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CC BY-NC 4.0 · Arch Plast Surg 2019; 46(06): 525-534
DOI: 10.5999/aps.2019.00661
Original Article

Safety and efficacy of transcutaneous bone conduction implant surgery for hearing improvement in microtia patients with bilateral hearing impairment

Jeong Hyun Cheon 
Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea
,
Hyung Chul Lee 
Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea
,
Gi Jung Im 
Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
,
Jung Youl Park 
Seoul Center for Developmental Ear Anomalies, BIO Plastic Surgery Clinic, Seoul, Korea
,
Chul Park 
Seoul Center for Developmental Ear Anomalies, BIO Plastic Surgery Clinic, Seoul, Korea
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Background In microtia patients with bilateral hearing impairment, hearing improvement is crucial for language development and performance. External auditory canal reconstruction (EACR) has been performed to improve hearing, but often results in complications. We performed transcutaneous bone conduction implant (TBCI) surgery in these patients. This study aimed to evaluate the safety and efficacy of TBCI surgery.

Methods A retrospective review was performed of five patients who underwent auricular reconstruction and TBCI surgery and 12 patients who underwent EACR between March 2007 and August 2018. Hearing improvement was measured based on the air-bone gap values using pure-tone audiometry over a 6-week postoperative period. We reviewed other studies on hearing improvement using EACR and compared the findings with our results. The surgical techniques for TBCI were reviewed through case analyses.

Results Postoperative hearing outcomes showed a significant improvement, with a mean gain of 34.1 dB in the TBCI cohort and 14.1 dB in the EACR cohort. Both gains were statistically significant; however, the TBCI cohort showed much larger gains. Only three of the 12 patients who underwent EACR achieved hearing gains of more than 20 dB, which is consistent with previous studies. All patients who underwent TBCI surgery demonstrated hearing gains of more than 20 dB and experienced no device-related complications.

Conclusions TBCI is a safe and effective method of promoting hearing gains in microtia patients with bilateral hearing impairment. TBCI surgery provided better hearing outcomes than EACR and could be performed along with various auricular reconstruction techniques using virgin mastoid skin.

Keywords

Congenital microtia - Ear canal - Hearing loss - Hearing aids - Bone conduction


Publication History

Received: 24 May 2019

Accepted: 19 September 2019

Article published online:
25 March 2022

© 2019. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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