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Ren AZ, Sung V. Factors that influence health service access in deaf and hard-of-hearing children: a narrative review. Int J Audiol 2024; 63:171-181. [PMID: 37335176 DOI: 10.1080/14992027.2023.2223357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/31/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES Early diagnosis and intervention of deaf and hard-of-hearing (DHH) children leads to improved language and psychosocial outcomes. However, many child, parent and provider related factors can influence access to early intervention services, including hearing devices. This narrative review aims to explore factors that influence health service access in DHH children. DESIGN A systematic search was conducted to identify articles that explored factors that influenced health service access in DHH children in countries with Universal Newborn Hearing Screening, published between 2010 and 2022. STUDY SAMPLES Fifty-nine articles met the inclusion criteria for data extraction. This included 4 systematic reviews, 2 reviews, 39 quantitative and 5 mixed methods studies and 9 qualitative studies. RESULTS The identified factors were grouped into the following themes: (a) demographic factors, (b) family related factors, (c) child related factors, (d) factors specific to hearing devices, (e) service delivery, f) telehealth and (g) COVID-19. CONCLUSION This review provided a comprehensive summary of multiple factors that affect access to health services in DHH children. Psychosocial support, consistent clinical advice, allocation of resources to rural communities and use of telehealth are possible ways to address barriers and improve health service access.
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Affiliation(s)
- Angela Z Ren
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Valerie Sung
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Centre for Community Child Health, Royal Children's Hospital, Parkville, Victoria, Australia
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2
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Garcia RTR, dos Santos AC, Danieli F, Hyppolito MA. Symmetrical placement of bilateral percutaneous bone-anchored hearing systems via guide-marker. Laryngoscope Investig Otolaryngol 2024; 9:e1195. [PMID: 38362200 PMCID: PMC10866580 DOI: 10.1002/lio2.1195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/04/2023] [Accepted: 11/22/2023] [Indexed: 02/17/2024] Open
Abstract
Objectives To investigate the use of a novel technique to estimate the symmetrical placement of percutaneous bone-anchored hearing systems (BAHS) with a guide-marker in patients undergoing bilateral surgery with this device. Study Design Prospective cohort study. Methods A guide-marker and anatomical landmarks were used to estimate the implant placement and transferred to the contralateral ear in 12 subjects eligible for bilateral BAHS surgery. To investigate the bilateral symmetry, preoperative tri-dimensional (3D) computed tomography (CT) image reconstruction was used to compare the distances between the mandibular condyle and implant placement estimation (mandible-implant distance) in both the right and left ears of the subjects. Results The guide-marker could be used to estimate the bilateral implant placement in all subjects included in this study, simply and easily, including one subject with craniofacial malformation. The mean mandible-implant distances were 5.37 and 5.38 cm, in the right and left ears of the subjects, respectively, and no differences were observed between them, thereby indicating optimal bilateral symmetry. Conclusion The use of the guide-marker proved to be an effective tool to provide symmetrical placement of bilateral BAHS. We propose a novel method employing a simple guide-marker and tracing based on symmetrical anatomical landmarks to achieve precise placement and optimal symmetry and which may be easily adopted in the surgical routine of BAHS. Level of Evidence 3.
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Affiliation(s)
- Renata Tadeu Ramirez Garcia
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirão Preto Medical SchoolUniversity of São PauloRibeirão PretoSão PauloBrazil
| | - Antonio Carlos dos Santos
- Center for Imaging Sciences and Medical Physics of the Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical SchoolUniversity of São PauloRibeirão PretoSão PauloBrazil
| | - Fabiana Danieli
- Department of Health Sciences, RCS, Ribeirão Preto Medical SchoolUniversity of São PauloRibeirão PretoSão PauloBrazil
| | - Miguel Angelo Hyppolito
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirão Preto Medical SchoolUniversity of São PauloRibeirão PretoSão PauloBrazil
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Pantaleo A, Murri A, Cavallaro G, Pontillo V, Auricchio D, Quaranta N. Single-Sided Deafness and Hearing Rehabilitation Modalities: Contralateral Routing of Signal Devices, Bone Conduction Devices, and Cochlear Implants. Brain Sci 2024; 14:99. [PMID: 38275519 PMCID: PMC10814000 DOI: 10.3390/brainsci14010099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/10/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Single sided deafness (SSD) is characterized by significant sensorineural hearing loss, severe or profound, in only one ear. SSD adversely affects various aspects of auditory perception, including causing impairment in sound localization, difficulties with speech comprehension in noisy environments, and decreased spatial awareness, resulting in a significant decline in overall quality of life (QoL). Several treatment options are available for SSD, including cochlear implants (CI), contralateral routing of signal (CROS), and bone conduction devices (BCD). The lack of consensus on outcome domains and measurement tools complicates treatment comparisons and decision-making. This narrative overview aims to summarize the treatment options available for SSD in adult and pediatric populations, discussing their respective advantages and disadvantages. Rerouting devices (CROS and BCD) attenuate the effects of head shadow and improve sound awareness and signal-to-noise ratio in the affected ear; however, they cannot restore binaural hearing. CROS devices, being non-implantable, are the least invasive option. Cochlear implantation is the only strategy that can restore binaural hearing, delivering significant improvements in speech perception, spatial localization, tinnitus control, and overall QoL. Comprehensive preoperative counseling, including a discussion of alternative technologies, implications of no treatment, expectations, and auditory training, is critical to optimizing therapeutic outcomes.
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Affiliation(s)
- Alessandra Pantaleo
- Otolaryngology Unit, Department of BMS, Neuroscience and Sensory Organs, University of Bari, 70121 Bari, Italy; (A.P.); (A.M.); (V.P.); (D.A.)
| | - Alessandra Murri
- Otolaryngology Unit, Department of BMS, Neuroscience and Sensory Organs, University of Bari, 70121 Bari, Italy; (A.P.); (A.M.); (V.P.); (D.A.)
| | - Giada Cavallaro
- Otolaryngology Unit, Madonna delle Grazie Hospital, 75100 Matera, Italy;
| | - Vito Pontillo
- Otolaryngology Unit, Department of BMS, Neuroscience and Sensory Organs, University of Bari, 70121 Bari, Italy; (A.P.); (A.M.); (V.P.); (D.A.)
| | - Debora Auricchio
- Otolaryngology Unit, Department of BMS, Neuroscience and Sensory Organs, University of Bari, 70121 Bari, Italy; (A.P.); (A.M.); (V.P.); (D.A.)
| | - Nicola Quaranta
- Otolaryngology Unit, Department of BMS, Neuroscience and Sensory Organs, University of Bari, 70121 Bari, Italy; (A.P.); (A.M.); (V.P.); (D.A.)
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Li B, Lee S, Cao Z, Koike T, Joseph R, Brown TH, Zhao F. A Systematic Review of the Audiological Efficacy of Cartilage Conduction Hearing Aids and the Factors Influencing Their Clinical Application. Audiol Res 2023; 13:636-650. [PMID: 37622931 PMCID: PMC10451753 DOI: 10.3390/audiolres13040055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
This systematic review evaluates the efficacy and benefit of cartilage conduction hearing aids (CC-HAs) and that factors that influence purchasing decisions. The hearing thresholds and functional gain following CC-HA wear were synthesised. A one-way analysis of variance compared the differences in the hearing thresholds and functional gain at individual frequencies and in patients with a variety of pathological changes. The synchronised aided hearing threshold and functional gain at 2.0 kHz were significantly better than at 0.5, 1.0, and 4.0 kHz. There was no significant difference in the synchronised unaided hearing thresholds across individual frequencies between 0.5 and 4.0 kHz. The synchronised functional gain in patients with atresia was significantly greater than in patients with aural atresia or stenosis and middle ear pathologies with normal ear canals. The acceptability of CC-HAs in terms of purchase decision is influenced by the condition of the external auditory meatus and severity of hearing loss, with the highest purchase rate seen in patients with aural atresia or stenosis. CC-HAs' fitting procedure advantages and cosmetic considerations make these devices a viable and preferred choice for individuals with microtia and aural atresia. Additional research to evaluate the benefits towards emotional well-being is crucial to gain insights into the psychological impact of CC-HA use.
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Affiliation(s)
- Bei Li
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF5 2YB, UK;
- Department of Otolaryngology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
| | - Sinyoung Lee
- Department of Mechanical Engineering, Faculty of Engineering, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, Yamanashi 400-8511, Japan;
| | - Zuwei Cao
- Centre for Rehabilitative Auditory Research, Guizhou Provincial People’s Hospital, Guiyang 550002, China;
| | - Takuji Koike
- Department of Mechanical and Intelligent Systems Engineering, Graduate School of Informatics and Engineering, The University of Electro-Communications, Chofu 182-8585, Japan;
| | - Robin Joseph
- King Edward VII Hospital, Berkshire NHS Foundation Trust, Winsor SL4 3DP, UK;
| | | | - Fei Zhao
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF5 2YB, UK;
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Wendrich AW, van Heteren JAA, Peters JPM, Cattani G, Stokroos RJ, Versnel H, Smit AL. Choice of treatment evaluated after trial periods with bone conduction devices and contralateral routing of sound systems in patients with single-sided deafness. Laryngoscope Investig Otolaryngol 2023; 8:192-200. [PMID: 36846432 PMCID: PMC9948587 DOI: 10.1002/lio2.1002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/14/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022] Open
Abstract
Objectives Patients with single-sided deafness (SSD) may experience difficulties with speech perception in noise, sound localization, have tinnitus and experience a reduced quality of life (QoL). contralateral routing of sound hearing aids (CROS) or bone conduction devices (BCD) may partly improve subjective speech communication and QoL in SSD patients. A trial period with these devices can help in making a well-informed choice of treatment. Our aim was to evaluate factors influencing the choice of treatment made after a BCD and CROS trial period in adult SSD patients. Methods Patients were randomized in the: "first BCD, then CROS" or "first CROS, then BCD" trial period group. After the BCD on headband and CROS were tested for 6 weeks each, patients choose for BCD, CROS or no treatment. Primary outcome was the distribution of choice of treatment. Secondary outcomes included the association between the choice of treatment and patient characteristics, reasons for treatment acceptance or rejection, device usage during the trial periods, and disease-specific QoL outcomes. Results Of 91 patients randomized, 84 completed both trial periods and made their choice of treatment: 25 (30%) BCD, 34 (40%) CROS, and 25 (30%) no treatment. No characteristics were found to be related to choice of treatment. Top three reasons for acceptance or rejection were: device (dis)comfort, sound quality and (dis)advantage of subjective hearing. Average daily device use during the trial periods was higher for CROS than for BCD. Choice of treatment was significantly related with both duration of device usage and greater improvement of QoL after the corresponding trial period. Conclusion The majority of SSD patients preferred BCD or CROS over no treatment. Evaluating device usage, discussing treatment (dis)advantages and disease-specific QoL outcomes after trial periods are to be considered during patient counseling and could facilitate whether to choose one of these treatments. Level of evidence 1B.
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Affiliation(s)
- Anne W. Wendrich
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands
- UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
| | - Jan A. A. van Heteren
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands
- UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
| | - Jeroen P. M. Peters
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands
- UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
| | - Guido Cattani
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands
- Adelante Center of Expertise in rehabilitation and AudiologyHoensbroekNetherlands
| | - Robert J. Stokroos
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands
- UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
| | - Huib Versnel
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands
- UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
| | - Adriana L. Smit
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands
- UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
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Siegel L, Araslanova R, Stepniak C, Zimmerman K, Agrawal SK. Achondroplasia and severe sensorineural hearing loss: The role of active bone conduction implants. Cochlear Implants Int 2022; 23:291-299. [DOI: 10.1080/14670100.2022.2045073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Lauren Siegel
- Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Rakhna Araslanova
- Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Canada
- Department of Otolaryngology-Head and Neck Surgery, Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
| | - Camilla Stepniak
- Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Kim Zimmerman
- Cochlear Implant Program, London Health Sciences Centre, London, Canada
| | - Sumit K. Agrawal
- Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Canada
- Cochlear Implant Program, London Health Sciences Centre, London, Canada
- National Centre for Audiology, University of Western Ontario, London, Canada
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Early Outcomes of a New Active Transcutaneous Bone Conduction Implant in Pediatric Patients. Otol Neurotol 2021; 43:212-218. [PMID: 34855683 DOI: 10.1097/mao.0000000000003426] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To describe the early surgical and audiometric outcomes in pediatric patients implanted with a new active transcutaneous bone conduction implant system. STUDY DESIGN Retrospective case review. SETTING Tertiary pediatric hospital. PATIENTS Pediatric patients (18 or younger) with conductive or mixed hearing loss that completed postoperative aided testing following implantation with the Cochlear Osia system from December 2019 to December 2020. INTERVENTION Rehabilitative. MAIN OUTCOME MEASURE Preoperative air conduction (AC), preoperative bone conduction (BC), and postoperative aided thresholds were compared. Pure-tone averages (PTA), air-bone gap (ABG), and functional gain were calculated. Surgical complications and patient satisfaction were summarized from the chart review. RESULTS Sixteen patients (20 implants) met the inclusion criteria. The average age at the time of implantation was 12.9 ± 2.4 years. The preoperative AC and BC thresholds were 64.4 dB (±11.9 dB) and 7.9 dB (±4.90 dB), respectively, with an average ABG of 56.5 dB (±12.8 dB). The average postoperative aided threshold was 21.2 dB (± 4.25 dB) with a mean functional gain of 43.1 dB (±10.2 dB). One patient developed seroma postoperatively, which was treated conservatively. No other complications were reported over a mean follow-up time of 7.1 ± 4 months. For 13 patients with previous passive bone conduction implants or devices, the Osia system was universally favored. CONCLUSIONS The new active transcutaneous bone conduction system showed favorable early clinical and audiometric outcomes. Repeated processor connectivity issues represent a potential area for future device development. This is the largest pediatric case series to date.Level of Evidence: Level 4-Retrospective Review.
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Underdown T, Pryce H. How do patients decide on interventions for single sided deafness? A qualitative investigation of patient views. Int J Audiol 2021; 61:551-560. [PMID: 34376116 DOI: 10.1080/14992027.2021.1951853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Single-sided deafness presents communication challenges for adults. There are a range of care options, including CROS hearing aids, available but little is known about patient preferences for these interventions. OBJECTIVE The objective of this study was to understand the viewpoints of patients making decisions about audiological interventions they use. METHODS A constructivist worldview using thematic analysis to undertake a constant comparative analysis of 8 semi-structured interviews. SAMPLING Participants were recruited from Portsmouth Hospitals University NHS Trust audiology service in England. FINDINGS The results of the study describe ongoing iterative judgements being made by participants, informed by their access to information, effectiveness of audiological interventions, stigma, barriers to accessing care, and constant cost-benefit analyses being made. The key factors involved in decision-making by individuals with Single-sided deafness (SSD) are discussed. CONCLUSIONS This study represents the first in-depth exploration of the individual's lifeworld related to which factors influence use of different audiological interventions by individuals with SSD. It highlights the complex and ongoing nature of how decisions are made by these individuals and identifies the need for greater information provision by clinicians, such as through use of a decision aid tool.
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Affiliation(s)
- Thomas Underdown
- Audiology Department, Portsmouth Hospitals University NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - Helen Pryce
- Audiology Department, College of Health and Life Sciences, Aston University, Birmingham, UK
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Nishimura T, Akasaka S, Morimoto C, Okayasu T, Kitahara T, Hosoi H. Speech recognition scores in bilateral and unilateral atretic ears. Int J Audiol 2021; 61:663-669. [PMID: 34370598 DOI: 10.1080/14992027.2021.1961169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Congenital aural atresia causes severe conductive hearing loss disturbing auditory development. The differences in speech recognition were investigated between bilateral and unilateral aural atresia. DESIGN The maximum speech recognition scores (SRSs) were compared between patients with bilateral and unilateral aural atresia. In patients with unilateral aural atresia, the maximum SRSs were compared between the atretic and unaffected ears. Furthermore, the correct response rates for test material monosyllables were compared with those of patients with sensorineural hearing loss (SNHL), which had been previously obtained. STUDY SAMPLE Twenty-four patients with aural atresia (8 bilateral, and 16 unilateral) participated. RESULTS The maximum SRS in unilateral atretic ears (median: 72%) was significantly lower than that in unaffected ears (median: 89%) (p < 0.05) and in bilateral atretic ears (median: 91%) (p < 0.05). Patients with aural atresia had relatively high correct response rates for monosyllables with low correct response rates by patients with SNHL. Conversely, incorrect responses were obtained for several words for which high correct-response rates were attained by patients with SNHL. CONCLUSIONS Poor unilateral atretic-ear development may induce low speech recognition, and the mechanisms underlying speech-recognition reduction differ from those in SNHL.
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Affiliation(s)
- Tadashi Nishimura
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Japan
| | - Sakie Akasaka
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Japan
| | - Chihiro Morimoto
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Japan
| | - Tadao Okayasu
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Japan
| | - Tadashi Kitahara
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Japan
| | - Hiroshi Hosoi
- MBT (Medicine-Based Town) Institute, Nara Medical University, Kashihara, Japan
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Cartilage Conduction Hearing and Its Clinical Application. Audiol Res 2021; 11:254-262. [PMID: 34204875 PMCID: PMC8293084 DOI: 10.3390/audiolres11020023] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/26/2021] [Accepted: 06/01/2021] [Indexed: 11/24/2022] Open
Abstract
Cartilage conduction (CC) is a form of conduction that allows a relatively loud sound to be audible when a transducer is placed on the aural cartilage. The CC transmission mechanism has gradually been elucidated, allowing for the development of CC hearing aids (CC-HAs), which are clinically available in Japan. However, CC is still not fully understood. This review summarizes previous CC reports to facilitate its understanding. Concerning the transmission mechanism, the sound pressure level in the ear canal was found to increase when the transducer was attached to the aural cartilage, compared to an unattached condition. Further, inserting an earplug and injecting water into the ear canal shifted the CC threshold, indicating the considerable influence of cartilage–air conduction on the transmission. In CC, the aural cartilage resembles the movable plate of a vibration speaker. This unique transduction mechanism is responsible for the CC characteristics. In terms of clinical applications, CC-HAs are a good option for patients with aural atresia, despite inferior signal transmission compared to bone conduction in bony atretic ears. The advantages of CC, namely comfort, stable fixation, esthetics, and non-invasiveness, facilitate its clinical use.
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Garcier M, Lavedrine A, Gagneux C, Eluecque T, Bozorg Grayeli A. Bone-Anchored and Closed Skin Bonebridge Implant in Adults: Hearing Performances and Quality of Life. Audiol Neurootol 2021; 26:310-316. [PMID: 33662952 DOI: 10.1159/000512496] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 10/05/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Bonebridge® is a novel active bone-anchored hearing implant. The purpose of this study was to evaluate the ease of implantation, the hearing performances, and the patient-reported benefit. MATERIALS AND METHODS This is a prospective cross-sectional study of 24 consecutive adult patients implanted for a mixed hearing loss (13 chronic otitis media (COM) and 11 other aetiologies). Twenty-one implants were placed in the retrosigmoid position and 3 in the mastoid. Audiometry, Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, as well as 5 implant-specific questions (analogue visual scale [AVS] 0-10 score), was administered. RESULTS Surgery lasted 73 ± 29.7 min on average. No major complication occurred. All patients were users at the last follow-up visit (median: 9-month range: 3-25). The average prosthetic gain was similar in COM and other aetiologies (43 ± 4.8 dB and 50 ± 7.2, respectively, not significant, Wilcoxon test). Bone-conduction thresholds were not deteriorated by surgery (Kruskal-Wallis test, not significant). APHAB scores improved in all categories except aversiveness (global score 45 ± 7.0% in COM and 32 ± 10.2% in others, not significant, and Wilcoxon test). Local pain (AVS: 3.23 ± 3.2, n = 16) and manipulation difficulties (3.1 ± 3.69) were low. The device was considered aesthetic (8.3 ± 2.49). Perfectible autonomy (5.0 ± 2.8) and difficulties wearing the implant during sport or at work (5.1 ± 3.47) were the weakest points. CONCLUSIONS BoneBridge® implant provides reproducible results for the rehabilitation of mixed hearing losses and unilateral hearing loss.
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Affiliation(s)
- Martin Garcier
- Otolaryngology Department, Dijon University Hospital, Dijon, France
| | - Angela Lavedrine
- Otolaryngology Department, Dijon University Hospital, Dijon, France
| | - Claude Gagneux
- Otolaryngology Department, Dijon University Hospital, Dijon, France.,Entendre Hearing Aid Center, Dijon, France
| | | | - Alexis Bozorg Grayeli
- Otolaryngology Department, Dijon University Hospital, Dijon, France, .,ImVia Research Laboratory, Université Bourgogne-Franche-Comté, Dijon, France,
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Patients’ Experiences of Deciding Whether or Not to Accept Bone Conduction Hearing Implants: A Qualitative Investigation. Ear Hear 2020; 42:456-464. [DOI: 10.1097/aud.0000000000000952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Osborne MS, Child-Hymas A, Gill J, Lloyd MS, McDermott AL. First Pediatric Experience With a Novel, Adhesive Adapter Retained, Bone Conduction Hearing Aid System. Otol Neurotol 2020; 40:1199-1207. [PMID: 31469800 DOI: 10.1097/mao.0000000000002363] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To assess the audiological outcomes, practicalities, and impact on quality of life of a new, nonimplantable, adhesive retained bone conduction hearing aid in children. STUDY DESIGN A prospective, single-subject repeat measure, cohort study. SETTING Community and in pediatric assessment center. PATIENTS Twenty-one children aged between 5 and 15 years with a conductive hearing loss of >/=25 dB HL in the better hearing ear. INTERVENTION Audiological comparisons were made using pure-tone thresholds; unaided, with a softband aid, and with the new adhesive retained bone conducting system. MAIN OUTCOME MEASURES Comparison of hearing threshold levels. Data analysis via paired t-testing, significance set at p value <0.01. Quality of life was assessed via the Glasgow Children's Benefit Inventory and a 10 cm linear analogue scale. A hearing aid review questionnaire provided insight into practical use. RESULTS Statistically significant improvement in thresholds of 7.3 dB HL (p=0.0001) was demonstrated with the adhesive system as compared with softband aids. After 4 weeks of usage, the mean hearing thresholds for the adhesive hearing system improved from 55 dB HL ± 2.4 to 31 dB HL± 7.9 in unaided and aided conditions.Improvements in QOL were demonstrated with LAS and GCBI. Four children reported mild skin reactions. Eighty-six percent reported improved self-confidence. CONCLUSION The adhesive aid produces comparable audiological results to the commercial softband hearing aids. It provides an excellent alternative in the treatment of conductive hearing loss without the possible complications and costs of a surgical intervention. Furthermore, it preserves skin envelope over the mastoid for those who wish to proceed with an autologous pinna reconstruction in the future.
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Almugathwi M, Wearden A, Green K, Hill-Feltham P, Powell R. Online support group users' perceptions and experiences of bone-anchored hearing aids (BAHAs): a qualitative study. Int J Audiol 2020; 59:850-858. [PMID: 32522055 DOI: 10.1080/14992027.2020.1771440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: Better understanding of the decision-making process for bone-anchored hearing aid (BAHA) candidates has been identified by clinicians as a research priority. This study aimed to understand experiences and perceptions of BAHA candidates and users who use online support groups.Design: One thousand posts retrieved from a public UK-based online support group were thematically analysed.Study sample: Messages were posted by 270 BAHA users and candidates.Results: Individuals used the online group to obtain information about BAHAs and support for decision-making regarding accepting BAHA surgery and wearing a percutaneous device. BAHA users evaluated the efficacy of the system, perceiving it to be highly effective in improving their hearing. The BAHA influenced individuals' self-image and impacted their social lives. Fears of surgery and post-implantation infections were regarded as challenges to be faced when choosing to accept implantation.Conclusions: BAHA candidates found the online support group useful in helping them to decide whether or not to proceed with surgery, and the personal experiences of BAHA users were predominantly positive. However, it is not clear to what extent such positive experiences are representative of BAHA users more generally, and candidates need to be aware of this when using these groups to support decision-making.
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Affiliation(s)
- Manal Almugathwi
- School of Health Sciences and Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Alison Wearden
- School of Health Sciences and Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Kevin Green
- Department of Otolaryngology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| | - Penny Hill-Feltham
- Department of Audiology, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| | - Rachael Powell
- School of Health Sciences and Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
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Active Transcutaneous Bone Conduction Implant: Audiometric Outcomes Following a Novel Middle Fossa Approach With Self-Drilling Screws. Otol Neurotol 2020; 41:605-613. [PMID: 32080031 DOI: 10.1097/mao.0000000000002597] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To present surgical and audiometric outcomes of patients implanted with an active transcutaneous bone conduction implant following the novel middle fossa surgical approach with self-drilling screws. STUDY DESIGN Retrospective review. SETTING Tertiary care center. PATIENTS Thirty-seven adults with either conductive or mixed hearing loss that met indications for an active transcutaneous bone conduction implant were consecutively implanted from April, 2013 to May, 2018. INTERVENTION Unilateral middle fossa implantation of an active transcutaneous bone conduction implant. MAIN OUTCOME MEASURES Patient charts were reviewed for surgical outcomes and complications over the 6-year period. Preoperative air conduction, preoperative bone conduction, and 3-month postoperative aided thresholds were recorded. Speech perception was assessed using CNC words and AzBio sentences. Pure-tone averages (PTAs; measured at 0.5, 1.0, 2.0 and 3.0 kHz), air-bone gap, and functional gain were calculated. RESULTS Mean air conduction and bone conduction PTAs (±standard deviation) of the implanted ear were 66.8 dB (±14.9 dB) and 21.9 dB (±14.0 dB), respectively. Mean aided PTA was 26.5 dB (± 8.5 dB). The average functional gain was 40.3 dB (±19.0 dB). Favorable speech perception outcomes were observed. No complications or instances of revision surgery were reported, with a mean follow-up time of 32 months (range, 9-71 mo). CONCLUSIONS This is the first paper to describe outcomes of patients implanted with an active transcutaneous bone conduction implant via the middle fossa with self-drilling screws. Favorable surgical outcomes were observed with a follow-up of up to 6 years.
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van Hoof M, Wigren S, Ivarsson Blechert J, Joore MA, Mateijsen DJM, Bom SJH, Stalfors J, Eeg-Olofsson M, Deguine O, van der Rijt AJM, Flynn MC, Algarra JM, Stokroos RJ. Clinical Outcomes of Soft Tissue Preservation Surgery With Hydroxyapatite-Coated Abutments Compared to Traditional Percutaneous Bone Conduction Hearing Implant Surgery-A Pragmatic Multi-Center Randomized Controlled Trial. Front Surg 2020; 7:5. [PMID: 32211417 PMCID: PMC7066494 DOI: 10.3389/fsurg.2020.00005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 01/30/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Soft tissue preservation using a hydroxyapatite-coated abutment in bone conduction hearing implant surgery may lead to improved clinical outcomes over the short (1 year) and long term (3 years). Methods: In this open multi-center, randomized (1:1), controlled clinical trial, subjects with conductive, mixed hearing loss or single-sided sensorineural deafness were randomly assigned to receive the conventional intervention, a titanium abutment with soft tissue reduction surgery (control), or a new intervention, a hydroxyapatite-coated abutment with soft tissue preservation surgery (test). The primary efficacy outcome was the combined endpoint of numbness, pain, peri-abutment dermatitis, and soft tissue thickening/overgrowth after 1 and 3 years. Results: The Intention-to-treat (ITT) population consisted of 52 control subjects and 51 test subjects. The difference between the groups after 1 year of follow-up as measured by the primary efficacy outcome was not statistically significant (p = 0.12) in the ITT population (n = 103), but did reach statistical significance (p = 0.03) in the per-protocol (PP) population (n = 96). It showed an advantage for the test group, with over twice as many subjects (29%) without these medical events during the first year compared to the control group (13%). After 3 years, the difference between the two groups had declined and did not reach statistical significance (24 vs. 10%, ITT p = 0.45). Secondary outcome measures which showed a statistical significant difference during the first year, such as surgical time (15 vs. 25 minutes, p < 0.0001), numbness (90 vs. 69% of subjects experienced no numbness at 1 year, p < 0.01), neuropathic pain at 3 months (p = 0.0087) and the overall opinion of the esthetic outcome (observer POSAS scale at 3 months, p < 0.01) were favorable for the test group. More soft tissue thickening/overgrowth was observed at 3 weeks for the test group (p = 0.016). Similar results were achieved for the long term follow up. Conclusions: Soft tissue preservation with a hydroxyapatite-coated abutment leads to a reduction in the combined occurrence of complications over the first year which is not statistically significant in the ITT population but is in the PP population. This effect decreased for the long-term study follow up of 3 years and did also not reach statistical significance.
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Affiliation(s)
- M van Hoof
- School for Mental Health and Neuroscience (MHENS), Ear, Nose and Throat (ENT) Department, Maastricht University Medical Center, Maastricht, Netherlands
| | - S Wigren
- Cochlear Bone Anchored Solutions AB, Mölnlycke, Sweden
| | | | - M A Joore
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, Netherlands
| | | | - S J H Bom
- ENT Department, Deventer Hospital, Deventer, Netherlands
| | - J Stalfors
- Department of Otorhinolaryngology, Sahlgrenska University Hospital, and Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Måns Eeg-Olofsson
- Department of Otorhinolaryngology, Sahlgrenska University Hospital, and Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - O Deguine
- ENT Department, Purpan Hospital, Toulouse, France
| | | | - M C Flynn
- Cochlear Bone Anchored Solutions AB, Mölnlycke, Sweden.,University of Newcastle, Callaghan, NSW, Australia
| | - J Marco Algarra
- ENT Department, Clinical University Hospital, Valencia, Spain
| | - R J Stokroos
- Department of Otolaryngology, Head and Neck Surgery, Brain Center Rudolph Magnus, University Medical Center Utrecht, Utrecht, Netherlands
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Rader T, Stöver T, Lenarz T, Maier H, Zahnert T, Beleites T, Hagen R, Mlynski R, Baumgartner WD. Retrospective Analysis of Hearing-Impaired Adult Patients Treated With an Active Transcutaneous Bone Conduction Implant. Otol Neurotol 2019; 39:874-881. [PMID: 29847467 DOI: 10.1097/mao.0000000000001834] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the therapeutic success and safety of an active transcutaneous bone conduction implant (tBCI) in adult patients with conductive or mixed hearing loss. STUDY DESIGN Retrospective case review. SETTING Five university hospitals in Frankfurt, Hannover, Dresden, Würzburg, and Vienna. PATIENTS Data were analyzed from 61 patients (31 women, 30 men) with a mean age of 50 years (min. 26, max. 80). Forty patients had mixed, and 21 conductive hearing loss. Typical etiologies were history of otitis media (n = 20) and cholesteatoma (n = 17). INTERVENTIONS Implantation of the active tBCI. MAIN OUTCOME MEASURES Data were analyzed for the following time points: up to 6 months postoperatively ("short-term"), 6 to 37 months postoperatively ("long-term"), and the last available measurement per patient ("most recent"). Pure-tone audiometry (air and bone conduction, AC and BC) and sound field thresholds with warble tones (WT), word recognition scores with Freiburger monosyllables (WRS), as well as speech reception thresholds (SRT) using the Oldenburg sentence test (OLSA) in quiet (SRT) and in noise (signal-to-noise ratio, SNR) were collected. RESULTS No significant changes in air- and bone-conduction thresholds were observed after implantation. A mean WRS improvement of 54% using the active tBCI was shown at the short-term assessment, i.e., a mean score of 79% compared with 25% in the unaided condition. Results remained stable, with a mean score of 75% at the long-term assessment. SRT in noise improved by 3.6 dB SNR in the implanted ear at the short-term assessment. Overall six adverse events and four serious adverse events were reported, resulting in a rate of 9.84 and 6.56%, respectively. CONCLUSION The tBCI clearly improves speech intelligibility in patients with conductive or mixed hearing loss, showing stable results up to 1 year post-implantation.
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Affiliation(s)
- Tobias Rader
- Department of Otolaryngology, University Hospital Frankfurt, Frankfurt am Main
| | - Timo Stöver
- Department of Otolaryngology, University Hospital Frankfurt, Frankfurt am Main
| | - Thomas Lenarz
- Department of Otorhinolaryngology, Hannover Medical School
| | - Hannes Maier
- Department of Otorhinolaryngology, Hannover Medical School
| | | | | | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Clinic Würzburg, Würzburg, Germany
| | - Robert Mlynski
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Clinic Würzburg, Würzburg, Germany
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18
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You P, Siegel LH, Kassam Z, Hebb M, Parnes L, Ladak HM, Agrawal SK. The middle fossa approach with self-drilling screws: a novel technique for BONEBRIDGE implantation. J Otolaryngol Head Neck Surg 2019; 48:35. [PMID: 31358057 PMCID: PMC6664741 DOI: 10.1186/s40463-019-0354-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 06/25/2019] [Indexed: 12/05/2022] Open
Abstract
Background Bone conduction implants can be used in the treatment of conductive or mixed hearing loss. The BONEBRIDGE bone conduction implant (BB-BCI) is an active, transcutaneous device. BB-BCI implantation can be performed through either the transmastoid or retrosigmoid approach with their respective limitations. Here, we present a third, novel approach for BB-BCI implantation. Objective Describe the detailed surgical technique of BB-BCI implantation through a middle fossa approach with self-drilling screws and present preliminary audiometric outcome data following this approach. Methods A single institution, retrospective chart review was completed for patients implanted with the BB-BCI via the middle fossa approach. Preoperative planning and modelling were performed using 3D Slicer. Audiological testing was performed pre- and post-operatively following standard audiometric techniques. Results Forty patients underwent BB-BCI implantation using the middle fossa approach. Modelling techniques allowed for implantation through the use of external landmarks, obviating the need for intraoperative image guidance. The surgical technique was refined over time through experience and adaptation. Mean follow-up was 29 months (range 3–71 months) with no surgical complications, favourable cosmesis, and expected audiometric outcomes. An average functional gain of 39.6 dB (± 14.7 SD) was found. Conclusion The middle fossa technique with self-drilling screws is a safe and effective option for BONEBRIDGE implantation. As a reference for other groups considering this approach, an annotated video has been included as a supplement to the study. Electronic supplementary material The online version of this article (10.1186/s40463-019-0354-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Peng You
- Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Lauren H Siegel
- Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Zahra Kassam
- Department of Medical Imaging, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Matthew Hebb
- Department of Clinical Neurological Sciences, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Lorne Parnes
- Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Hanif M Ladak
- Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine & Dentistry, Western University, London, Canada.,Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, Canada.,Department of Electrical & Computer Engineering, Faculty of Engineering, Western University, London, Canada
| | - Sumit Kishore Agrawal
- Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine & Dentistry, Western University, London, Canada. .,University Hospital, Room B1-333, London Health Sciences Centre - University Hospital, 339 Windermere Road, London, Ontario, N6A 5A5, Canada. .,Department of Electrical & Computer Engineering, Faculty of Engineering, Western University, London, Canada.
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Systematic Review on the Trial Period for Bone Conduction Devices in Single-Sided Deafness: Rates and Reasons for Rejection. Otol Neurotol 2018; 38:632-641. [PMID: 28414693 DOI: 10.1097/mao.0000000000001405] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To systematically review the literature to evaluate the trial period of bone conduction devices (BCDs) for adult patients with single-sided deafness (SSD). DATA SOURCES The PubMed, Embase, and Cochrane Library databases were searched from their inception up to August 15, 2016 for SSD, BCD, and their synonyms. STUDY SELECTION In total, 523 articles were retrieved, of which 12 satisfied the eligibility quality criteria. Our outcomes of interest were: 1) the BCD implantation rejection percentage, 2) reasons to reject BCD implantation, and 3) possible prognostic factors predicting the trial outcome. DATA EXTRACTION AND SYNTHESIS At critical appraisal, six studies (n = 471 patients) scored a moderate to high directness of evidence and a medium or low risk of bias and were selected for data extraction. Due to heterogeneity between studies, pooling of data for meta-analysis was not feasible. Therefore, results of studies were summarized per outcome: 1) after the BCD trial, 32.0 to 69.6% of SSD patients rejected BCD implantation, 2) the three main reasons for rejection were experiencing limited benefit from the device, patients fearing or being unfit for surgery and cosmetic aspects, 3) no clear prognostic factors predicting the trial outcome could be identified. CONCLUSION Roughly half of patients rejected BCD implantation after a trial period. From the current literature it is unclear which patients could benefit most from BCD implantation. High level of evidence studies should be conducted to investigate possible prognostic factors that predict the BCD trial outcome.
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20
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A New Transcutaneous Bone Conduction Hearing Implant: Short-term Safety and Efficacy in Children. Otol Neurotol 2017; 37:713-20. [PMID: 27153327 DOI: 10.1097/mao.0000000000001038] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the safety and efficacy of a new bone conduction hearing implant in children, during a 3-month follow-up period. STUDY DESIGN Prospective, single-subject repeated-measures design in which each subject serves as his/her own control. SETTING Otolaryngology departments of four Austrian hospitals. PATIENTS Twelve German-speaking children aged 5 to 17 suffering from conductive or mixed hearing loss, with an upper bone conduction threshold limit of 45 dB HL at frequencies between 500 and 4000 Hz. INTERVENTION Implantation of the Bonebridge transcutaneous bone conduction hearing implant (tBCI). MAIN OUTCOME MEASURES The subjects' audiometric thresholds (air conduction, bone conduction, and sound field at frequencies 500 Hz to 8 kHz) and speech perception (word recognition scores [WRS] and 50% word intelligibility in sentences [SRT50%]) were tested preoperatively and at 1 and 3 months postoperatively. The patients were also monitored for adverse events and they or their parents filled out questionnaires to analyze satisfaction levels. RESULTS Speech perception as measured by WRS and SRT50% improved on average approximately 67.6% and 27.5 dB, respectively, 3 months after implantation. Aided thresholds also improved postoperatively, showing statistical significance at all tested frequencies. Air conduction and bone conduction thresholds showed no significant changes, confirming that subjects' residual unaided hearing was not damaged by the treatment. Only minor adverse events were reported and resolved by the end of the study. CONCLUSION Safety and efficacy of the new bone conduction implant was demonstrated in children followed up to 3 months postoperatively.
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21
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Sharma S, Reddy-Kolanu G, Marshall A. UK tertiary centre experience of outcomes from osseointegrated transcutaneous magnetic bone conduction hearing system implanted in twenty-five patients using a linear incision technique. Clin Otolaryngol 2017; 42:1041-1043. [DOI: 10.1111/coa.12815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2016] [Indexed: 12/01/2022]
Affiliation(s)
- S. Sharma
- Queen's Medical Centre Nottingham; Nottingham UK
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Understanding the low uptake of bone-anchored hearing aids: a review. The Journal of Laryngology & Otology 2017; 131:190-201. [PMID: 28124627 DOI: 10.1017/s0022215116009981] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Bone-anchored hearing aids improve hearing for patients for whom conventional behind-the-ear aids are problematic. However, uptake of bone-anchored hearing aids is low and it is important to understand why this is the case. METHOD A narrative review was conducted. Studies examining why people accept or decline bone-anchored hearing aids and satisfaction levels of people with bone-anchored hearing aids were reviewed. RESULTS Reasons for declining bone-anchored hearing aids included limited perceived benefits, concerns about surgery, aesthetic concerns and treatment cost. No studies providing in-depth analysis of the reasons for declining or accepting bone-anchored hearing aids were identified. Studies of patient satisfaction showed that most participants reported benefits with bone-anchored hearing aids. However, most studies used cross-sectional and/or retrospective designs and only included people with bone-anchored hearing aids. CONCLUSION Important avenues for further research are in-depth qualitative research designed to fully understand the decision-making process for bone-anchored hearing aids and rigorous quantitative research comparing satisfaction of people who receive bone-anchored hearing aids with those who receive alternative (or no) treatments.
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23
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Calon TGA, van Hoof M, van den Berge H, de Bruijn AJG, van Tongeren J, Hof JR, Brunings JW, Jonhede S, Anteunis LJC, Janssen M, Joore MA, Holmberg M, Johansson ML, Stokroos RJ. Minimally Invasive Ponto Surgery compared to the linear incision technique without soft tissue reduction for bone conduction hearing implants: study protocol for a randomized controlled trial. Trials 2016; 17:540. [PMID: 27829464 PMCID: PMC5103483 DOI: 10.1186/s13063-016-1662-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 10/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Over the last years, less invasive surgical techniques with soft tissue preservation for bone conduction hearing implants (BCHI) have been introduced such as the linear incision technique combined with a punch. Results using this technique seem favorable in terms of rate of peri-abutment dermatitis (PAD), esthetics, and preservation of skin sensibility. Recently, a new standardized surgical technique for BCHI placement, the Minimally Invasive Ponto Surgery (MIPS) technique has been developed by Oticon Medical AB (Askim, Sweden). This technique aims to standardize surgery by using a novel surgical instrumentation kit and minimize soft tissue trauma. METHODS A multicenter randomized controlled trial is designed to compare the MIPS technique to the linear incision technique with soft tissue preservation. The primary investigation center is Maastricht University Medical Center. Sixty-two participants will be included with a 2-year follow-up period. Parameters are introduced to quantify factors such as loss of skin sensibility, dehiscence of the skin next to the abutment, skin overgrowth, and cosmetic results. A new type of sampling method is incorporated to aid in the estimation of complications. To gain further understanding of PAD, swabs and skin biopsies are collected during follow-up visits for evaluation of the bacterial profile and inflammatory cytokine expression. The primary objective of the study is to compare the incidence of PAD during the first 3 months after BCHI placement. Secondary objectives include the assessment of parameters related to surgery, wound healing, pain, loss of sensibility of the skin around the implant, implant extrusion rate, implant stability measurements, dehiscence of the skin next to the abutment, and esthetic appeal. Tertiary objectives include assessment of other factors related to PAD and a health economic evaluation. DISCUSSION This is the first trial to compare the recently developed MIPS technique to the linear incision technique with soft tissue preservation for BCHI surgery. Newly introduced parameters and sampling method will aid in the prediction of results and complications after BCHI placement. TRIAL REGISTRATION Registered at the CCMO register in the Netherlands on 24 November 2014: NL50072.068.14 . Retrospectively registered on 21 April 2015 at ClinicalTrials.gov: NCT02438618 . This trial is sponsored by Oticon Medical AB.
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Affiliation(s)
- Tim G A Calon
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Marc van Hoof
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Herbert van den Berge
- Department of Otorhinolaryngology, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands
| | - Arthur J G de Bruijn
- Department of Otorhinolaryngology, ZiekenhuisGroep Twente, Almelo, The Netherlands
| | - Joost van Tongeren
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Janny R Hof
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jan Wouter Brunings
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Lucien J C Anteunis
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Miranda Janssen
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Methodology and Statistics, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Manuela A Joore
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - Martin L Johansson
- Oticon Medical AB, Askim, Sweden.,Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Robert J Stokroos
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
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Ramos Macías Á, Borkoski-Barreiro SA, Falcón González JC, Ramos de Miguel Á. AHL, SSD and bimodal CI results in children. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133 Suppl 1:S15-20. [PMID: 27236852 DOI: 10.1016/j.anorl.2016.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 01/29/2016] [Accepted: 04/28/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This article aims to demonstrate that children with asymmetric hearing loss (AHL), specifically those with single side deafness (SSD condition) and pure SSD, with substantial hearing (>70% normal speech discrimination) in the ear with hearing aid (HA), obtain clinically relevant speech perception benefit after cochlear implantation in the contralateral side. RESULTS Retrospective study of two groups: (1) 36 AHL children with bimodal hearing and (2) SSD children with SSD. They had follow-ups of 24 and 12 months duration, respectively. The AHL children where implanted on one ear and depending on the contralateral ear condition, they were divided into two groups: children who reach a disyllabic speech test score lower than 50% in quiet at 65dB-SPL without lip reading (27) and children with test score higher than 70% (9). The second group consisted on 2 children implanted to obtain SSD condition, as preliminary data, with 1 year of follow-up. They showed benefits of binaural stimulation. CONCLUSION Children in a bimodal situation, with substantial hearing (>70% speech discrimination) in the ear with HA, obtain clinically relevant speech perception benefit after cochlear implantation in the contralateral side.
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Affiliation(s)
- Á Ramos Macías
- Hearing Loss Unit, Otorhinolaryngology, Head and Neck Department, Complejo Hospitalario Universitario Insular Materno Infantil, Av. Marítima del Sur s/n, Las Palmas of Gran Canaria 35016, Spain.
| | - S A Borkoski-Barreiro
- Hearing Loss Unit, Otorhinolaryngology, Head and Neck Department, Complejo Hospitalario Universitario Insular Materno Infantil, Av. Marítima del Sur s/n, Las Palmas of Gran Canaria 35016, Spain
| | - J C Falcón González
- Hearing Loss Unit, Otorhinolaryngology, Head and Neck Department, Complejo Hospitalario Universitario Insular Materno Infantil, Av. Marítima del Sur s/n, Las Palmas of Gran Canaria 35016, Spain
| | - Á Ramos de Miguel
- Hearing Loss Unit, Otorhinolaryngology, Head and Neck Department, Complejo Hospitalario Universitario Insular Materno Infantil, Av. Marítima del Sur s/n, Las Palmas of Gran Canaria 35016, Spain
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Siau RTK, Dhillon B, Siau D, Green KMJ. Bone-anchored hearing aids in conductive and mixed hearing losses: why do patients reject them? Eur Arch Otorhinolaryngol 2016; 273:3117-22. [DOI: 10.1007/s00405-016-3941-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 02/14/2016] [Indexed: 10/22/2022]
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26
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Bone conduction implants – a rapidly developing field. The Journal of Laryngology & Otology 2015; 129:936-40. [DOI: 10.1017/s0022215115002042] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackground:Since their introduction in 1977, the technology and surgical techniques surrounding the use and application of bone-anchored hearing devices have developed considerably.Objective:This article reviews current developments in the use of bone-anchored hearing devices, looking at the possible options for patients, complications encountered and future possibilities.Conclusion:Advances in surgical technique are described, with the move towards the use of linear incisions and no soft tissue reduction. Methods for preventing complications are analysed, with review of different abutments and the introduction of the active bone conduction implant.
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27
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Graham ME, Haworth R, Chorney J, Bance M, Hong P. Decisional Conflict in Parents Considering Bone-Anchored Hearing Devices in Children With Unilateral Aural Atresia. Ann Otol Rhinol Laryngol 2015; 124:925-30. [PMID: 26082472 DOI: 10.1177/0003489415592000] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The benefits of bone-anchored hearing devices (BAHD) in children with unilateral aural atresia are controversial. We sought to determine whether there is parental decisional conflict surrounding elective placement of BAHD for this indication. METHODS Caregivers of pediatric patients with unilateral aural atresia and normal contralateral ear undergoing percutaneous BAHD consultation were enrolled. All consultations were carried out by one pediatric otolaryngologist in a consistent manner. After consultation, the participants completed a demographics form and the Decisional Conflict Scale (DCS) questionnaire. RESULTS Twenty-three caregivers of 15 male (65.2%) and 8 female (34.8%) children (mean age 5.65 years) participated. The overall median DCS score was 15.63 (standard error = 4.21). Significant decisional conflict (DCS score ≥ 25) was found in 10 participants (43.5%). The median DCS score in the group choosing surgery was 5.47, and it was 23.44 in those who did not choose surgery (Mann-Whitney U = 39, Z = -1.391, P = .164). The median DCS score for mothers and fathers was 25 and 3.91, respectively. CONCLUSION Many parents experienced significant decisional conflict when considering percutaneous BAHD surgery in children with unilateral aural atresia in our study population. Future research should explore the impact of decisional conflict on health outcomes.
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Affiliation(s)
- M Elise Graham
- IWK Health Centre, Halifax, Nova Scotia, Canada Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Jill Chorney
- IWK Health Centre, Halifax, Nova Scotia, Canada Dalhousie University, Halifax, Nova Scotia, Canada
| | - Manohar Bance
- IWK Health Centre, Halifax, Nova Scotia, Canada Dalhousie University, Halifax, Nova Scotia, Canada
| | - Paul Hong
- IWK Health Centre, Halifax, Nova Scotia, Canada Dalhousie University, Halifax, Nova Scotia, Canada
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Switching from a percutaneous to a transcutaneous bone anchored hearing system: the utility of the fascia temporalis superficialis pedicled flap in case of skin intolerance. Eur Arch Otorhinolaryngol 2015; 272:2563-9. [PMID: 25634062 DOI: 10.1007/s00405-015-3521-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 01/19/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To present the option to use a Fascia Temporalis Superficialis pedicled flap for the implantation of a transcutaneous magnetic osseointegrated auditory implant in selected revision procedures. BACKGROUND Osseointegrated auditory implants represent a reliable option for patients. Skin intolerance and aesthetic issue are two clear limitations of percutaneous system. Magnetic transcutaneous devices have been developed to overcome such drawbacks. The current new experience of such a device shows that they are well tolerated in primary cases. However, switching from a previous percutaneous system raises the question of skin tolerance. Hence, previous implanted abutments with skin penetration and skin reduction are more likely cause to skin intolerance and complication. METHODS We described here the option to use a Fascia Temporalis Superficialis flap to cover the implanted magnet. CONCLUSION When switching from percutaneous osseointegrated auditory implant to transcutaneous system in case of high risk of skin intolerance, this procedure may provide sufficient tissue coverage to prevent skin intolerance, pain and delayed extrusion.
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Clamp PJ, Briggs RJS. The Cochlear Baha 4 Attract System – design concepts, surgical technique and early clinical results. Expert Rev Med Devices 2014; 12:223-30. [DOI: 10.1586/17434440.2015.990375] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Boyd PJ. Potential benefits from cochlear implantation of children with unilateral hearing loss. Cochlear Implants Int 2014; 16:121-36. [DOI: 10.1179/1754762814y.0000000100] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Kitterick PT, O'Donoghue GM, Edmondson-Jones M, Marshall A, Jeffs E, Craddock L, Riley A, Green K, O'Driscoll M, Jiang D, Nunn T, Saeed S, Aleksy W, Seeber BU. Comparison of the benefits of cochlear implantation versus contra-lateral routing of signal hearing aids in adult patients with single-sided deafness: study protocol for a prospective within-subject longitudinal trial. BMC EAR, NOSE, AND THROAT DISORDERS 2014; 14:7. [PMID: 25152694 PMCID: PMC4141989 DOI: 10.1186/1472-6815-14-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 07/18/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Individuals with a unilateral severe-to-profound hearing loss, or single-sided deafness, report difficulty with listening in many everyday situations despite having access to well-preserved acoustic hearing in one ear. The standard of care for single-sided deafness available on the UK National Health Service is a contra-lateral routing of signals hearing aid which transfers sounds from the impaired ear to the non-impaired ear. This hearing aid has been found to improve speech understanding in noise when the signal-to-noise ratio is more favourable at the impaired ear than the non-impaired ear. However, the indiscriminate routing of signals to a single ear can have detrimental effects when interfering sounds are located on the side of the impaired ear. Recent published evidence has suggested that cochlear implantation in individuals with a single-sided deafness can restore access to the binaural cues which underpin the ability to localise sounds and segregate speech from other interfering sounds. METHODS/DESIGN The current trial was designed to assess the efficacy of cochlear implantation compared to a contra-lateral routing of signals hearing aid in restoring binaural hearing in adults with acquired single-sided deafness. Patients are assessed at baseline and after receiving a contra-lateral routing of signals hearing aid. A cochlear implant is then provided to those patients who do not receive sufficient benefit from the hearing aid. This within-subject longitudinal design reflects the expected care pathway should cochlear implantation be provided for single-sided deafness on the UK National Health Service. The primary endpoints are measures of binaural hearing at baseline, after provision of a contra-lateral routing of signals hearing aid, and after cochlear implantation. Binaural hearing is assessed in terms of the accuracy with which sounds are localised and speech is perceived in background noise. The trial is also designed to measure the impact of the interventions on hearing- and health-related quality of life. DISCUSSION This multi-centre trial was designed to provide evidence for the efficacy of cochlear implantation compared to the contra-lateral routing of signals. A purpose-built sound presentation system and established measurement techniques will provide reliable and precise measures of binaural hearing. TRIAL REGISTRATION Current Controlled Trials http://www.controlled-trials.com/ISRCTN33301739 (05/JUL/2013).
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Affiliation(s)
- Pádraig T Kitterick
- National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, Ropewalk House, 113 The Ropewalk, NG1 5DU Nottingham, UK ; Otology and Hearing group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, NG7 2UH Nottingham, UK
| | - Gerard M O'Donoghue
- National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, Ropewalk House, 113 The Ropewalk, NG1 5DU Nottingham, UK ; Nottingham University Hospitals NHS Trust, Queen's Medical Centre, NG7 2UH Nottingham, UK
| | - Mark Edmondson-Jones
- National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, Ropewalk House, 113 The Ropewalk, NG1 5DU Nottingham, UK ; Otology and Hearing group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, NG7 2UH Nottingham, UK
| | - Andrew Marshall
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, NG7 2UH Nottingham, UK
| | - Ellen Jeffs
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, NG7 2UH Nottingham, UK
| | - Louise Craddock
- Midlands Hearing Implant Programme, Queen Elizabeth Hospital Audiology Centre, University Hospitals Birmingham, B15 2TH Birmingham, UK
| | - Alison Riley
- Midlands Hearing Implant Programme, Queen Elizabeth Hospital Audiology Centre, University Hospitals Birmingham, B15 2TH Birmingham, UK
| | - Kevin Green
- Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, M13 9WL Manchester, UK ; University of Manchester, Oxford Rd, M13 9PL Manchester, UK
| | - Martin O'Driscoll
- Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, M13 9WL Manchester, UK ; University of Manchester, Oxford Rd, M13 9PL Manchester, UK
| | - Dan Jiang
- Department of Audiology, St Thomas' Hospital, Lambeth Palace Road, SE1 7EH London, UK
| | - Terry Nunn
- Department of Audiology, St Thomas' Hospital, Lambeth Palace Road, SE1 7EH London, UK
| | - Shakeel Saeed
- The Royal National Throat, Nose and Ear Hospital, 330 Gray's Inn Road, WC1X 8DA London, UK
| | - Wanda Aleksy
- The Royal National Throat, Nose and Ear Hospital, 330 Gray's Inn Road, WC1X 8DA London, UK
| | - Bernhard U Seeber
- MRC Institute of Hearing Research, University Park, NG7 2RD Nottingham, UK ; Technische Universität München, Associated Institute Audio Information Processing, Arcisstrasse 21, 80333 Munich, Germany
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