BAHA in the auditory rehabilitation of patients with chronic cholesteatomatous otitis media
DOI:
https://doi.org/10.34631/sporl.3110Keywords:
Chronic cholesteatomatous otitis media, conductive hearing loss, mixed hearing loss, auditory rehabilitation, Bone Anchored Hearing Aid, otorrhea, quality of lifeAbstract
Introduction: The treatment of chronic cholesteatomatous otitis media (CCOM) is surgical and may require an open technique mastoidectomy. Hearing loss resulting from the disease and/or its surgical removal is traditionally corrected with tympanoplasty or conventional hearing aids, but other options are available, such as the Bone Anchored Hearing Aid (BAHA).
Objective: To evaluate the functional outcomes and impact on the quality of life of patients with CCOM rehabilitated with BAHA.
Material and Methods: All patients with CCOM who underwent auditory rehabilitation with BAHA in 2022 and 2023 at a Tertiary Hospital Center were included. Demographic data, surgical interventions performed for CCOM, pre- and post-implantation tonal and speech thresholds, type of anesthesia used, and complications associated with the procedure were collected. The impact on quality of life was assessed using the Nijmegen Cochlear Implant Questionnaire (NCIQ) validated for European Portuguese.
Results: Eight patients, seven female, with a mean age of 56 years, were rehabilitated with unilateral BAHA (a total of 8 ears) due to conductive hearing loss (1 patient) or mixed hearing loss (7 patients). All rehabilitated ears had undergone an open technique mastoidectomy for CCOM surgical treatment. All implanted BAHA devices were percutaneous.
Before implantation, the average tonal threshold of the nine patients was 87 dB, and the mean audiometric Rinne was 45 dB. The preoperative mean speech recognition threshold (SRT) was 69 dB. After implantation, the mean tonal thresholds improved to 38 dB, with an average tonal threshold improvement of 49 dB. The postoperative SRT mean was 32 dB.
Four patients presented skin alterations classified as grades 1 and 2 according to the Holgers classification, and there was one case of spontaneous pillar extrusion.
The average overall satisfaction score on the NCIQ was 79.36. The subdomains with the highest mean scores were speech production (86.25) and advanced sound perception (84.9). The self-esteem subdomain had the lowest mean score (66.48).
Conclusion: Auditory rehabilitation with BAHA proved effective in improving hearing thresholds and quality of life in CCOM patients who underwent open technique mastoidectomy, making it a valid option for their auditory rehabilitation. Cutaneous complications with percutaneous BAHA are frequent, highlighting the importance of skin care and monitoring around the pillar area.
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Copyright (c) 2025 Joana Guincho, Luís Baptista, Carlota Sousa, Beatriz Rodrigues, Ricardo Santos, Tiago Colaço, Beatriz Lança, Rui Cabral, Gonçalo Nunes, Assunção O’Neill, Pedro Escada
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