Comparison of hearing outcomes in patients with congenital aural atresia managed with canaloplasty and bone conduction hearing devices

Abstract

Background

Treatment options for congenital aural atresia (CAA) include canaloplasty and implantation of an osseointegrated bone conduction device (OBCD). Few studies have compared hearing outcomes in these two treatment methods.

Objectives

Hearing outcomes and revision surgery rates were compared in CAA patients managed by canaloplasty and surgically implanted OBCD.

Methods

This study retrospectively analyzed 36 patients with CAA at a single institution. The same surgeon performed canaloplasty on 23 patients. Hearing outcomes before surgery as well as 3 and 6 months after surgery were compared to those of 13 patients with OBCD implantation.

Results

Postoperative hearing outcomes were better in the OBCD group, but the difference was not statistically significant. At 6-month follow-up, the hearing thresholds in the canaloplasty and OBCD group were 38.6 ± 21.4 and 31.9 ± 6.4 dB, respectively. The success rates 6 months after surgery were 75.0% in the canaloplasty group and 100% in the OBCD group. Two out of 23 patients in the canaloplasty group and 7 out of 13 patients in the OBCD group underwent revision surgery.

Conclusion

In terms of hearing, the outcome was better with the OBCD compared to canaloplasty. Canaloplasty may be an alternative option in patients who refuse OBCD implantation.

Chinese Abstract

背景：先天性耳道闭锁 (CAA) 的治疗选择包括耳道成形术和骨整合骨传导装置 (OBCD) 植入。比较这两种治疗方法的听力结果的研究很少。

目的：比较接受耳道成形术和OBCD植入术的CAA 患者的听力结果和修复手术率。

方法：本研究回顾性分析了一家医院的 36 名 CAA 患者。同一名外科医生对 23 名患者进行了耳道成形术。术前听力结果以及术后 3 个月和6 个月的听力结果与 13 名 OBCD 植入患者进行了比较。

结果：OBCD组术后听力结果较好, 但差异没有统计学显著性。在 6 个月时的随访中, 耳道成形术组和 OBCD 组的听力阈值分别为 38.6 ± 21.4 dB 和 31.9 ± 6.4 dB。术后 6 个月的成功率：耳道成形术组为 75.0%, OBCD 组为 100%。耳道成形术组 23 名患者中有 2 名以及 OBCD 组 13 名患者中有 7 名接受了修复手术。

结论：就听力而言, OBCD 的结果优于耳道成形术。对于拒绝OBCD植入的患者, 耳道成形术可能是一种选择。

Keywords:

• Congenital aural atresia
• canaloplasty
• bone conduction device
• hearing outcome

Disclosure statement

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

Additional information

Funding

This study was supported by the National Research Foundation (NRF) of Korea (NRF- 2017R1C1B3005431, 90%) and Seoul National University Hospital (0420180630, 2018- 1247, 10%).