Cho Eun-Hyun, Shim Leeseul, Choi Hyo Geun, Hong Sung Kwang, Kim Hyung-Jong, Lee Hyo-Jeong
Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, Korea.
Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, Korea.
J Korean Med Sci. 2022 Jan 10;37(2):e19. doi: 10.3346/jkms.2022.37.e19.
South Korea has one of the world's fastest aging populations and is witnessing increased age-related hearing impairment cases as well as an increase in the number of hearing aid users. The aim of this study was to analyze complications caused by hearing aid mold materials. In addition, we hope to raise awareness of the harm and danger that inexperienced hearing aid providers can cause to patients.
We retrospectively reviewed the medical records of 11 patients who were diagnosed with hearing aid mold material as a foreign body in the ear at a tertiary center between 2016 and 2020. The following data were analyzed: symptoms, endoscopic findings, audiometry, temporal bone CT images, treatment methods, and complications after removal. The currently available literature was also reviewed to develop clinical guidelines, to identify the systematic weaknesses in the South Korean hearing aid market, and to identify policies that warrant better quality control.
Among the 11 cases, 9 were restricted to the external auditory canal, all of which were successfully removed under endoscopy with minor complications. Two cases with middle ear involvement resulted in infection and thus required surgical removal with mastoidectomy. The average age of these patients was 76.4, and all patients received their molding procedure at private hearing aid shops without an otolaryngologist's examination.
Thorough patient history-taking and otologic examination must be performed to identify patients at higher risk of complications. Such patients should be referred to an otolaryngologist. If a patient exhibits alarming symptoms, early referral is critical since prompt surgery can minimize complications. A CT scan is highly recommended to determine an optimal approach for foreign body removal. Systematic and regulatory changes in hearing aid dispensers, such as requiring apprenticeship, raising the required level of education, and legally mandating referrals, can help reduce these complications.
韩国是世界上人口老龄化速度最快的国家之一，与年龄相关的听力障碍病例不断增加，助听器使用者数量也在上升。本研究的目的是分析助听器耳模材料引起的并发症。此外，我们希望提高人们对经验不足的助听器提供者可能给患者带来的危害和危险的认识。
我们回顾性分析了2016年至2020年期间在一家三级中心被诊断为助听器耳模材料为耳内异物的11例患者的病历。分析了以下数据：症状、内镜检查结果、听力测定、颞骨CT图像、治疗方法以及取出后的并发症。还查阅了现有文献，以制定临床指南，确定韩国助听器市场的系统弱点，并确定需要更好质量控制的政策。
在这11例病例中，9例局限于外耳道，所有病例在内镜下均成功取出，并发症轻微。2例中耳受累导致感染，因此需要进行乳突切除手术取出。这些患者的平均年龄为76.4岁，所有患者均在私人助听器店进行耳模制作，未经过耳鼻喉科医生检查。
必须进行全面的病史采集和耳科检查，以识别并发症风险较高的患者。此类患者应转诊至耳鼻喉科医生处。如果患者出现警示症状，早期转诊至关重要，因为及时手术可将并发症降至最低。强烈建议进行CT扫描，以确定取出异物的最佳方法。对助听器配给者进行系统性和规范性变革，如要求学徒培训、提高所需教育水平以及依法强制转诊，有助于减少这些并发症。
