Comparative effects of unilateral and bilateral bone conduction hearing devices on functional hearing and sound localization abilities in patients with bilateral microtia-atresia

Abstract

Background: Various amplification options are available for patients with congenital bilateral conductive hearing loss. Unilateral bone conduction hearing device (BCHD) is widely used for these patients, whereas benefits of bilateral BCHDs in certain subgroups of patients require further exploration.

Objectives: To evaluate functional and directional hearing in patients with unilateral Bonebridge (MEDEL) and contralateral ADHEAR (MEDEL) devices.

Materials and methods: This study included 32 patients (20 males, 12 females), of mean age 11.8 years (range 7–27 years). Hearing thresholds, speech perception and sound localization were tested three months after activation of the Bonebridge under three conditions: unaided, unilateral BHCD (Bonebridge) and bilateral BHCDs (Bonebridge plus contralateral ADHEAR). Patient acceptance of these devices in daily life was evaluated by questionnaire.

Results: Compared with unaided, the mean hearing thresholds (0.5, 1, 2, and 4 kHz) and speech perception with unilateral BCHD and bilateral BCHDs were improved significantly (p < .05 each). Markers of directional hearing ability, including percentages of accurate responses, bias angles and RMS errors, were significantly better with bilateral BCHDs than unilateral BHCD (p < .05 each). Questionnaire revealed high patient satisfaction with both unilateral and bilateral devices.

Conclusions: Functional hearing and sound localization abilities were better with bilateral BCHDs than unilateral BCHD.

Chinese abstract

背景：先天性双侧传导性听力损失患者可以使用多种扩音选择。单侧骨传导听力装置（BCHD）被广泛用于这些患者, 而双侧BCHD对于某些患者亚组的益处尚需进一步探索。

目的：评估带单侧骨桥（MEDEL）和对侧ADHEAR（MEDEL）装置的患者的功能性和定向性听力。

材料和方法：本研究包括32例平均年龄为11.8岁（范围7–27年）的患者（男性20例, 女性12例）。在Bonebridge激活三个月后, 在以下三种情况下对听力阈值、语音感知和声音本地化进行了测试：无装置、BHCD（骨桥）和双侧BHCD（骨桥加对侧ADHEAR）。通过问卷调查评估了接受这些装置的患者在日常生活中的使用情况。

结果：与独立疗法相比, 接受单侧BCHD和双侧BCHD的患者的平均听力阈值（0.5、1、2和4 kHz）和语音知觉得到了显著改善（p <0.05）。定向听觉能力的标示, 包括准确响应的百分比、偏角和RMS误差, 在双边BCHD情况下明显好于单侧BHCD（每种都是p <.05）。问卷调查显示患者对单侧和双侧装置的高度满意。

结论：双侧BCHD的功能性听力和声音定位能力优于单侧BCHD。

Keywords:

• Congenital microtia
• Bonebridge
• transcutaneous
• sound localization

Disclosure statement

The authors report no conflicts of interest and have received no payment in the preparation of this manuscript. The authors alone are responsible for the content and writing of this paper.

Author contributions

Xiaowei Chen acted as head surgeon for the Bonebridge performed in this study and collected data. Xinmiao Fan analyzed data, composed the manuscript, and participated in some of the operations as an assistant. Lu Ping analyzed data and composed the manuscript. Xiaomin Niu, Tengyu Yang, Xin Xia, Ruzhen Gao and Yue Fan participated in some of the operations as assistants, and collected and analyzed data. All authors read and approved the final manuscript.

Additional information

Funding

This work was supported by grant to Xiaowei Chen from the General Programs of National Natural Science Foundation of China (81974143) and The National Key Research and Development Program of China (2016YFC0901501).