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https://codas.org.br/article/doi/10.1590/2317-1782/20232022271pt
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Artigo Original

Reabilitação auditiva com sistemas Baha® transcutâneo e percutâneo

Hearing rehabilitation with Baha® transcutaneous and percutaneous systems

Eliane Aparecida Techi Castiquini; Kátia de Freitas Alvarenga; Lucilena Miranda de Souza; Valdéia Vieira de Oliveira; Juliana Nogueira Chaves; Luiz Fernando Manzoni Lourençone; Rubens Vuono de Brito Neto

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Resumo

RESUMO: Objetivo: Verificar longitudinalmente a influência dos limiares tonais auditivos obtidos com as próteses auditivas ancoradas no osso transcutâneas e percutâneas na percepção da fala em indivíduos com malformação de orelha externa e/ou média e Otite Média Crônica.

Método: Estudo observacional, retrospectivo, de seguimento longitudinal de 30 indivíduos usuários unilaterais de sistema Baha® transcutâneo e percutâneo, para coleta de dados secundários dos limiares tonais obtidos por meio da audiometria em campo livre e do limiar de reconhecimento de sentenças no silêncio e no ruído nas condições: sem a prótese; no momento de ativação; no primeiro mês de uso (pós 1); e no terceiro mês (pós 2).

Resultados: Houve diferença significante entre os limiares tonais obtidos nas frequências de 3 e 4kHz, com melhores resultados para o percutâneo em todos os momentos de avaliação. Para os dois sistemas, observou-se melhor desempenho no reconhecimento de sentenças no silêncio e ruído, com diferença significante na ativação (p<0,001), porém manteve-se estável nos demais momentos de avaliação. O sistema percutâneo mostrou melhor benefício no reconhecimento de sentenças no ruído apenas na ativação (p=0,036), quando comparado ao transcutâneo.

Conclusão: O sistema percutâneo possibilitou melhor audibilidade para as frequências altas; contudo, tal audibilidade não influenciou no reconhecimento de sentenças na situação de silêncio para ambos os sistemas. Para a situação de ruído, melhores respostas foram observadas no sistema percutâneo; porém, a diferença não se manteve no decorrer do tempo.

Palavras-chave

Condução Óssea, Malformação de Orelha, Audiometria da Fala, Perda Auditiva, Auxiliares de Audição

Abstract

Purpose: Longitudinally verify the influence of auditory tonal thresholds obtained with transcutaneous and percutaneous bone-anchored hearing aids on speech perception in individuals with external and/or middle ear malformation and chronic otitis media.

Methods: Observational, retrospective, longitudinal follow-up study of 30 unilateral users of the transcutaneous and percutaneous Baha® system for the collection of secondary data on pure tone thresholds obtained through free field audiometry and sentence recognition threshold in silence and noise in conditions: without the prosthesis; at the time of activation; in the first month of use (post 1); and in the third month (post 2).

Results: There was a significant difference between pure tone thresholds obtained at frequencies of 3 and 4kHz with better results for the percutaneous technique at all evaluation moments. For both systems, better performance was observed in sentence recognition in silence and in noise, with a significant difference in activation (p<0.001), but it remained stable during the other evaluation moments. The percutaneous system showed better benefit in recognizing sentences in noise only on activation (p=0.036), when compared to the transcutaneous system.

Conclusion: The percutaneous system provided better audibility for high frequencies; however, such audibility did not influence sentence recognition in the silent situation for both systems. For the noise situation, better responses were observed in the percutaneous system, however, the difference was not maintained over time.

Keywords

Bone Conduction; Ear Malformation; Speech Audiometry; Hearing Loss; Hearing Aids

Referências

1 Jardim IS, Brito R No, Costa OA. Próteses auditivas cirurgicamente implantáveis de orelha média. In: Boéchat EM, Menezes PL, Couto CM, Frizzo ACF, Scharlach RC, Anastasio ART, editores. Tratado de audiologia. 2. ed. Rio de Janeiro: Guanabara Koogan; 2015. p. 342-52.

2 Fan X, Yang T, Niu X, Wang Y, Fan Y, Chen X. Long-term outcomes of bone conduction hearing implants in patients with bilateral microtia-atresia. Otol Neurotol. 2019;40(8):998-1005. http://dx.doi.org/10.1097/MAO.0000000000002370. PMid:31318785.

3 Beutner D, Delb W, Frenzel H, Hoppe U, Hüttenbrink KB, Mlynski R, et al. Guideline implantable hearing aids: short version. HNO. 2018;66(Supl. 2):71-6. http://dx.doi.org/10.1007/s00106-018-0533-2. PMid:30259069.

4 Consensus statement on bone conduction devices and active middle ear implants in conductive and mixed hearing loss. Otol Neurotol. 2022;43(5):513-29. http://dx.doi.org/10.1097/MAO.0000000000003491. PMid:35383700.

5 Park MJ, Lee JR, Yang CJ, Yoo MH, Jin IS, Choi CH, et al. Amplification of transcutaneous and percutaneous bone-conduction devices with a test-band in an induced model of conductive hearing loss. Int J Audiol. 2016;55(11):653-7. http://dx.doi.org/10.1080/14992027.2016.1193234. PMid:27347717.

6 Röösli C, Dobrev I, Pfiffner F. Transcranial attenuation in bone conduction stimulation. Hear Res. 2022;419:108318. http://dx.doi.org/10.1016/j.heares.2021.108318. PMid:34334219.

7 Reinfeldt S, Håkansson B, Taghavi H, Eeg-Olofsson M. New developments in bone-conduction hearing implants: a review. Med Devices. 2015;8:79-93. http://dx.doi.org/10.2147/MDER.S39691. PMid:25653565.

8 Gawęcki W, Stieler OM, Balcerowiak A, Komar D, Gibasiewicz R, Karlik M, et al. Surgical, functional and audiological evaluation of new Baha(®) Attract system implantations. Eur Arch Otorhinolaryngol. 2016;273(10):3123-30. http://dx.doi.org/10.1007/s00405-016-3917-5. PMid:26899281.

9 Brasil. Ministério da Saúde. Portaria GM/MS nº 2776, de 18 de dezembro de 2014. Diretrizes gerais para a atenção especializada às pessoas com deficiência auditiva no Sistema Único de Saúde (SUS) [Internet]. Diário Oficial da União; Brasília; 2014 [citado em 2022 Nov 22]. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_gerais_atencao_especializada_pessoas_deficiencia_auditiva_SUS.pdf

10 den Besten CA, Monksfield P, Bosman A, Skarzynski PH, Green K, Runge C, et al. Audiological and clinical outcomes of a transcutaneous bone conduction hearing implant: six-month results from a multicentre study. Clin Otolaryngol. 2019;44(2):144-57. http://dx.doi.org/10.1111/coa.13248. PMid:30358920.

11 Scotta G, Allam A, Dimitriadis PA, Wright K, Yardley M, Ray J. Surgical and functional outcomes of two types of transcutaneous bone conduction implants. J Laryngol Otol. 2020;134(12):1065-8. http://dx.doi.org/10.1017/S0022215120002339. PMid:33336637.

12 Rahne T, Plontke SK. Systematic and audiological indication criteria for bone conduction devices and active middle ear implants. Hear Res. 2022;421:108424. http://dx.doi.org/10.1016/j.heares.2021.108424. PMid:34987018.

13 Fritz CG, Bojrab DI 2nd, Lin KF, Schutt CA, Babu SC, Hong RS. Surgical explantation of bone-anchored hearing devices: a 10-year single institution review. Otolaryngol Head Neck Surg. 2020;162(1):95-101. http://dx.doi.org/10.1177/0194599819879653. PMid:31570059.

14 Kruyt IJ, Monksfield P, Skarzynski PH, Green K, Runge C, Bosman A, et al. Results of a 2-year prospective multicenter study evaluating long-term audiological and clinical outcomes of a transcutaneous implant for bone conduction hearing. Otol Neurotol. 2020;41(7):901-11. http://dx.doi.org/10.1097/MAO.0000000000002689. PMid:32310837.

15 Verstraeten N, Zarowski AJ, Somers T, Riff D, Offeciers EF. Comparison of the audiologic results obtained with the bone-anchored hearing aid attached to the headband, the testband, and to the “snap” abutment. Otol Neurotol. 2009;30(1):70-5. http://dx.doi.org/10.1097/MAO.0b013e31818be97a. PMid:18957902.

16 Hol MKS, Nelissen RC, Agterberg MJH, Cremers CWRJ, Snik AFM. Comparison between a new implantable transcutaneous bone conductor and percutaneous bone-conduction hearing implant. Otol Neurotol. 2013;34(6):1071-5. http://dx.doi.org/10.1097/MAO.0b013e3182868608. PMid:23598702.

17 Ellsperman SE, Nairn EM, Stucken EZ. Review of bone conduction hearing devices. Audiology Res. 2021;11(2):207-19. http://dx.doi.org/10.3390/audiolres11020019. PMid:34069846.

18 Ontario Health (Quality). Implantable devices for single-sided deafness and conductive or mixed hearing loss: a health technology assessment. Ont Health Technol Assess Ser. 2020;20(1):1-165. PMid:32194878.

19 Iseri M, Orhan KS, Tuncer U, Kara A, Durgut M, Guldiken Y, et al. Transcutaneous bone-anchored hearing aids versus percutaneous ones: multicenter comparative clinical study. Otol Neurotol. 2015;36(5):849-53. http://dx.doi.org/10.1097/MAO.0000000000000733. PMid:25730451.

20 Tobia A, Yehudai N, Khnifes R, Shpak T, Roth O, Khayr R, et al. Hearing outcomes with percutaneous and transcutaneous BAHA® technology in conductive and mixed hearing loss. Otol Neurotol. 2021;42(9):1382-9. http://dx.doi.org/10.1097/MAO.0000000000003231. PMid:34528924.

21 Costa MJ. Lista de sentenças em português: apresentação e estratégias de aplicação na audiologia. Santa Maria: Pallotti; 1998.

22 Levitt H, Rabiner LR. Binaural release from masking for speech and gain in intelligibility. J Acoust Soc Am. 1967;42(3):601-8. http://dx.doi.org/10.1121/1.1910629. PMid:6073973.

23 Rigato C, Reinfeldt S, Håkansson B, Jansson KJ, Hol MK, Eeg-Olofsson M. Audiometric comparison between the first patients with the transcutaneous bone conduction implant and matched percutaneous bone anchored hearing device users. Otol Neurotol. 2016;37(9):1381-7. http://dx.doi.org/10.1097/MAO.0000000000001183. PMid:27631828.

24 Lippmann E, Pritchett C, Ittner C, Hoff SR. Transcutaneous osseointegrated implants for pediatric patients with aural atresia. JAMA Otolaryngol Head Neck Surg. 2018;144(8):704-9. http://dx.doi.org/10.1001/jamaoto.2018.0911. PMid:29978214.

25 Vaughan-Christensen L, Reed K, Smith-Olinde L. Audiological outcomes utilizing a transcutaneous ossseointegrated implant system in pediatric patients. J Otolaryngol ENT Res. 2019;11(1):90-5. http://dx.doi.org/10.15406/joentr.2019.11.00415.

26 Oberlies NR, Castaño JE, Freiser ME, McCoy JL, Shaffer AD, Jabbour N. Outcomes of BAHA connect vs BAHA attract in pediatric patients. Int J Pediatr Otorhinolaryngol. 2020;135:110125. http://dx.doi.org/10.1016/j.ijporl.2020.110125. PMid:32497910.

27 Moore BC. A review of the perceptual effects of hearing loss for frequencies above 3 kHz. Int J Audiol. 2016;55(12):707-14. http://dx.doi.org/10.1080/14992027.2016.1204565. PMid:27414746.

28 Rahim SA, Goh BS, Zainor S, Rahman RA, Abdullah A. Outcomes of bone anchored hearing aid implant at Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Indian J Otolaryngol Head Neck Surg. 2018;70(1):28-32. http://dx.doi.org/10.1007/s12070-017-1193-3. PMid:29456939.

29 Catalani B, Sassi TSS, Bucuvic EC, Lourençone LFM, Alvarenga KF, Brito RV No. Prótese auditiva ancorada ao osso percutânea: benefícios auditivos. Audiol Commun Res. 2021;26:e2412. http://dx.doi.org/10.1590/2317-6431-2020-2412.
 


Submetido em:
22/11/2022

Aceito em:
01/05/2023

66576d5fa953955c31197df4 codas Articles

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