Estimating Real-World Performance of Percutaneously Coupled Bone-Conduction Device Users With Severe-to-Profound Unilateral Hearing Loss

Systematic Review of Quality of Life in Bone Anchored Hearing: Conductive vs. Unilateral Sensorineural Hearing Loss

OBJECTIVE

The purpose of this study was to systematically review the differences in disease-specific quality of life (QoL) benefits experienced by bone-anchored hearing implant (BAHI) users between those diagnosed with unilateral sensorineural hearing loss (U-SNHL) and those with conductive/mixed hearing loss (CHL).

DATA SOURCES

Eligible studies were searched for in Medline (Ovid), Embase (Ovid), CINAHL (Ebsco), Cochrane (Wiley), Global Health (Ovid), Web of Science (Clarivate Analytics), Africa Wide Information (Ebsco) and Global Index Medicus (WHO) from inception to October 23, 2022. Updated searches were performed on November 9, 2023, and July 11, 2024.

REVIEW METHODS

There were no restrictions on language. PRISMA standards were followed, and screening was conducted by two independent reviewers in Rayyan, with a third reviewer resolving conflicts. Risk of bias was assessed using RoBANS. Articles were included if patients were implanted with a BAHI and administered a validated, disease-specific QoL measure.

RESULTS

One thousand, three hundred twelve articles were identified after duplicate removal, with 56 articles meeting the inclusion criteria. Eight different disease-specific QoL measures were administered. In all, the APHAB's "Global" (p = 0.0002), EC (p < 0.00001), and BN (p = 0.02) scores, as well as the GBI's "Global" (p = 0.0001), "General" (p = 0.002), and "Physical" (p = 0.02) scores were significantly different between U-SNHL and CHL populations.

CONCLUSION

These results demonstrated disease-specific QoL differences between BAHI users with U-SNHL and CHL. Specifically, patients with CHL reported greater benefits in domains pertaining to communication ease, the clarity of sound, and their overall health and psychosocial status.

Investigating Real-World Benefits of High-Frequency Gain in Bone-Anchored Users with Ecological Momentary Assessment and Real-Time Data Logging

Purpose: To compare listening ability (speech reception thresholds) and real-life listening experience in users with a percutaneous bone conduction device (BCD) with two listening programs differing only in high-frequency gain. In situ real-life experiences were recorded with ecological momentary assessment (EMA) techniques combined with real-time acoustical data logging and standard retrospective questionnaires. Methods: Nineteen experienced BCD users participated in this study. They all used a Ponto 4 BCD from Oticon Medical during a 4-week trial period. Environmental data and device parameters (i.e., device usage and volume control) were logged in real-time on an iPhone via a custom iOS research app. At the end of the trial period, subjects filled in APHAB, SSQ, and preference questionnaires. Listening abilities with the two programs were evaluated with speech reception threshold tests. Results: The APHAB and SSQ questionnaires did not reveal any differences between the two listening programs. The EMAs revealed group-level effects, indicating that in speech and noisy listening environments, subjects preferred the default listening program, and found the program with additional high-frequency gain too loud. This finding was corroborated by the volume log—subjects avoided the higher volume control setting and reacted more to changes in environmental sound pressure levels when using the high-frequency gain program. Finally, day-to-day changes in EMAs revealed acclimatization effects in the listening experience for ratings of “sound quality” and “program suitability” of the BCD, but not for ratings of “loudness perception” and “speech understanding”. The acclimatization effect did not differ among the listening programs. Conclusion: Adding custom high-frequency amplification to the BCD target-gain prescription improves speech reception in laboratory tests under quiet conditions, but results in poorer real-life listening experiences due to loudness.