Audiological results and subjective benefit of an active transcutaneous bone-conduction device in patients with congenital aural atresia

Abstract

Purpose: To review functional and subjective benefit after implantation of an active transcutaneous bone conduction device (BCD) in patients with congenital microtia with atresia or stenosis of the external auditory canal.

Methods: Retrospective chart analysis and questionnaire on the subjective impression of hearing ( Speech, Spatial and Qualities of Hearing Scale (SSQ-B) of patients treated between 2012 and 2015.

Resultsresults: 18 patients (24 ears) with conductive or mixed hearing loss in unilateral (n = 10) or bilateral (n = 8) atresia were implanted with a BCD. No major complications occurred after implantation. Preoperative unaided air conduction pure tone average at 0.5, 1, 2 and 4 kHz (PTA 4 ) was 69.2 ± 11.7 dB, while postoperative aided PTA 4 was 33.4 ± 6.3 dB, resulting in a mean functional hearing gain of 35.9 +/- 15.6 dB. Preoperatively, the mean monosyllabic word recognition score was 22.9 % ± 22.3 %, which increased to 87.1 % +/- 15.1 % in the aided condition. The Oldenburger Sentence Test at S₀N₀ revealed a decrease in signal-to-noise-ratio from - 0.58 ± 4.40 dB in the unaided to - 5.67 ± 3.21 dB in the postoperative aided condition for all patients investigated. 15 of 18 patients had a subjective benefit showing a positive SSQ-B score (mean 1.7).

Conclusion: The implantation of an active bone conduction device brings along subjective and functional benefit for patients with conductive or combined hearing loss.

Keywords: Bone conduction device; Bonebridge; Congenital aural atresia; Hearing rehabilitation; SSQ.

Fig. 1

Preoperative unaided (light grey) and postoperative Bonebridge-aided (dark grey) pure-tone air conduction threshold (PTA₄) as well as preoperative (grey, dotted) and postoperative (black, dotted) pure-tone bone-conduction threshold for all patients with atresia (n = 18). PTA₄ = pure-tone average at 0.5, 1, 2 and 4 kHz

Fig. 2

Discrimination rate tested with the German Freiburg test in a preoperative unaided and postoperative Bonebridge-aided condition for patients with unilateral atresia and unilateral implantation (n = 10)

Fig. 3

Discrimination rate tested with the German Freiburg test in a preoperative unaided and postoperative Bonebridge-aided condition for patients with bilateral atresia and bilateral implantation (n = 6)

Fig. 4

Bar diagram showing the Results of the Speech, Spatial, and Qualities of Hearing Scale (SSQ-B) for patients with unilateral atresia and unilateral implantation. Answers are selected from a Likert Scale ranging from  − 5 (maximal adverse effect) to 5 (maximal positive effect)

Fig. 5

Bar diagram showing the Results of the Speech, Spatial, and Qualities of Hearing Scale (SSQ-B) for patients with bilateral atresia and bilateral implantation. Answers are selected from a Likert Scale ranging from  − 5 (maximal adverse effect) to 5 (maximal positive effect)