Audiological performance and subjective satisfaction of the ADHEAR system in experienced pediatric users with unilateral microtia and aural atresia.

Introduction: Despite the reported auditory deficits and developmental challenges in children with unilateral microtia and aural atresia (UMAA), there remains a lack of consensus on early intervention with bone conduction hearing aids (BCHAs) to restore binaural hearing due to the uncertain clinical benefits and intolerability of the conventional devices. Previous studies investigating the auditory benefits under binaural hearing condition were limited and demonstrated controversial opinions in heterogenous patient groups with various devices. Our study aimed to evaluate the audiological performance, including monoaural and binaural hearing, and subjective satisfaction of the ADHEAR system, a novel adhesive BCHA, in experienced pediatric users with UMAA.

Methods: Twelve children, with a mean age of 9.08 years and previous experience using the ADHEAR system averaging 2.76 years, were included in our final analysis. Auditory performance of monoaural hearing with the affected ears was assessed by sound-field audiometry, speech recognition threshold (SRT), word recognition score (WRS) in quiet and noise. Auditory performance of binaural hearing was assessed by SRT in quiet and noise, along with a virtual sound localization test. Subjective satisfaction was measured with questionnaires.

Results: Monoaural hearing of the affected ears improved in sound-field audiometry (by 18.44 dB HL), SRT (by 17.08 dB HL) and WRS (by 27.00 % in quiet and 30.50 % in noise). Binaural hearing improved in SRT in quiet (by 1.17 dB HL), remained no significant difference in noise and enhanced in sound localization test (reduction of RMS error by 5.96°). The questionnaires indicate satisfying experiences despite skin reactions encountered.

Conclusions: In children with UMAA under long-term and routine use of the ADHEAR system reveals not only enhancement of audiological performance in the affected ears but also demonstrates potential benefits in speech recognition and sound localization under binaural hearing condition. Users generally expressed satisfaction with the device, while skin reaction is more noticeable in humid subtropical climate.