Long-term hearing performance and soft tissue outcomes of Baha@ Attract
system in patients with bilateral congenital microtia in a single center
Abstract
Abstract: Background: Baha Attract System was designed as non-skin
penetrating bone conduction implant to minimize skin complication.
However, there were insufficient studies on its long-time acoustic
outcome and safety in microtia patients with auricle reconstruction
surgeries, who have thinner retroauricular subcutaneous layer and
theoretically vulnerable skin at the implant side. Objectives: To
analysis the long-term hearing performance and soft tissue complications
of Baha@ Attract System in microtia population. Study Design & setting:
A prospective cohort study at single tertiary referral center. Patients:
Twenty Mandarin-speaking patients with congenital bilateral microtia who
were underwent Baha@ Attract implantation with or without auricle
reconstruction surgeries simultaneously. Main Outcome Measure(s):
Comparative analysis of audiological test results including hearing
thresholds and speech recognition in quiet and in noise were pre- and
post-operatively performed. subjective benefit as measured with the SSQ
Scale. Soft tissue outcomes were monitored and documented. Results: The
mean follow-up time was 36.11±3.30 months. Significant and stable
improvements in hearing threshold and speech understanding in noise and
quiet were demonstrated with aided condition. Subject evaluation
revealed high level of patients’ satisfaction with the amplification in
all the subscales. Adverse events including skin necrosis increased
after one year post-operatively. Soft tissue evolution including sin
thinning, erythema, epidermis atrophy, soft tissue atrophy, skin
necrosis was seen or once developed in most of the participants.
However, prevalence of severe soft tissue complication was not higher to
non-microtia population. Conclusions: Baha@ Attract System provides
favorable and stable hearing improvements for microtia patients.
Combining plastic surgeries with implantation will not increase the
prevalence of soft tissue complication. However, long-term soft tissue
problems should be highly aware of even after one year post
implantation. Key words: Baha Attract, microtia, hearing, soft tissue,
skin necrosis