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William E. Walsh, MD, CMI; Brian Dougherty, BS; David J. Reisberg, DDS; Edward L. Applebaum, MD; Chirag Shah, BS; Patrick O’Donnell, MD; Claus-Peter Richter, MD, PhD

Arch Facial Plast Surg. 2008;10(5):321-328.

Objectives  To examine the effects of an auricular prosthesis on sound levels at the entrance of the ear canal by measuring the auricular prosthesis transfer function (APTF) and to determine the effect of the prosthesis on speech recognition in noisy hearing conditions.

Methods  Eight prostheses were used to measure the APTF. A microphone at the entrance of the ear canal measured sound pressure levels with the prosthesis present or absent while the head was rotated 360° at 30° increments. The Hearing in Noise Test was modified by the APTF to simulate the absence of an auricular prosthesis. Speech recognition was measured by testing 11 subjects with the unmodified Hearing in Noise Test and the modified Hearing in Noise Test.

Results  The APTF changed with the head's position relative to the speaker. The mean (SD) maximal gain provided by an auricular prosthesis was 8.1 (2.7) dB at 4.6 (1.0) kHz and 9.7 (1.7) dB at 11.5 (0.9) kHz at 0° rotation. During speech testing, the auricular prosthesis improved the mean (SD) signal to noise ratio by 1.7 (1.7) dB at 0° (P < .001), 0.9 (2.2) dB at 90° (P =.04), and 0.5 (2.3) dB at 180° (P =.52).

Conclusions  The acoustic gain provided by an auricular prosthesis increases speech recognition in noisy environments. Auricular prostheses not only restore aesthetics but also improve hearing.

Author Affiliations: Department of Otolaryngology–Head and Neck Surgery, Northwestern University Feinberg School of Medicine (Drs Walsh, Applebaum, and Richter and Mr Shah), and Craniofacial Center, University of Illinois at Chicago (Dr Reisberg); Royal College of Surgeons, Dublin, Ireland (Mr Dougherty); and Department of Otolaryngology–Head and Neck Surgery, Temple University, Philadelphia, Pennsylvania (Dr O’Donnell). Dr Walsh is now with the Department of Otolaryngology–Head and Neck Surgery, Louisiana State University, Shreveport.

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