骨锚式助听器在双侧先天性外中耳畸形患者中的应用效果分析

The efficacy of bone anchored hearing aid application in patients with bilateral congenital aural atresia

目的:探讨骨锚式助听器(Baha)对双侧先天性外中耳畸形患者的应用效果。方法:选取双侧先天性外中耳畸形接受单侧Baha植入患者18例,分别于术前、术后行纯音测听,安静环境下及噪声下言语测试以及助听器效果评估简表(APHAB)评估,通过对比分析Baha对双侧先天性外中耳畸形患者的听功能改善效果。结果:18例患者术后助听听阈较术前平均降低(31.06±14.32)dB;安静环境下单音节言语识别率平均提高(62.4±31.1)%;噪声下言语识别率平均提高(34.3±10.8)%。APHAB评估结果显示在"交流的难易"、"背景噪声"及"回声"这3个分量表中植入Baha后的得分均明显低于术前,其差值分别为59.3±14.5、46.7±10.1和58.8±8.1,而在"对声音的厌恶程度"这一分量表中,应用Baha时得分却提高66.4±11.9。术后平均随访9.6个月,无骨融合失败、大出血、脑脊液漏、植入体脱出等严重并发症。3例患者曾出现桥基周围皮肤感染、肉芽组织增生,予以对症治疗后恢复良好。结论:双侧先天性外中耳畸形患者植入Baha后可显著改善其听力及言语识别能力,而患者主观满意度也较高,其主观评价与测试结果相一致。Baha植入手术风险较小,无严重并发症,是理想的听力解决方案之一。

Objective：To evaluate the efficacy of Bone anchored hearing aid（Baha） application in patients with bilateral congenital aural atresia. Method：Prospective study of 18 patients with bilateral congenital aural atresia received unilateral Baha implanted. Aided and unaided hearing was assessed using pure tone audiometry（PTA）, Speech Recognition in quiet and noisy circumstances and the abbreviated profile of hearing and benefit（APHAB） questionnaire. Result： The average decline in pure-tone threshold was（31.06±14.32）dB HL for those with implanted Baha. The average improvement in Mandarin speech test was（62.4±31.1） %, and the average improvement in hearing in noise test（HINT） was （34.3 ± 10.8）%. In the APHAB questionnaire survey, the mean Baha scores of ease of communication（EC）, backgroud noise and revereration were decreased by 59.3±14.5,46.7 ±10.1,58.8 ± 8.1 compared to the unaided scores, and the Baha score of aversiveness was （66.4±11.9） higher than the unaided score. After the mean 9.6 months＇s follow-up,no serious complications were recorded. Conclusion：Baha can significantly improve hearing ability and quality of life of patients with bilateral congenital aural atresia. It has been one of the most reliable methods of auditory rehabilitation.