Liu Yujie, Chen Peiwei, Yang Lin, Zhu Jikai, Yang Jinsong, Wang Danni, Ren Ran, Li Ying, Zhao Chunli, Zhao Shouqin
Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, China.
Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Audiol Neurootol. 2023;28(2):128-137. doi: 10.1159/000526890. Epub 2022 Oct 31.
A nonsurgical bone conduction hearing aid (BCHA) is a well-established treatment for children with congenital unilateral microtia and atresia (UMA). To date, limited studies have evaluated the audiological characteristics of the different wearing modes in the same nonsurgical BCHA.
Eighteen patients with UMA aged 5-24 years were included. Warble tones at frequencies of 0.5, 1, 2, and 4 kHz were presented to determine functional hearing gain (FHG) of hearing thresholds (in dB HL) in the sound field. The speech perception abilities were assessed by the speech discrimination score (SDS, in %) of monosyllables, disyllables, and sentences in quiet and noise using the Chinese Mandarin speech test materials. Hearing outcomes were evaluated with the ADHEAR™ worn on a softband and with an adhesive adapter. A correlational analysis was conducted to analyze the correlations between variables (e.g., age, height, weight, body mass index [BMI], bone conduction pure-tone threshold, and air conduction pure-tone threshold) and the differences in the two wearing modes.
The mean FHG (standard deviation, SD) at 0.5-4 kHz was 20.63 (3.94) dB HL with the adhesive adapter and 26.39 (3.15) dB HL with the softband. When aided with the BCHA, significant improvements in SDS were revealed in all Mandarin speech test material lists either in quiet or noise for both wearing modes. Compared with the adapter mode, the softband provided higher aided SDS values. Correctional analyses revealed that higher BMI values were positively associated with larger delta outcomes between the two coupling methods of the softband and adhesive adapter in patients with UMA. Furthermore, a larger delta average FHG of 0.5-4 kHz was consistently associated with larger delta monosyllabic SDS in quiet, disyllabic SDS in quiet, and disyllabic SDS in noise.
To the best of our knowledge, this is the first study to compare the hearing benefits of coupling methods using novel adhesive adapters and conventional softbands with the same audio processor (ADHEAR™). Under uniform internal settings, softband integration provided more hearing benefits than adhesive adapter integration, and the differences were more obvious in patients with higher BMI values. Besides, a brief measurement of FHG can be utilized to predict individualized speech perception levels.
非手术骨传导助听器（BCHA）是治疗先天性单侧小耳畸形和外耳道闭锁（UMA）儿童的一种成熟疗法。迄今为止，针对同一非手术BCHA不同佩戴模式的听力学特征进行评估的研究有限。
纳入18例年龄在5至24岁的UMA患者。呈现0.5、1、2和4kHz频率的啭音，以确定声场中听力阈值（以dB HL为单位）的功能听力增益（FHG）。使用汉语普通话语音测试材料，通过安静和噪声环境下单音节、双音节和句子的言语辨别得分（SDS，以%为单位）评估言语感知能力。使用ADHEAR™软带和粘性适配器佩戴时评估听力结果。进行相关性分析，以分析变量（如年龄、身高、体重、体重指数[BMI]、骨传导纯音阈值和气传导纯音阈值）之间的相关性以及两种佩戴模式的差异。
使用粘性适配器时，0.5至4kHz的平均FHG（标准差，SD）为20.63（3.94）dB HL，使用软带时为26.39（3.15）dB HL。在两种佩戴模式下，当使用BCHA辅助时，所有普通话语音测试材料清单在安静或噪声环境下的SDS均有显著改善。与适配器模式相比，软带提供了更高的辅助SDS值。校正分析显示，较高的BMI值与UMA患者软带和粘性适配器两种耦合方法之间更大的差值结果呈正相关。此外，0.5至4kHz更大的平均FHG差值始终与安静环境下单音节SDS、安静环境下双音节SDS和噪声环境下双音节SDS的更大差值相关。
据我们所知，这是第一项比较使用新型粘性适配器和传统软带与同一音频处理器（ADHEAR™）的耦合方法的听力益处的研究。在统一的内部设置下，软带整合比粘性适配器整合提供了更多的听力益处，并且在BMI值较高的患者中差异更明显。此外，简短的FHG测量可用于预测个体言语感知水平。
