Efficacy of a bone-anchored hearing aid for a mixed hearing loss patient with suppurative ear discharge after chemoradiotherapy for nasopharyngeal cancer

Abstract

The bone-anchored hearing aid (Baha; Cochlear, Sydney, Australia) implant system is based on the principle of osseointegration, which is fundamental to the survival of the implant. However, a history of exposure to irradiation compromises osseointegration, and there is a dearth of data regarding the outcomes of Baha implantation in patients who have undergone radiation therapy. We herein report the clinical results of Baha implantation in a patient who had a history of chemoradiotherapy. A 53-year-old Japanese man presented to our hospital because of suppurative otorrhea and hearing loss after undergoing chemoradiotherapy for nasopharyngeal cancer at 50 years old. He had been deaf in his right ear from 38 years old due to subtotal temporal bone resection for carcinoma of the middle ear. Based on a preoperative implant simulation using computed tomography, the implant site was set at the parietal bone, which was considered outside the irradiation area due to the radiation protocols conventionally used. The Baha implant was placed in his left parietal bone. Aided thresholds using the Baha implant indicated a benefit, with an improvement to 28dB. He was freed from the need for a conventional hearing aid, which helped stop the suppurative otorrhea. No adverse skin reaction was identified in the follow-up period for two years after Baha implantation. Implant stability was assessed by a resonance frequency analysis, which revealed an implant stability quotient of 52.