Soo Gordon, Tong Michael C F, Tsang Willis S S, Wong Terence K C, To Ka-fai, Leung Sing-fai, van Hasselt C Andrew
Department of Otorhinolaryngology, Head and Neck Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China.
Otol Neurotol. 2009 Jun;30(4):496-501. doi: 10.1097/MAO.0b013e31819d34ab.
Radiation for patients who have nasopharyngeal cancer (NPC) often renders them hearing challenged and facing difficulties from treatment sequelae such as chronic suppurative otitis media and osteoradionecrosis. Conventional hearing aids aggravate otorrhea, and ear moulds traumatize osteoradionecrosis ulcers in the ear canal. The bone-anchored hearing aid (BAHA) hearing system might represent an excellent hearing solution.
To investigate the BAHA benefit and osseointegration results for hearing-impaired postirradiated NPC patients.
A prospective longitudinal study.
Tertiary university center.
Eleven hearing-impaired postirradiated NPC patients were studied from October 2002 to October 2006.
Two-stage BAHA surgeries were performed. Assessments include pure-tone and speech audiometry, implant integrity, periabutment audit, and patient satisfaction analysis during a 24-month period. Radiation dosimetric analysis and bone sampling at the fixture implant sites were studied.
No implant fixtures were lost (follow-up, 13-58 mo). Average patient satisfaction scores were 84.4%, with 80% using their BAHA everyday and 90% using their devices for more than 8 hours. Dosimetric analysis of the implant site revealed that all fixtures were outside the irradiated field. There was a reduction in otorrhea rates after BAHA use over the course of the study.
Successful osseointegration was demonstrated in postirradiated NPC patients. Improved subjective hearing clarity, reduced ear discharge rates, and extended BAHA usage times accounted for high patient satisfaction with the BAHA hearing system. This is the first study to demonstrate long-term osseointegration and hearing benefit in postirradiated NPC patients. We recommend the BAHA hearing system for the treatment of chronic suppurative otitis media-related hearing problems in NPC patients.
鼻咽癌（NPC）患者接受放疗后常出现听力问题，并面临慢性化脓性中耳炎和放射性骨坏死等治疗后遗症带来的困难。传统助听器会加重耳漏，而耳模会损伤耳道内的放射性骨坏死溃疡。骨锚式助听器（BAHA）听力系统可能是一种理想的听力解决方案。
研究BAHA对放疗后听力受损的NPC患者的益处及骨整合结果。
前瞻性纵向研究。
三级大学中心。
2002年10月至2006年10月，对11例放疗后听力受损的NPC患者进行了研究。
进行两阶段BAHA手术。评估包括在24个月期间的纯音和言语听力测定、植入物完整性、基台周围检查以及患者满意度分析。研究了固定植入部位的放射剂量分析和骨取样。
无植入固定装置丢失（随访13 - 58个月）。患者平均满意度得分84.4%，80%的患者每天使用BAHA，90%的患者使用设备超过8小时。植入部位的剂量分析显示，所有固定装置均在照射野之外。在研究过程中，使用BAHA后耳漏率有所降低。
放疗后的NPC患者成功实现了骨整合。主观听力清晰度提高、耳漏率降低以及BAHA使用时间延长，使得患者对BAHA听力系统高度满意。这是第一项证明放疗后NPC患者长期骨整合和听力受益的研究。我们推荐BAHA听力系统用于治疗NPC患者中与慢性化脓性中耳炎相关的听力问题。
