The BAHA hearing system for hearing-impaired postirradiated nasopharyngeal cancer patients: a new indication.
BACKGROUND
Radiation for patients who have nasopharyngeal cancer (NPC) often renders them hearing challenged and facing difficulties from treatment sequelae such as chronic suppurative otitis media and osteoradionecrosis. Conventional hearing aids aggravate otorrhea, and ear moulds traumatize osteoradionecrosis ulcers in the ear canal. The bone-anchored hearing aid (BAHA) hearing system might represent an excellent hearing solution.


OBJECTIVE
To investigate the BAHA benefit and osseointegration results for hearing-impaired postirradiated NPC patients.


METHODS
A prospective longitudinal study.


METHODS
Tertiary university center.


METHODS
Eleven hearing-impaired postirradiated NPC patients were studied from October 2002 to October 2006.


METHODS
Two-stage BAHA surgeries were performed. Assessments include pure-tone and speech audiometry, implant integrity, periabutment audit, and patient satisfaction analysis during a 24-month period. Radiation dosimetric analysis and bone sampling at the fixture implant sites were studied.


RESULTS
No implant fixtures were lost (follow-up, 13-58 mo). Average patient satisfaction scores were 84.4%, with 80% using their BAHA everyday and 90% using their devices for more than 8 hours. Dosimetric analysis of the implant site revealed that all fixtures were outside the irradiated field. There was a reduction in otorrhea rates after BAHA use over the course of the study.


CONCLUSIONS
Successful osseointegration was demonstrated in postirradiated NPC patients. Improved subjective hearing clarity, reduced ear discharge rates, and extended BAHA usage times accounted for high patient satisfaction with the BAHA hearing system. This is the first study to demonstrate long-term osseointegration and hearing benefit in postirradiated NPC patients. We recommend the BAHA hearing system for the treatment of chronic suppurative otitis media-related hearing problems in NPC patients.
Department of Otorhinolaryngology, Head and Neck Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China. gsoo@ent.cuhk.edu.hk
Gordon
G
Soo
Michael C F
MC
Tong
Willis S S
WS
Tsang
Terence K C
TK
Wong
Ka-fai
KF
To
Sing-fai
SF
Leung
C Andrew
CA
van Hasselt
D000328:Adult; D000368:Aged; D019929:Cochlear Implantation / Q000295:instrumentation* / Q000379:methods; D003054:Cochlear Implants; D005260:Female; D034381:Hearing Loss / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011832:Radiation Injuries; D016896:Treatment Outcome