Sun Ping Hsueh, Hsu Shui-Ching, Chen Huan-Rong, Chou Hsiao-Hsiuan, Lin Hsiao-Yun, Chan Kai-Chieh
Department of Otorhinolaryngology & Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Division of Otology, Department of Otorhinolaryngology & Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Int J Pediatr Otorhinolaryngol. 2025 Jan;188:112210. doi: 10.1016/j.ijporl.2024.112210. Epub 2024 Dec 24.
Despite the reported auditory deficits and developmental challenges in children with unilateral microtia and aural atresia (UMAA), there remains a lack of consensus on early intervention with bone conduction hearing aids (BCHAs) to restore binaural hearing due to the uncertain clinical benefits and intolerability of the conventional devices. Previous studies investigating the auditory benefits under binaural hearing condition were limited and demonstrated controversial opinions in heterogenous patient groups with various devices. Our study aimed to evaluate the audiological performance, including monoaural and binaural hearing, and subjective satisfaction of the ADHEAR system, a novel adhesive BCHA, in experienced pediatric users with UMAA.
Twelve children, with a mean age of 9.08 years and previous experience using the ADHEAR system averaging 2.76 years, were included in our final analysis. Auditory performance of monoaural hearing with the affected ears was assessed by sound-field audiometry, speech recognition threshold (SRT), word recognition score (WRS) in quiet and noise. Auditory performance of binaural hearing was assessed by SRT in quiet and noise, along with a virtual sound localization test. Subjective satisfaction was measured with questionnaires.
Monoaural hearing of the affected ears improved in sound-field audiometry (by 18.44 dB HL), SRT (by 17.08 dB HL) and WRS (by 27.00 % in quiet and 30.50 % in noise). Binaural hearing improved in SRT in quiet (by 1.17 dB HL), remained no significant difference in noise and enhanced in sound localization test (reduction of RMS error by 5.96°). The questionnaires indicate satisfying experiences despite skin reactions encountered.
In children with UMAA under long-term and routine use of the ADHEAR system reveals not only enhancement of audiological performance in the affected ears but also demonstrates potential benefits in speech recognition and sound localization under binaural hearing condition. Users generally expressed satisfaction with the device, while skin reaction is more noticeable in humid subtropical climate.
尽管有报道称单侧小耳畸形和外耳道闭锁（UMAA）患儿存在听觉缺陷和发育挑战，但由于传统骨传导助听器（BCHA）的临床益处不确定且耐受性差，对于早期使用骨传导助听器恢复双耳听力仍缺乏共识。以往研究在双耳听力条件下对听觉益处的调查有限，并且在使用各种设备的异质性患者群体中存在争议性观点。我们的研究旨在评估一种新型粘性骨传导助听器ADHEAR系统在有经验的UMAA儿科使用者中的听力学性能，包括单耳和双耳听力，以及主观满意度。
我们最终分析纳入了12名儿童，平均年龄9.08岁，之前使用ADHEAR系统的平均时长为2.76年。通过声场测听法、言语识别阈值（SRT）、安静和噪声环境下的单词识别分数（WRS）评估患耳的单耳听力听觉性能。通过安静和噪声环境下的SRT以及虚拟声音定位测试评估双耳听力听觉性能。通过问卷调查测量主观满意度。
患耳的单耳听力在声场测听法中有所改善（提高18.44 dB HL）、SRT（提高17.08 dB HL）以及WRS（安静环境下提高27.00%，噪声环境下提高30.50%）。双耳听力在安静环境下的SRT有所改善（提高1.17 dB HL），在噪声环境下无显著差异，在声音定位测试中得到增强（均方根误差降低5.96°）。问卷调查表明尽管出现了皮肤反应，但使用体验令人满意。
长期常规使用ADHEAR系统的UMAA患儿不仅患耳的听力学性能得到增强，而且在双耳听力条件下的言语识别和声音定位方面也显示出潜在益处。使用者总体上对该设备表示满意，而在潮湿的亚热带气候中皮肤反应更为明显。
