*Department of Otolaryngology-Head and Neck Surgery, Stanford School of Medicine, Stanford, California; †Division of Otolaryngology, Department of Surgery, and ‡Division of Public Health, Study Design and Biostatistics Center, University of Utah, Salt Lake City, Utah, U.S.A.
Otol Neurotol. 2013 Oct;34(8):1394-9. doi: 10.1097/MAO.0b013e3182a36065.
To perform a systematic review, comparing hearing outcomes of atresiaplasty versus osseointegrated bone conduction device (OBCD) in congenital aural atresia (CAA) patients.
Approximately 107 studies, published from 1975 to 2012, evaluating hearing outcomes after atresiaplasty and/or OBCD in CAA patients were identified through a PubMed search.
Articles that evaluated external auditory canal stenosis alone, did not report speech reception threshold (SRT), pure tone average (PTA), hearing gain, or air-bone gap (ABG) or had less than 5 patients were excluded. For authors or institutions with multiple reports, the largest or most recent study was included. Forty-one articles satisfied our inclusion and exclusion criteria.
The number and percentage of ears with a postoperative SRT, PTA, ABG less than 30 dB, and/or average hearing gain were extracted. The total number of ears and the timing of the postoperative audiogram were also noted.
Of the atresiaplasty ears, 73.8% (95% CI, 62.2%-85.4%), had a SRT less than 30 dB (338 ears), 60.3% (95% CI, 45.8%-74.8%) had a PTA less than 30 dB (390 ears), and 68.9% (95% CI, 59.4%-78.3%) had an ABG less than 30 dB (852 ears). The average hearing gain was 24.1 dB (95% CI, 21.62-26.51) for 516 ears. Hearing outcomes deteriorated with time. Of OBCD patients, 95.9% (95% CI, 91.5%-100.0%) had a PTA less than 30 dB (77 ears), and 98.2% (95% CI, 94.5%-100.0%) had an ABG less than 30 dB (47 ears); the average hearing gain was 38.0 dB (95% CI, 33.14-45.22) in 100 ears.
The OBCD has better hearing outcomes compared with atresiaplasty in patients with CAA.
对先天性外耳闭锁（CAA）患者行外耳道再通成形术与骨导式听力植入（OBCD）的听力结果进行系统评价。
通过 PubMed 检索，共检索到 1975 年至 2012 年间评估外耳道再通成形术与/或 OBCD 术后听力结果的约 107 项研究。
排除仅评估外耳道狭窄、未报告言语接受阈（SRT）、纯音平均听阈（PTA）、听力增益或气骨导差（ABG），或患者数小于 5 例的文章；对于有多份报告的作者或机构，只纳入其中最大或最新的研究。41 篇文章符合纳入和排除标准。
提取术后 SRT、PTA、ABG 小于 30dB、听力增益平均值小于等于 30dB 的耳数及百分比。还记录了总的耳数和术后听力图的时间。
在外耳道再通成形术耳中，73.8%（95%可信区间，62.2%至 85.4%）的 SRT 小于 30dB（338 耳），60.3%（95%可信区间，45.8%至 74.8%）的 PTA 小于 30dB（390 耳），68.9%（95%可信区间，59.4%至 78.3%）的 ABG 小于 30dB（852 耳）。516 耳的平均听力增益为 24.1dB（95%可信区间，21.62 至 26.51）。听力结果随时间而恶化。在 OBCD 患者中，95.9%（95%可信区间，91.5%至 100.0%）的 PTA 小于 30dB（77 耳），98.2%（95%可信区间，94.5%至 100.0%）的 ABG 小于 30dB（47 耳）；100 耳的平均听力增益为 38.0dB（95%可信区间，33.14 至 45.22）。
与 CAA 患者的外耳道再通成形术相比，OBCD 的听力结果更好。
