Purposes: To evaluate the instant auditory benefit of an adhesive bone conduction hearing aid (ADHEAR) on children with bilateral congenital microtia, especially the sound localization ability under unilateral and bilateral fitting. Methods: Twelve patients with bilateral congenital microtia aged from 6 to 17 were included in this study. Pure tone threshold under sound field, speech recognition threshold in quiet and sound localization abilities were tested and compared before and after wearing the device. The pure tone threshold test was additionally repeated for two different wearing method -adhesive or fixed with softband; the sound localization test was repeated for both unilateral and bilateral fitting. Correlation analysis was then conducted to find the influencing factors of sound localization improvement. Results: Significant auditory improvement were found: the average pure tone threshold (PTA) reduced by 24.8 (adhesive) and 27.3 dB HL (softband), with no significant difference between the two wearing methods. The speech recognition threshold also improved by 29.0 dB. As for sound localization abilities, no significant improvement was found under unilateral fitting; but half (6 of 12) of the patients were notably benefited from bilateral fitting. The improvement was found to be strong correlated with the patients' unaided sound localization ability -those with poorer localization abilities tends to benefit more. Moreover, it was found that the sound localization improvement was also negatively related with the malformation degrees of the patients' head. Summary: ADHEAR affords significant auditory benefits for children with bilateral congenital microtia, in terms of sound and speech perception. The sound localization abilities could be partly improved instantly by bilateral fitting, and the improvement is related with factors such as adaption and skull malformations.
Key points:1. The adhesive bone conduction hearing device (BCHD) -ADHEAR offers significant auditory gain to children with bilateral congenital microtia. 2. The adhesive wearing method of ADHEAR performs as well as the conventional softband, which sufficiently releases the static pressure and offers more comfort. 3. For bilateral congenital microtia, unilateral fitting of ADHEAR does not improvement the sound localization ability, while bilateral fitting demonstrates instant improvement in half of the patients. 4. The improvement of sound localization ability under bilateral fitting is strongly correlated with the unaided sound localization ability -patients who performs worse when unaided tend to benefit more. 5. The skull malformation also disturbs the sound localization after bilateral fitting. Therefore, a detailed fitting procedure may be in need.