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DOI: 10.1055/s-0044-1788910
Hearing Performance and Soft-Tissue Outcomes of Minimally Invasive Ponto Surgery and Local Anesthesia in Children with Unilateral Craniofacial Malformation
Autor*innen
Funding The authors declare that they did not receive funding from agencies in the public, commercial, or not-for-profit sectors to conduct the present study.
Abstract
Introduction Minimally invasive Ponto surgery (MIPS) enables the installation of percutaneous bone-anchored hearing implants (BAHIs) with a drill guide through a hole punch incision. Despite being well established for adults, there is a lack of studies in the literature regarding its use in pediatric patients.
Objective The aim of the present study was to investigate the hearing performance and soft-tissue outcomes of the use of MIPS under local anesthesia in children with unilateral craniofacial malformation (UCM).
Methods The study used a retrospective cohort design. Nine subjects with UCM, aged between 6.5 and 17.1 (median = 12) years, who underwent the MIPS procedure under local anesthesia were included. Surgical procedure, intra, and postoperative complications were investigated. Speech recognition thresholds in quiet (SRTQ) and in noise (SRTN), daily use, satisfaction, and perceptual listening effort of the subjects were assessed after 4 months of postoperative follow-up.
Results It was possible to perform MIPS under local anesthesia in 8 of 9 subjects, with no intraoperative complications. One subject (11.11%) showed adverse skin reactions during a mean follow-up period of 11.4 months with MIPS. Speech recognition thresholds in quiet, SRTN, and subjective listening effort scores significantly decreased with the use of BAHI. The subjects were overall satisfied with the device and using it 8.2 hours/day, on average.
Conclusion Under local anesthesia, MIPS showed to be a viable option for BAHI installation in children with UCM. The hearing performance of the subjects improved, and they were globally satisfied with the device. Soft-tissue complications were minimal, and our results are comparable to those reported in the literature for adults.
Keywords
bone conduction - minimally invasive - bone drilling - craniofacial abnormalities - bone-anchored prosthesis - childrenDeclaration of Competing Interest
F.D. works at Oticon Medical. The remaining authors declare no competing interests.
Publikationsverlauf
Eingereicht: 21. Februar 2024
Angenommen: 17. Juni 2024
Artikel online veröffentlicht:
27. Januar 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
Andrea Caruso Leone, Arthur Menino Castilho, Fabiana Danieli, Daniela Bortoloti Calil, Katia de Almeida. Hearing Performance and Soft-Tissue Outcomes of Minimally Invasive Ponto Surgery and Local Anesthesia in Children with Unilateral Craniofacial Malformation. Int Arch Otorhinolaryngol 2025; 29: s00441788910.
DOI: 10.1055/s-0044-1788910
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References
- 1 Stenfelt S. Acoustic and physiologic aspects of bone conduction hearing. Adv Otorhinolaryngol 2011; 71: 10-21
- 2 Yu JK, Wong LL, Tsang WS, Tong MC. A tutorial on implantable hearing amplification options for adults with unilateral microtia and atresia. BioMed Res Int 2014; 2014: 703256
- 3 Ricci G, Della Volpe A, Faralli M. et al. Results and complications of the Baha system (bone-anchored hearing aid). Eur Arch Otorhinolaryngol 2010; 267 (10) 1539-1545
- 4 Kruyt IJ, Bakkum KHE, Caspers CJI, Hol MKS. The efficacy of bone-anchored hearing implant surgery in children: A systematic review. Int J Pediatr Otorhinolaryngol 2020; 132: 109906
- 5 Hultcrantz M. Outcome of the bone-anchored hearing aid procedure without skin thinning: a prospective clinical trial. Otol Neurotol 2011; 32 (07) 1134-1139
- 6 Bezdjian A, Smith RA, Gabra N, Yang L, Bianchi M, Daniel SJ. Experience with Minimally Invasive Ponto Surgery and Linear Incision Approach for Pediatric and Adult Bone Anchored Hearing Implants. Ann Otol Rhinol Laryngol 2020; 129 (04) 380-387
- 7 French G, Lee KH, Yunker WK. A retrospective evaluation of minimally invasive ponto surgery (MIPS) in two pediatric centers. Cochlear Implants Int 2021; 22 (05) 265-269
- 8 Sardiwalla Y, Jufas N, Morris DP. Direct cost comparison of minimally invasive punch technique versus traditional approaches for percutaneous bone anchored hearing devices. J Otolaryngol Head Neck Surg 2017; 46 (01) 46
- 9 Holgers KM, Tjellstrom A, Bjursten LM, Erlandsson BE. Soft tissue reactions around percutaneous implants: a clinical study on skin-penetrating titanium implants used for bone-anchored auricular prostheses. Int J Oral Maxillofac Implants 1987; 2 (01) 35-39
- 10 den Besten CA, Stalfors J, Wigren S. et al. Stability, Survival, and Tolerability of an Auditory Osseointegrated Implant for Bone Conduction Hearing: Long-Term Follow-Up of a Randomized Controlled Trial. Otol Neurotol 2016; 37 (08) 1077-1083
- 11 Costa MJ, Iório MCM, Albernaz PLM. Desenvolvimento de um teste para avaliar a habilidade de reconhecer a fala no silêncio e no ruído. Pro Fono 2000; 12 (02) 9-16
- 12 Levitt H, Rabiner LR. Binaural release from masking for speech and gain in intelligibility. J Acoust Soc Am 1967; 42 (03) 601-608
- 13 Cox RM, Alexander GC. Measuring Satisfaction with Amplification in Daily Life: the SADL scale. Ear Hear 1999; 20 (04) 306-320
- 14 McDermott AL, Williams J, Kuo M, Reid A, Proops D. The birmingham pediatric bone-anchored hearing aid program: a 15-year experience. Otol Neurotol 2009; 30 (02) 178-183
- 15 Ghossaini SN, Roehm PC. Osseointegrated Auditory Devices: Bone-Anchored Hearing Aid and PONTO. Otolaryngol Clin North Am 2019; 52 (02) 243-251
- 16 Willenborg K, Avallone E, Maier H, Lenarz T, Busch S. A New Active Osseointegrated Implant System in Patients with Single-Sided Deafness. Audiol Neurotol 2022; 27 (01) 83-92
- 17 Plomp R, Mimpen AM. Improving the reliability of testing the speech reception threshold for sentences. Audiology 1979; 18 (01) 43-52
- 18 Kunst SJ, Leijendeckers JM, Mylanus EA, Hol MK, Snik AF, Cremers CW. Bone-anchored hearing aid system application for unilateral congenital conductive hearing impairment: audiometric results. Otol Neurotol 2008; 29 (01) 2-7
- 19 Pichora-Fuller MK, Kramer SE, Eckert MA. et al. Hearing Impairment and Cognitive Energy: The Framework for Understanding Effortful Listening (FUEL). Ear Hear 2016; 37 (Suppl. 01) 5S-27S
- 20 Hornsby BW. The effects of hearing aid use on listening effort and mental fatigue associated with sustained speech processing demands. Ear Hear 2013; 34 (05) 523-534
- 21 Lunner T, Rudner M, Rosenbom T, Ågren J, Ng EH. Using Speech Recall in Hearing Aid Fitting and Outcome Evaluation Under Ecological Test Conditions. Ear Hear 2016; 37 (Suppl. 01) 145S-154S
- 22 Bianchi F, Wendt D, Wassard C. et al. Benefit of Higher Maximum Force Output on Listening Effort in Bone-Anchored Hearing System Users: A Pupillometry Study. Ear Hear 2019; 40 (05) 1220-1232
- 23 Dutt SN, McDermott AL, Burrell SP, Cooper HR, Reid AP, Proops DW. Patient satisfaction with bilateral bone-anchored hearing aids: the Birmingham experience. J Laryngol Otol Suppl 2002; (28) 37-46
- 24 Gunduz B, Bilgin C, Gokdogan C, Tutar H, Bayazıt YA, Goksu N. Hearing Amplification and Quality of Life with Bone Anchored Hearing Aid (BAHA) in Turkish Population. J Int Adv Otol 2013; 9: 55-60
- 25 Badran K, Bunstone D, Arya AK, Suryanarayanan R, Mackinnon N. Patient satisfaction with the bone-anchored hearing aid: a 14-year experience. Otol Neurotol 2006; 27 (05) 659-666