ABSTRACT
Objectives:
To evaluate the
therapeutic effects of unilateral/bilateral
bone conduction hearing rehabilitation in
patients with bilateral
microtia accompanied with severe
conductive hearing loss following staged auricle reconstruction and bonebridge implantation.
Methods:
Thirty-two
patients, including 20
males and 12
females, with an average age of 11.8,
who received surgical
treatment in
Peking Union Medical College
Hospital (PUMCH) from March, 2016 to January, 2020 with bilateral
microtia-atresia were included.
Hearing thresholds,
speech perception and high-resolution CT of the
temporal bone were evaluated prior to
surgery and individualized
surgery plans (staged auricle reconstruction and bonebridge implantation) were made.
Hearing thresholds and
speech perception in quiet and
noise (SNR = 5 dB) using unilateral Bonebridge were tested two weeks after the implantation
surgery when the Bonebridge was activated and at 3th, 6th, 12th month after activation.
Hearing thresholds and
speech perception were also tested at least three months after the activation of the Bonebridge under three conditions unaided, unilateral Bonebridge, and bilateral
bone conduction hearing devices (Bonebridge plus contralateral ADHEAR). The international
hearing aid assessment
questionnaire (IOI-HA) and Glasgow
children's benefit
questionnaire were used to evaluate the subjective benefits of the
patients. SPSS 21.0
software was used for
statistical analysis.
Results:
Among these 32
patients, nine were conducted Bonebridge implantation
surgery before auricle reconstruction, six were simultaneously with auricle reconstruction and 17 were implanted after auricle reconstruction
surgery. Compared with unaided, the mean
hearing thresholds (0.5, 1, 2, and 4 kHz) and
speech perception following unilateral BCHD and bilateral BCHD attachment were improved significantly (P<0.05 each). The
speech perceptin in
noise of bilateral BCHD was better than unilateral (P<0.05 each). The modified
questionnaire revealed high levels of
patient satisfaction following use of both unilateral and bilateral
devices.
Conclusions:
Individulized
surgical procedures involving auricle reconstruction and Bonebridge implantation are safe and effective for
patients with bilateral
microtia-atresia, solving both appearance and
hearing problems.
Speech perception in
noise is better following bilateral BCHD than unilateral BCHD attachment.