Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada.
Clin Otolaryngol. 2011 Oct;36(5):442-9. doi: 10.1111/j.1749-4486.2011.02388.x.
The influence of an extended preoperative trial of bone-anchored hearing aid (BAHA) and headband on the decision to proceed with surgery in cases of unilateral sensorineural hearing loss is studied.
In this prospective study, the headband was introduced after assessment confirmed suitable candidacy. Those who had an initially favourable response to the headband trial were encouraged to complete a 2-week home trial of device and headband. Patients were asked to pay special attention to situations where they perceived high demands on their hearing, e.g. at the dinner table, in the car, walking outside etc. Counselling regarding the BAHA placement, the need for daily care of the implant site and the financial implications of acquiring the device was also given.
Tertiary university hospital.
Patients with unilateral sensorineural hearing loss, fulfilling criteria for BAHA surgery, with favourable response to initial 'office trial' of headband.
After 2-week home trial, BAHA and headband were returned with a statement of the patient's intentions.
Sixteen of 50 (32%) patients who expressed definite interest in BAHA surgery after a positive introduction to the headband in the office did not wish to proceed to surgery having completed a more thorough 2-week trial of device at home. Most patients cited a failure of the device to meet their hearing requirements. Subsequently, we found further attrition with nine more patients (18%) deciding at a still later date, not to proceed with surgery. Ultimately, just 25 of 50 (50%) of our initially enthusiastic group chose not to proceed to surgery. In the group who did proceed, there were no non-users.
We propose the importance of an extended preoperative trial where BAHA is considered in the rehabilitation of unilateral sensorineural hearing loss. The trial may foster more realistic expectations of device performance in this challenging group. A 'cooling-off' period before surgery also appears to lead to further attrition with the ultimate reward of no non-users in those proceeding to surgery.
研究骨锚式助听器（BAHA）和头带的延长术前试用对单侧感音神经性听力损失患者决定是否进行手术的影响。
在这项前瞻性研究中，在评估确认适合候选资格后引入头带。那些对头带试验有初步良好反应的人被鼓励完成为期 2 周的设备和头带家庭试验。患者被要求特别注意他们认为听力要求高的情况，例如在餐桌上、在汽车中、在户外行走等。还就 BAHA 放置、对植入部位进行日常护理的必要性以及获取设备的经济影响提供咨询。
三级大学医院。
单侧感音神经性听力损失患者，符合 BAHA 手术标准，对头带的初始“办公室试验”有良好反应。
家庭试验 2 周后，BAHA 和头带随患者意向声明一并归还。
在办公室对头带进行积极介绍后，表示对 BAHA 手术有明确兴趣的 50 名患者中的 16 名在完成更全面的 2 周设备家庭试验后，不希望进行手术。大多数患者表示设备未能满足他们的听力要求。随后，我们发现还有 9 名患者（18%）在更晚的日期决定不进行手术。最终，在我们最初热情的 50 名患者中，只有 25 名（50%）选择不进行手术。在继续进行手术的患者中，没有非使用者。
我们提出在单侧感音神经性听力损失的康复中考虑 BAHA 时，需要进行延长的术前试验。该试验可能会促进对这一具有挑战性的群体中设备性能的更现实的期望。在手术前有一个“冷静期”，似乎也会导致更多的患者流失，最终在继续进行手术的患者中没有非使用者。
