[Efficacy of three hearing intervention strategies in microtia patients with concomitant ossicular malformation]

A retrospective analysis was conducted on microtia patients with concomitant ossicular malformation who underwent hearing intervention at Sun Yat-sen Memorial Hospital, Sun Yat-sen University from August 2019 to November 2024. A total of 22 patients aged (10.4±7.3) years were included. Among them, 11 patients underwent hearing reconstruction surgery, six were fitted with non-implantable bone conduction hearing aids, and five received bone-anchored hearing aid Attract (BAHA Attract). No significant intergroup differences were observed in pre-intervention air-conduction thresholds, bone-conduction thresholds, or air-bone gaps (all P>0.05). In the hearing reconstruction group, postoperative air-conduction pure-tone averages (PTA) and air-bone gap were significantly decreased compared with preoperative values [(51.8±5.1) dB HL vs (74.4±5.0) dB HL, P=0.003; (29.0±2.0) dB HL vs (51.3±3.9) dB HL, P=0.001]. In the non-implantable bone conduction hearing aid group and the BAHA Attract group, the pre-intervention PTA were (58.5±2.4) dB HL and (76.8±4.6) dB HL, respectively, while the postoperative sound-field pure-tone averages were (27.5±1.9) dB HL and (28.5±3.1) dB HL, respectively. There was no significant difference in postoperative sound-field thresholds between the two groups (P=0.790). No statistically significant difference was found in total costs among the three groups (P=0.118). However, out-of-pocket costs differed significantly (P=0.007), being higher in the bone conduction hearing aid group than in the hearing reconstruction group and the BAHA Attract group (both P<0.05). Collectively, these findings demonstrate that all three intervention modalities yield favorable audiological outcomes, with comparable total treatment costs but distinct out-of-pocket financial burdens.