Ricci Giampietro, Volpe Antonio Della, Faralli Mario, Longari Fabrizio, Lancione Carla, Varricchio Alfonso Maria, Frenguelli Antonio
ENT Department, University of Perugia, Loc. Sant'Andrea delle Fratte, 06156 Perugia, Italy.
Int J Pediatr Otorhinolaryngol. 2011 Mar;75(3):342-6. doi: 10.1016/j.ijporl.2010.11.027. Epub 2011 Jan 13.
Aural atresia is a congenital disease constituted by partial or complete lack of development of the external auditory canal, which is generally associated with malformations of the auricle and middle ear. Reconstruction of the auditory canal and correction of any deformities of the middle ear have yielded unpredictable results and variable functional outcomes, and there is a high rate of complications. Therefore, the use of bone-conduction hearing aids, such as the Baha, may represent a valid alternative for subjects who have conductive hearing loss with cochlear reserve that, as a rule, is fully conserved. The aim of this work is to reexamine our experience with the management of conductive and mixed hearing loss using the Baha system in children with bilateral aural atresia.
We examined 31 patients with bilateral congenital aural atresia in whom a Baha system had been implanted. The patients, 16 males and 15 females, were between 5 and 14 years of age (mean 8.7). The following parameters were assessed for each patient: mean preoperative air and bone conduction for frequencies between 0.5 and 4kHz; mean preoperative threshold with conventional bone-conduction hearing aids; mean postoperative threshold with the Baha system; improvement in quality of life evaluated with the Glasgow Children's Benefit Inventory; rate and type of surgical complications.
The mean preoperative air- and bone-conduction thresholds were 51.2±12.5 and 14.1±6.3dB HL, respectively. The mean preoperative threshold with a conventional bone-conduction hearing aid was 29.3±7.2dB HL, and the mean postoperative threshold with the Baha system was 18.1±7.5dB HL. Quality of life improved for all operated patients.
The results of our study of the Baha system to treat patients with bilateral aural atresia were extremely satisfactory compared both with those of surgical reconstruction of the auditory canal and those of traditional bone-conduction hearing aids. Furthermore, great improvement was noted in quality of life, while the rate of complications was very low. Therefore, we are convinced that the Baha system is the treatment of choice for hearing loss due to bilateral congenital aural atresia.
外耳道闭锁是一种先天性疾病，由外耳道部分或完全发育不全构成，通常与耳廓和中耳畸形相关。外耳道重建及中耳任何畸形的矫正效果难以预测，功能结局各异，且并发症发生率高。因此，对于有传导性听力损失且耳蜗储备功能通常完全保留的患者，使用骨传导助听器（如巴哈）可能是一种有效的替代方案。本研究旨在重新审视我们使用巴哈系统治疗双侧外耳道闭锁儿童传导性和混合性听力损失的经验。
我们检查了31例植入巴哈系统的双侧先天性外耳道闭锁患者。患者年龄在5至14岁之间（平均8.7岁），其中男性16例，女性15例。对每位患者评估以下参数：0.5至4kHz频率的术前平均气导和骨导；使用传统骨传导助听器的术前平均阈值；使用巴哈系统的术后平均阈值；用格拉斯哥儿童受益量表评估的生活质量改善情况；手术并发症的发生率及类型。
术前平均气导和骨导阈值分别为51.2±12.5dB HL和14.1±6.3dB HL。使用传统骨传导助听器的术前平均阈值为29.3±7.2dB HL，使用巴哈系统的术后平均阈值为18.1±7.5dB HL。所有接受手术的患者生活质量均有改善。
与外耳道手术重建及传统骨传导助听器相比，我们使用巴哈系统治疗双侧外耳道闭锁患者的研究结果非常令人满意。此外，生活质量有显著改善，而并发症发生率很低。因此，我们坚信巴哈系统是双侧先天性外耳道闭锁所致听力损失的首选治疗方法。
