Aesthetic and hearing rehabilitation in patients with bilateral microtia-atresia

Int J Pediatr Otorhinolaryngol. 2017 Oct:101:150-157. doi: 10.1016/j.ijporl.2017.08.008. Epub 2017 Aug 10.

Abstract

Objectives: To evaluate the safety and efficacy of auricle reconstruction and active transcutaneous bone-conduction implantation in patients with bilateral microtia-atresia.

Design: Patients were chosen prospectively, with each being his/her own control.

Setting: The setting was a tertiary referral center.

Participants: Twelve patients, aged 6-18 years, with bilateral microtia-atresia suffering from bilateral conductive hearing loss. All had an upper bone conduction threshold limit of 45 dB HL at frequencies of 0.5-4 kHz.

Main outcome measures: Patient satisfaction with the reconstructed auricle was rated as highly satisfactory, basically satisfactory, or unsatisfactory. Mean pure-tone thresholds and speech audiometry test results were compared among patients unaided, with a soft-band Bonebridge, and with an implanted Bonebridge. Subjective satisfaction was analyzed using three questionnaires: the Abbreviated Profile of Hearing Aid Benefit (APHAB), the Glasgow children's benefit inventory (GCBI), and the International Outcome Inventory for Hearing Aids (IOI-HA).

Results: All patients who underwent auricle reconstruction expressed satisfaction with their appearance. The mean pure-tone thresholds of unaided patients and those with soft-band and implanted Bonebridge were 55.25 ± 3.43 dBHL, 31.37 ± 3.03 dBHL, and 21.25 ± 2.16 dBHL, respectively. The mean speech discrimination scores measured in a sound field with a presentation level of 65 dB SPL under these three conditions were 46.0 ± 0.11%, 80.0 ± 0.09%, and 94.0 ± 0.02%, respectively. Questionnaires demonstrated patients' benefits and satisfaction with this surgery.

Conclusions: The surgical procedure involving auricle reconstruction and Bonebridge implantation was safe and effective for patients with bilateral microtia-atresia, solving both appearance and hearing problems.

Keywords: Auricle reconstruction; Bonebridge; Congenital microtia; Hearing rehabilitation.

MeSH terms

  • Adolescent
  • Audiometry, Speech
  • Child
  • Congenital Microtia / surgery*
  • Ear, External / surgery*
  • Female
  • Hearing
  • Hearing Aids / adverse effects*
  • Hearing Loss, Conductive / surgery*
  • Hearing Tests
  • Humans
  • Male
  • Patient Satisfaction / statistics & numerical data
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / methods*
  • Prospective Studies
  • Surveys and Questionnaires