Clin Exp Otorhinolaryngol.  2016 Mar;9(1):21-26. 10.21053/ceo.2016.9.1.21.

Surgical and Audiologic Comparison Between Sophono and Bone-Anchored Hearing Aids Implantation

• Shin JW
• Kim SH
• Choi JY
• Park HJ
• Lee SC
• Choi JS
• Park HQ
• Lee HK

• KMID: 2166278
• DOI: http://doi.org/10.21053/ceo.2016.9.1.21

Abstract

OBJECTIVES
Bone-anchored hearing aids (BAHA) occasionally cause soft tissue problems due to abutment. Because Sophono does not have abutment penetrating skin, it is thought that Sophono has no soft tissue problem relating to abutment. On the other hand, transcutaneous device's output is reported to be 10 to 15 dB lower than percutaneous device. Therefore, in this study, Sophono and BAHA were compared to each other from surgical and audiological points of view.
METHODS
We retrospectively reviewed the medical records of 9 Sophono patients and 10 BAHA patients. In BAHA cases, single vertical incision without skin thinning technique was done. We compared Sophono to BAHA by operation time, wound healing time, postoperative complications, postoperative hearing gain after switch on, and postoperative air-bone gap.
RESULTS
The mean operation time was 60 minutes for Sophono and 25 minutes for BAHA. The wound healing time was 14 days for Sophono and 28 days for BAHA. No major intraoperative complication was observed. Skin problem was not observed in the 2 devices for the follow-up period. Postoperative hearing gain of bilateral aural atresia patients was 39.4 dB for BAHA (n=4) and 25.5 dB for Sophono (n=5). However, the difference was not statistically significant. In all patients included in this study, the difference of air-bone gap between two groups was 16.6 dB at 0.5 kHz and 18.2 dB at 4 kHz. BAHA was statistically significantly better than Sophono.
CONCLUSION
Considering the audiologic outcome, BAHA users were thought to have more audiologic benefit than Sophono users. However, Sophono had advantages over BAHA with abutment in cosmetic outcome. Sophono needed no daily skin maintenance and soft tissue complication due to abutment would not happen in Sophono. Therefore, a full explanation about each device is necessary before deciding implantation.

Keyword

Hearing Aids; Hearing Loss; Hearing Loss, Conductive; Aural Atresia, Congenital; Bone Conduction

MeSH Terms

Bone Conduction
Follow-Up Studies
Hand
Hearing Aids*
Hearing Loss
Hearing Loss, Conductive
Hearing*
Humans
Intraoperative Complications
Medical Records
Postoperative Complications
Retrospective Studies
Skin
Wound Healing

Figure

• 

  Fig. 1. Operative procedure of Sophono. (A) The curved skin incision is marked using the template. Seven to 8 cm-sized curved incision was made along the template at the postauricular area. (B) The pericranium was dissected and elevated anteriorly enough to drill and insert the implantable component. (C) Well for implantable component was drilled. The recommended size of the well was 2.5 mm in depth and 10 mm in diameter. It could be gazed by the template. (D) Another drillings for five screws were done. After then, the implant was fixed by five titanium screws.

• 

  Fig. 2. The comparison of the bilateral aural atresia patients (Sophono, n=5; BAHA, n=4). (A) Unaided mean AC hearing of BAHA was 62.8 dB and aided mean free-field AC hearing was 22.2 dB. Postoperative hearing gain was 40.6 dB. (B) Unaided mean AC hearing of Sophono was 53.7 dB and aided mean free-field AC hearing was 23.7 dB. Postoperative hearing gain was 30 dB. BAHA was better than the Sophono in the postoperative hearing gain, but the difference was not statistically significant. BAHA, bone-anchored hearing aids; AC, air-conduction; BC, bone-conduction; HL, hearing loss.

• 

  Fig. 3. The postoperative AB gap comparison of all patients included in this study (Sophono, n=9; BAHA, n=10). We compared postoperative AB gap of Sophono and BAHA according to the frequency. BAHA was better than Sophono in the AB gap, and the difference of 0.5 and 4 kHz was statistically significant. AB, air-bone; BAHA, bone-anchored hearing aids; HL, hearing loss.

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  Fig. 4. The audiogram of patient who was implanted both Sophono and BAHA. Hearing gain of BAHA was better than Sophono in all audiologic frequencies. (A) Preoperative audiogram. (B) Aided audiogram. BAHA, bone-anchored hearing aids; B, BAHA; S, Sophono; HL, hearing loss.

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