Total auricular reconstruction concomitant with BONEBRIDGE implantation using a retrosigmoid sinus approach

Abstract

Background

Retrosigmoid sinus (RS) approach was not the dominant choice for BONEBRIDGE implantation.

Objective

To investigate the efficacy and safety of auricular reconstruction concomitant with BONEBRIDGE implantation using retrosigmoid approach for aural atresia patients.

Materials and methods

A retrospective analysis was conducted of 15 children (28 ears) who underwent auricular reconstruction using a completely expanded postauricular flap with a skin expander concomitant with retrosigmoid BONEBRIDGE implantation from July 2019 to September 2020.

Results

All 15 patients healed well and had no bone conduction shift. Average SFT improvement was 27.1 dB HL (p < .001). Comparison between aided and unaided speech recognition rate in quiet and in noise showed significant improvements, respectively (p < .001). After a follow-up of 21-35 months, the hearing results were stable and the aesthetic outcomes were satisfying.

Conclusions and significance

For patients who undergo auricle reconstruction using expanded postauricular flap, retrosigmoid approach can avoid interfering the flap of reconstructed auricular without increasing the surgical risk or impact the clinical efficacy, and without significantly prolonging the total anesthesia time. The integrated surgical approach is a safe, and convenient option for patients who require simultaneous auricular reconstruction with BONEBRIDGE implantation.

Chinese Abstract

背景：乙状窦后 (RS) 入路不是 BONEBRIDGE 植入的主要选择。

目的：探讨耳道闭锁患者耳廓再造术并由乙状结肠后入路植入BONEBRIDGE的有效性和安全性。

材料和方法：2019 年 7 月至 2020 年 9 月期间, 对15 名儿童（28 只耳朵）使用带有皮肤扩张器的完全扩张的耳后皮瓣进行了耳廓重建, 同时进行乙状窦BONEBRIDGE 植入。对这些儿童进行了回顾性分析。

结果：15例患者愈合良好, 无骨传导移位。平均 SFT 改善为27.1 分贝 HL (p < .001)。安静和噪声环境下, 辅助和无辅助语音识别率的比较都显示出显著改善（p < .001）。经过 12-26 个月的随访, 听力结果稳定, 美学效果令人满意。

结论和意义：使用扩张的耳后皮瓣进行了耳廓重建的患者, 乙状窦后 (RS) 入路可以避免干涉重建耳廓的皮瓣, 不会增加手术风险或影响临床疗效, 且不会延长总的麻醉时间。综合手术方法对于需要通过 BONEBRIDGE 植入同时进行耳廓重建的患者来说是一种安全、方便的选择。

Keywords:

• Hearing implantation
• bone conduction hearing aid
• congenital aural atresia
• surgical strategy
• plastic surgery

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the General Programs of Beijing Municipal Science and Technology Commission under Grant [No. Z171100001017079].