After more than 25 years of clinical experience, the BAHA (bone-anchored hearing aid) system is a well-established treatment for hearing-impaired patients with conductive or mixed hearing loss. Owing to its success, the use of the BAHA system has spread and the indications for application have gradually become broader. New indications, as well as clinical applications, were discussed during scientific roundtable meetings in 2004 by experts in the field, and the outcomes of these discussions are presented in the form of statements. The issues that were discussed concerned BAHA surgery, the fitting range of the BAHA system, the BAHA system compared to conventional devices, bilateral application, the BAHA system in children, the BAHA system in patients with single-sided deafness, and, finally, the BAHA system in patients with unilateral conductive hearing loss.
Radial forearm free flaps are a good reconstructive option after oropharyngeal cancer extirpation. Our acoustic and aeromechanical results indicated that issues related to quality of the speech signal require further study for resections of half or more than half of the soft palate.
Objectives/Hypothesis
The free flap reconstructive protocols of the jaws have been refined over the years and presently are based on bone‐driven approaches that generally use the lower border of the mandible or the anterior surface of the maxilla as the templates for reconstruction because these contours are deemed important to the eventual cosmetic outcomes of patients. The ultimate goal of functional jaw reconstruction, however, is the reconstruction of the dental occlusion and oral rehabilitation. The purpose of the present study was to evaluate the Alberta reconstructive technique (ART), which is a new approach of occlusion‐driven jaw reconstruction with digitally planned immediate osseointegrated implant installation.
Study Design
Prospective cohort study.
Methods
This research study considers the ART's safety, effectiveness, accuracy, timeliness of reconstruction, aesthetic appeal, and cost‐effectiveness in comparison with the standard bone‐driven and delayed osseointegrated implant installation (BDD) protocol.
Results
The ART procedures were as safe and more effective at achieving full occlusal reconstruction and oral rehabilitation. The ART cohort of patients achieved oral rehabilitation in 21.4 month as compared to 73.1 months for the BDD cohort. There were no differences in the aesthetic appeal the two groups. The ART cost an average of $22,004 less than BDD and we calculated the quality adjusted life years gain to be between 2.14 and 4.04 in favour of ART.
Conclusions
The ART is a good option for patients with jaw defects. It provides a safe, effective, accurate, aesthetic, and cost‐effective reconstruction that restores form and function in a timely manner.
Level of Evidence
2b Laryngoscope, 129:S1–S14, 2019
Results from instrumental assessments of speech seem to be informative regarding not only speech outcome but also a patient's satisfaction with the obturator. Consideration of background patient characteristics is important when interpreting both clinically obtained and patient-perceived outcomes.
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