50% of correct answers at a sound intensity of 50dB. The percentage of correct answers at 50dB changed from 11% without the implant to 85% with it. We only observed one complication consisting of an extrusion of the implant in a patient with a history of 2 previous rhytidectomies. CONCLUSIONS: The hearing outcomes obtained in our study are similar to those published in the literature. Bonebridge® represents an excellent alternative in the treatment of conductive or mixed hearing loss, and with a lower rate of complications.

Eficacia de las maniobras de reposicionamiento canalicular en el vértigo posicional paroxístico benigno: revisión de 176 casos tratados en un centro hospitalario de tercer nivel / Efficacy of particle repositioning manoeuvres in benign positional paroxysmal vertigo: A revision of 176 cases treated in a tertiary care centre

INTRODUCCIÓN Y OBJETIVOS: El vértigo posicional paroxístico benigno es la entidad más frecuente dentro de los vértigos de origen periférico. El objetivo del siguiente trabajo es revisar los resultados obtenidos con las diferentes maniobras de reposicionamiento canalicular específicas para cada tipo de canal semicircular afectado, evaluando posibles factores de riesgo relacionados con un peor pronóstico. MÉTODOS: Se han revisado retrospectivamente 176 pacientes diagnosticados de vértigo posicional paroxístico benigno en nuestro centro, de los cuales 150 tenían vértigo del canal semicircular posterior, 20 del horizontal, 3 del superior y 3 multicanal. Se ha usado la maniobra de Epley para el tratamiento del canal posterior y del superior y la maniobra de Lempert para el tratamiento del horizontal. En los casos refractarios se ha realizado siempre un estudio de imagen cerebral con resonancia. RESULTADOS: La maniobra de Epley ha mostrado una eficacia al primer intento del 74,6% para el canal posterior y del 100% para el superior. La eficacia de la maniobra de Lempert para el canal horizontal ha sido del 72,72% en los casos de canalolitiasis y del 58,33% en los de cupulolitiasis. Más complicado ha sido el tratamiento de los pacientes con más de un canal afectado y con antecedente quirúrgico en el mes previo. CONCLUSIONES: Las maniobras de reposicionamiento canalicular permiten alcanzar una tasa de éxito muy alta, obteniendo mejores resultados en el tratamiento del canal posterior. Hacen falta más estudios para confirmar la sospecha de que la cirugía previa pueda ser un factor de peor pronóstico

INTRODUCTION AND OBJECTIVES: Benign paroxysmal positional vertigo is the most common peripheral vertigo disease. The aim of this paper is to review the results obtained with the different specific particle repositioning manoeuvres, evaluating the possible risk factors linked to a poorer prognosis. METHODS: One hundred and seventy-six patients with a diagnosis of benign paroxysmal positional vertigo were reviewed retrospectively, of whom 150 had vertigo of the posterior canal, 20 had vertigo of the horizontal canal, 3 had vertigo of the superior canal, and 3 had a double vertigo. The Epley manoeuvre was used to treat the posterior and superior canals, and Lempert manoeuvre was used to treat the horizontal canal. An imaging study by nuclear magnetic resonance with gadolin was always used in refractory cases. RESULTS: The Epley manoeuvre showed an efficacy of 74.6 and 100% at first attempt for posterior and superior canals respectively. The efficacy of the Lempert manoeuvre for the horizontal canal was 72.72% in the patients with canalolithiasis, and 58.33% in the patients with cupulolithiasis. The treatment of patients with more than one affected canal and a history of surgery in the previous month was more difficult. CONCLUSIONS: Particle repositioning manoeuvres show a very high success rate, allowing better results in the treatment of the posterior canal. We need more studies to confirm the suspicion that surgery may be a factor of poorer prognosis

Efficacy of particle repositioning manoeuvres in benign positional paroxysmal vertigo: A revision of 176 cases treated in a tertiary care centre. / Eficacia de las maniobras de reposicionamiento canalicular en el vértigo posicional paroxístico benigno: revisión de 176 casos tratados en un centro hospitalario de tercer nivel.

INTRODUCTION AND OBJECTIVES: Benign paroxysmal positional vertigo is the most common peripheral vertigo disease. The aim of this paper is to review the results obtained with the different specific particle repositioning manoeuvres, evaluating the possible risk factors linked to a poorer prognosis. METHODS: One hundred and seventy-six patients with a diagnosis of benign paroxysmal positional vertigo were reviewed retrospectively, of whom 150 had vertigo of the posterior canal, 20 had vertigo of the horizontal canal, 3 had vertigo of the superior canal, and 3 had a double vertigo. The Epley manoeuvre was used to treat the posterior and superior canals, and Lempert manoeuvre was used to treat the horizontal canal. An imaging study by nuclear magnetic resonance with gadolin was always used in refractory cases. RESULTS: The Epley manoeuvre showed an efficacy of 74.6 and 100% at first attempt for posterior and superior canals respectively. The efficacy of the Lempert manoeuvre for the horizontal canal was 72.72% in the patients with canalolithiasis, and 58.33% in the patients with cupulolithiasis. The treatment of patients with more than one affected canal and a history of surgery in the previous month was more difficult. CONCLUSIONS: Particle repositioning manoeuvres show a very high success rate, allowing better results in the treatment of the posterior canal. We need more studies to confirm the suspicion that surgery may be a factor of poorer prognosis.