124 Chapter 4.2 Many children are concerned about their appearance and self-perception can cause more difficulties as they reach their teen years. Subjective feedback for our paediatric cohort reflected that children did not want to ‘stand out’, they wanted control over their appearance and some teenagers would rather manage without a hearing aid than stand out with one. The introduction of the adhesive device provides a further option for children with conductive hearing loss. The older children/teenagers in our institution made an informed and autonomous choice about the hearing aid they used. This engagement was ultimately thought to be a huge factor that increased compliance and retention of the adhesive hearing aid system. Although we found the positioning with the adhesive adaptor to be stable, the replacement of these pads does incur additional costs as compared with a softband device. In addition, each patient’s requirement for the frequency of replacement is variable and influenced by the patient’s own skin, hairline and impacted if wearing eye glasses and head scarves. No child has the same requirement for the pads and on average we found that the adhesive adaptors were changed every second day (three to four times a week); however, some individuals require this more frequently. This centre’s experience with the adhesive retained bone conduction system has been positive, and its application is growing. It is now a first choice for children with microtia and avoids the need for any hearing surgery before a decision on autologous reconstruction has been made. It is also a first choice for many children with long standing conductive hearing loss such as those children long standing otitis media with effusion, as seen in children with Down syndrome, Primary Ciliary Dyskinesia and those with a cleft palate. Applications for children with transient conductive hearing loss may also be appropriate in the future. These include otitis media with effusion and post-operative patents who may be waiting for second stage ossiculoplasty following mastoid surgery. The adhesive hearing device is also another reliable form of a Bone Conduction trial before planning an implantable hearing solution. Application in adults in the immediate post-operative period has already been studied to overcome this transient conductive hearing loss created by the tamponade effect from blocking the auditory canal. Speech perception for monosyllables in quiet improved by 46%, compared to the unaided condition after one week and a functional hearing gain improved by 19 dB [11] thus improving the recovery of patients even in short term. Future research into these types of application in the paediatric population is advised.
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