Author(s)
Douglas M. Worrall, MD
Sida Chen, BA
George B. Wanna, MD
Maura K. Cosetti, MD
Affiliation(s)
Abstract:
Objective: The objective of this study is to compare speech perception, device use, and skin complications between pediatric atresia patients using a non-surgical bone anchored hearing (BAHA) on a soft band or transcutaneous magnetic stimulation (ie BAHA Attract TM.)Study design: case-control studySetting: Tertiary referral centerPatients: Two groups of age-matched pediatric patients with unilateral aural atresia who utilize a Cochlear Americas BAHA on a soft band (n=10) and those who use the BAHA Attract (n=10.) Patients with any sensorineural hearing loss (in either the amplified or non-atretic ear) and those who had undergone atresiaplasty were excluded.Intervention: Surgical placement of a transcutaneous bone conduction deviceMain outcome measure: Aided ear speech performance, Holgers classification for skin complicationsResults: Age, length of follow-up (8 months- 3 years) and bone conduction thresholds for the atretic and non- atretic ear were comparable between groups. Holdger classification for skin complications were comparable between groups, despite utilization of high strength magnets in some Attract patients (n=5 using >/= #5 magnets.) Speech perception testing was comparable between groups, with a trend toward improved performance in the surgical group.Conclusion: Minimal complications following Attract surgery and skin irritation following long-term soft band use suggest these are comparable options. Parents may consider the impact of future auricular reconstruction for microtia and improved speech perception in patients with the BAHA Attract when navigating amplification options.Define Professional Practice Gap & Educational Need: 1. Incomplete understanding of benefits of surgical intervention for bone anchored hearing as compared to non-surgical options 2. Lack of awareness of factors involve in surgical decision-making process of parents of children with aural atresiaLearning Objective: to provide direct comparison of surgical intervention with the BAHA attract with continued use of the soft band BAHA in pediatric patients with aural atresia - complete understanding of the complications related to each optionDesired Result: Attendees will have greater understanding of the outcomes and complications related to each option and will have improved ability to counsel parents as they navigate these treatment decisionsIRB or IACUC Approval: ApprovedLevel of Evidence: 4