(845) Evaluating bone conductive devices in patients after radical modifies mastoidectomy

Introduction: Chronic otitis media with cholesteatoma necessitates surgical intervention, commonly involving radical modified mastoidectomy. Despite surgical management, hearing loss frequently persists as a sequela of the disease. In such cases, hearing rehabilitation via prosthetic devices is essential, with the choice of device primarily determined by the type and severity of hearing loss, local ear conditions, and anatomical considerations. The bone-anchored hearing device - Ponto (Oticon Medical), is one such solution employed in clinical practice.

Methods: This study included 67 patients who underwent unilateral implantation with Bone Conduction Systems, all of whom had a history of radical modified mastoidectomy. The mean age at implantation was 59 years (SD = 11). Benefits of systems were evaluated using free-field audiometry, speech recognition tests, and patient-reported outcome measures, including the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Speech, Spatial, and Qualities of Hearing Scale (SSQ) questionnaires.

Results: Statistically significant improvements in hearing thresholds and speech discrimination scores were observed following Ponto implantation. Patient questionnaires corroborated these findings, indicating enhanced hearing performance in diverse acoustic environments.

Conclusions: A bone-conductive bone-anchored hearing device represents a safe and effective intervention for compensating for conductive and mixed hearing loss in patients post-radical modified mastoidectomy. This system offers substantial auditory benefits, particularly for individuals at risk of recurrent otitis media with cholesteatoma who may require subsequent revision surgery.