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小耳症個案重建外耳廓對聽力閾值的影響

Effect of Auricle Reconstruction on Hearing Thresholds of Microtia Case

Abstracts


背景:小耳症個案因外耳生理結構發展異常,合併有聽力異常的情況。因其外觀異常,有個案會選擇外耳廓重建,使其外觀幾乎看不出差異。在觸覺上,重建的外耳廓明顯較硬且不易彎曲,因此在使用覆耳式耳機施測純音聽力檢查時,耳機與測試者重建外耳廓密合度不佳產生空隙,使測試音洩漏影響檢查精準度。方法:使用回溯方式找尋本院門診小耳症個案且做過純音聽力檢查,分成二組,一組小耳症個案未執行外耳廓重建,一組是小耳症個案有執行外耳廓重建,比較二組純音聽力閾值差異及其差異分析。結果:二組在250及500 Hz二個頻率統計分析為非常顯著差異,而4,000及8,000 Hz二個頻率則無顯著差異。符合相關研究覆耳式耳機密合度不佳是有顯著低頻音洩漏的情況。建議:臨床以全罩式耳機取代覆耳式耳機,減少因耳機與耳廓間密合度不佳造成的檢查誤差。

Parallel abstracts


Background: Microtia is a congenital ear deformity in which the external ear is malformed and underdeveloped. These cases suffer from hearing loss in the affected ears. Because of its abnormal appearance, some cases choose to have the auricle reconstructed so that there is almost no difference in appearance. Reconstruction of the auricle feels relatively hard and difficult to bend. When pure-tone audiometry is performed, there is a gap between the supra-aural headphones and the tester's reconstruction of the auricle, causing test sound leakage to affect the test accuracy. Methods: The retrospective method was used to find the outpatient microtia cases of New Taipei City Hospital who had undergone pure-tone audiometry. The cases are divided into two groups: a group of microtia cases without auricle reconstruction, and a group of microtia cases with auricle reconstruction. We compared the differences in pure tone hearing thresholds between the two groups and analyzed the differences. Results: Statistical analysis showed very significant differences between the two groups at 250 and 500 Hz, while there was no significant difference at 4,000 and 8,000 Hz. It is in line with the research that supra-aural headphones are prone to significant low-frequency sound leakage. Suggestion: In clinical practice, circum-aural headphones are used instead of supra-aural headphones to reduce inspection errors caused by the gap between the headphones and the auricle.

References


Ali, K., Mohan, K., & Liu, Y.-C. (2017). Otologic and audiology concerns of microtia repair. Seminars in Plastic Surgery, 31(3), 127-133. https://doi.org/10.1055/s-0037-1603957
Billings, K. R., Qureshi, H., Gouveia, C., Ittner, C., & Hoff, S. R. (2016). Management of hearing loss and the normal ear in cases of unilateral Microtia with aural atresia. The Laryngoscope, 126(6), 1470-1474. https://doi.org/10.1002/lary.25530
Flamme, G. A., Geda , K., McGregor, K., Wyllys, K., Deiters, K. K., Murphy, W. J., & Stephenson, M. R. (2015). Stimulus and transducer effects on threshold. International Journal of Audiology, 54(Suppl 1), S19-S29. https://doi.org/10.3109/14992027.2014.979300
Horlock, N., Vögelin, E., Bradbury, E. T., Grobbelaar, A. O., & Gault, D. T. (2005). Psychosocial outcome of patients after ear reconstruction: a retrospective study of 62 patients. Annals of Plastic Surgery, 54(5), 517–24. https://doi.org/10.1097/01.sap.0000155284.96308.32
Ishimoto, S., Ito, K., Karino, S., Takegoshi, H., Kaga, K., & Yamasoba, T. (2007). Hearing levels in patients with microtia: correlation with temporal bone malformation. The Laryngoscope, 117(3), 461-465. https://doi.org/10.1097/MLG.0b013e31802ca4d4

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