Comparison of Outcomes between Percutaneous and Transcutaneous Bone-anchored Hearing Aids in Bilateral Congenital Microtia
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维普
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目的 比较穿皮式与经皮式骨锚式助听器(bone anchored hearing aid,Baha)在双侧先天性小耳畸形患者中的应用效果.方法 回顾性选取2016年1月至2020年1月于首都医科大学附属北京天坛医院耳鼻喉科接受治疗的双侧先天性小耳畸形患者22例,根据术式不同分为穿皮式Baha组(A组)12例,经皮式Baha组(B组)10例.术前、术后分别进行纯音测听、安静及噪声条件下言语测试以及助听器效果评估简表(abbreviated profile of hearing aid benefit,APHAB)评估.结果 所有患者均无严重并发症,A组并发症发生率33％,B组并发症发生率20％.植入后,两组助听听阈均降低,差异均有统计学意义(P＜0.05);安静及噪声下言语识别率均提高,差异均有统计学意义(P＜0.05),两组听阈、言语识别率差值比较,差异无统计学意义(P＞0.05).两组APHAB评估中"交流的难易(ease of communication,EC)""背景噪声(backgroud noise,BN)""回声(revereration,RV)"评分均低于植入前,差异均有统计学意义(P＜0.05);两组"对声音的厌恶程度(aversiveness,AV)"评分均高于植入前,差异均有统计学意义(P＜0.05);A组APHAB评分与B组比较,差异无统计学意义(P＞0.05).结论 穿皮式Baha与经皮式Baha植入均可显著提高双侧先天性小耳畸形患者听力、言语识别能力及生活质量,但后者皮肤并发症较少,是更为理想的听力解决方案.
Objective To compare outcomes between percutaneous and transcutaneous bone-anchored hearing aids(Baha)in patients with bilateral congenital microtia.Methods Clinical data from 12 patients with bilateral microtia who received either percutaneous(n=12)or transcutaneous(n=10)Baha implantation from January 2016 to January 2020 were retrospectively analyzed,including pre-and post-operative pure tone audiometry(PTA),speech recognition in quiet and noise,and the bbreviated profile of hearing aid benefit(APHAB),and compared both within and between the groups.Results None of the 22 patients had serious complications.The incidence of complications was 33％in the percutaneous Baha group and 20％in the percutaneous Baha group,respectively.After implantation,hearing thresholds improved in both groups(P＜0.05),with improved speech recognition in both quiet and noise(P＜0.05)and no statistical-ly significant difference between the two groups.The subscales of"ease of communication(EC)","background noise(BN)"and"reverberation(RV)"in APHAB following implantation were lower than before implantation in both groups(P＜0.05),with increased"aversiveness(AV)"score(P＜0.05)and no significant difference between groups A and B(P＞0.05).Conclusion Both percutaneous and transcutaneous Baha can significantly improve hearing,speech recognition and ability in life in patients with bilateral congenital microtia,although the latter has fewer skin complications,which makes it more preferable.
维普
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