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Talon E, Wagner F, Weder S, Anschuetz L, Caversaccio M, Wimmer W. Evaluating temporal bone column density for optimized bone conduction implant placement. Front Surg 2023; 10:1293616. [PMID: 38098476 PMCID: PMC10720247 DOI: 10.3389/fsurg.2023.1293616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/17/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction An optimal placement of bone conduction implants can provide more efficient mechanical transmission to the cochlea if placed in regions with greater bone column density. The aim of this study was to test this hypothesis and to determine the clinical potential of preoperative bone column density assessment for optimal implant placement. Methods Five complete cadaver heads were scanned with quantitative computed tomography imaging to create topographic maps of bone density based on the column density index (CODI). Laser Doppler vibrometry was used to measure cochlear promontory acceleration under bone conduction stimulation in different locations on the temporal bone, using a bone-anchored hearing aid transducer at frequencies ranging from 355 Hz to 10 kHz. Results We found a statistically significant association between CODI levels and the accelerance of the cochlear promontory throughout the frequency spectrum, with an average increase of 0.6 dB per unit of CODI. The distance between the transducer and the cochlear promontory had no statistically significant effect on the overall spectrum. Discussion We highlight the importance of bone column density in relation to the mechanical transmission efficiency of bone conduction implants. It may be worthwhile to consider column density in preoperative planning in clinical practice.
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Affiliation(s)
- Emile Talon
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, Bern, Switzerland
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Franca Wagner
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Stefan Weder
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Lukas Anschuetz
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Marco Caversaccio
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, Bern, Switzerland
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Wilhelm Wimmer
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, Bern, Switzerland
- Department of Otorhinolaryngology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Willenborg K, Lenarz T, Busch S. Surgical and audiological outcomes with a new transcutaneous bone conduction device with reduced transducer thickness in children. Eur Arch Otorhinolaryngol 2023; 280:4381-4389. [PMID: 37000276 PMCID: PMC10477095 DOI: 10.1007/s00405-023-07927-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 03/13/2023] [Indexed: 04/01/2023]
Abstract
PURPOSE Due to smaller bone thickness, young children with conductive or mixed hearing loss or single-sided deafness were previously most commonly treated with a percutaneous osseointegrated bone-anchored hearing aid (BAHA) or an active middle-ear implant. While the BAHA increases the risk of implant infections, skin infection, overgrowth of the screw or involvement of the implant in head trauma, middle-ear implant surgery involves manipulation of the ossicles with possible risk of surgical trauma. These complications can be omitted with transcutaneous bone conduction implant systems like the MED-EL Bonebridge system. The purpose of this study was to analyze whether the second generation of the Bonebridge (BCI 602) that features a decreased implant thickness with a reduced surgical drilling depth can be implanted safely in young children with good postoperative hearing performance. METHODS In this study, 14 patients under 12 years were implanted with the second generation of the Bonebridge. Preoperative workup comprised a CT scan, an MRI scan, pure tone audiometry, or alternatively a BERA (bone conduction, air conduction). Since children under 12 years often have a lower bone thickness, the CT was performed to determine the suitability of the temporal bone for optimal implant placement using the Otoplan software. RESULTS All patients (including three under the age of five) were successfully implanted and showed a good postoperative hearing performance. CONCLUSION With adequate preoperative workup, this device can be safely implanted in children and even children under 5 years of age and allows for an extension of indication criteria toward younger children.
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Affiliation(s)
- Kerstin Willenborg
- Department of Otolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
- Cluster of Excellence H4A, Hannover, Germany.
| | - Thomas Lenarz
- Department of Otolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Cluster of Excellence H4A, Hannover, Germany
| | - Susan Busch
- Department of Otolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Cluster of Excellence H4A, Hannover, Germany
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Carnevale C, Morales-Olavarría C, Til-Pérez G, Sarría-Echegaray P. Bonebridge ® bone conduction implant. Hearing outcomes and quality of life in patients with conductive/mixed hearing loss. Eur Arch Otorhinolaryngol 2023; 280:1611-1619. [PMID: 36063211 DOI: 10.1007/s00405-022-07631-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 08/25/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to analyze the hearing outcomes and quality of life in a series of 52 patients affected by conductive or mixed hearing loss and treated with Bonebridge®. METHODS 52 of 71 patients implanted with Bonebridge® between October 2012 and January 2022, were included in the study. We compared the air conduction thresholds at the frequencies 500, 1000, 2000, 3000, 4000 Hz, the SRT50% and the World Recognition Score at an intensity of 50 dB with and without the implant. The Abbreviated Profile of Hearing Aid Benefit (APHAB) was employed to assess the quality of life of patients. RESULTS The liminal tone audiometry (free field) pure tone average for air conduction after 6 months with the implant was 35.12 dB, obtaining a mean gain of 31.83 dB. With Bonebridge®, the mean SRT was 34.17 dB, whereas before the surgery no patient achieved 50% of correct answers at a sound intensity of 50 dB. The world recognition score at 50 dB changed from 11% without the implant to 85% with it. We observed one case of implant failure and one case of implant exposure. The APHAB questionnaire showed an improvement after implantation in practically all the subscales. CONCLUSIONS The hearing outcomes and the subjective benefits reported by patients obtained in our study are similar to those published in the literature. Bonebridge® represents an excellent method for the rehabilitation of patients with conductive and mixed hearing loss, showing a low rate of complications.
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Affiliation(s)
- Claudio Carnevale
- Department of Otorhinolaryngology Head and Neck Surgery, Son Espases University Hospital, Carretera Valldemossa 79, 07210, Palma, Spain.
| | - C Morales-Olavarría
- Department of Otorhinolaryngology Head and Neck Surgery, Son Espases University Hospital, Carretera Valldemossa 79, 07210, Palma, Spain
| | - G Til-Pérez
- Department of Otorhinolaryngology Head and Neck Surgery, Son Espases University Hospital, Carretera Valldemossa 79, 07210, Palma, Spain
| | - P Sarría-Echegaray
- Department of Otorhinolaryngology Head and Neck Surgery, Son Espases University Hospital, Carretera Valldemossa 79, 07210, Palma, Spain
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Shoman NM, Khan U, Hong P. Comparison of passive versus active transcutaneous bone anchored hearing devices in the pediatric population. JOURNAL OF OTOLARYNGOLOGY - HEAD & NECK SURGERY 2022; 51:44. [DOI: 10.1186/s40463-022-00595-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 09/05/2022] [Indexed: 11/15/2022]
Abstract
Abstract
Objective
Transcutaneous bone anchored hearing devices (BAHDs) were introduced in an effort to avoid potential complications associated with the abutment of percutaneous BAHDs. Transcutaneous BAHDs can be active or passive. While studies have demonstrated good outcomes with both, a direct comparison of audiological and clinical outcomes of these devices in the pediatric population has not yet been studied.
Study design
Retrospective, multicenter study.
Setting
Two tertiary academic centers.
Methods
Between 2015 and 2019, all patients who received an active transcutaneous BAHD (Bonebridge, BB) at one center, and patients that received a passive transcutaneous BAHD (Attract, AT) at another center, were included in this study. Exclusion criteria included age > 18 years, and mixed hearing loss or single-sided deafness. Study outcomes included patient demographics, indications, complications and preoperative and one-year postoperative audiometric data.
Results
Eighteen BB and eight AT patients met the inclusion criteria. The age range was 5–16 years. There were no significant differences in complication outcomes. Both devices demonstrated similar mean improvements in hearing thresholds at frequencies of 250 Hz (38 dB Active vs. 38 dB Passive), 500 Hz (34 dB vs. 42 dB), 1000 Hz (34 dB vs. 40 dB) and 2000 Hz (31 dB vs. 22 dB). The BB was significantly more effective at frequencies of 4000 Hz (28 dB vs. 7 dB) and 8000 Hz (29 dB vs. 6 dB) (p < 0.05).
Conclusion
This is the first study comparing audiological outcomes between an active and a passive transcutaneous BAHD in the pediatric population. While both devices improved audiometric outcomes in the low and mid frequencies, the active BAHD demonstrated significantly better outcomes in the higher frequencies.
Graphical Abstract
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Hwa TP, Locketz G, Ruckenstein MJ. Novel Surgical Technique in Active Bone Conduction: Minimally Invasive Approach to Fully Implantable Osseointegrated Implant. Otolaryngol Head Neck Surg 2021; 167:206-208. [PMID: 34637372 DOI: 10.1177/01945998211044408] [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: 11/17/2022]
Abstract
We report our experience using a novel minimally invasive surgical technique for implantation of a fully implantable active bone conduction implant. This was a retrospective review of 16 adults, including 10 women and 6 men. The mean age was 54 years. Hearing loss profiles included 8 with mixed hearing loss, 5 with conductive hearing loss, and 3 with single-sided deafness. Nine patients underwent placement through the standard approach and 7 with the minimally invasive approach. There were no postoperative complications at a mean follow-up of 6.5 months (SD, 4; range, 1.5-12), and all patients received audiologic benefit with objective improvement in sound-field thresholds upon activation. Mean operative time was shorter with the minimally invasive approach (64 vs 41 minutes, P = .01). The fully implantable bone-anchored auditory implant can be effectively placed via a minimally invasive incision, with potential benefits of decreased operative time, low risk for intra- and postoperative complications, and rapid healing.
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Affiliation(s)
- Tiffany Peng Hwa
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Garrett Locketz
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael J Ruckenstein
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Hundertpfund J, Meyer JE, Ovari A. Long-term audiological benefit with an active transcutaneous bone-conduction device: a retrospective cohort analysis. Eur Arch Otorhinolaryngol 2021; 279:3309-3326. [PMID: 34424382 DOI: 10.1007/s00405-021-07031-w] [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: 04/25/2021] [Accepted: 08/03/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate long-term audiological, surgical and safety outcomes of a complex patient cohort treated with an active transcutaneous bone-conduction device (tBCD). METHODS This retrospective, monocentric cohort analysis involves 31 adults with conductive (CHL) and mixed hearing loss (MHL). For outcome analysis, study results were divided into short-term follow-up data (< 12 months) and long-term follow-up data (> 12 months). RESULTS 31 patients with a total person-time of 90.4 years and an average number of 3.2 ± 1.5 preoperatively performed surgeries on the implanted side were investigated. Mean BCD-aided PTA4 thresholds were significantly lower than unaided PTA4AC before surgery (64.7 ± 16.1 dB HL; CHL 50.6 ± 10.6 dB HL; MHL 72.8 ± 12.8 dB HL) and did not change between short-term (42.3 ± 13.1 dB HL; CHL 35.8 ± 6.8 dB HL; MHL 45.2 ± 14.3 dB HL) and long-term (43.4 ± 10.0 dB HL; CHL 35.8 ± 4.3 dB HL; MHL 48.1 ± 9.6 dB HL) follow-up periods. Speech intelligibility in the Freiburg monosyllables test at 65 dB improved significantly, from 16.3 ± 21.5% (CHL 26.8 ± 19.0%; MHL 8.7 ± 20.5%) in the unaided condition to 82.7 ± 15.5% (CHL 90.0 ± 12.2%; MHL 79.4 ± 16.3%) in the short-term and 85.5 ± 13.2% (CHL 93.8 ± 7.9%; MHL 79.5 ± 13.3%) BCD-aided in the long-term follow-up periods. Ten minor procedure-related and 6 implant-related (5 minor, 1 major) AEs occurred over the total follow-up period. CONCLUSION The device provides satisfactory audiological and speech benefit over long-term follow-up periods, up to 7 years. Explant rates were very low, while the overall rate of manageable AEs was high in this complex patient cohort. The device is considered a safe and effective option in the long-term hearing rehabilitation of patients with CHL and MHL.
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Affiliation(s)
| | - Jens Eduard Meyer
- Asklepios Medical School, Semmelweis University, Hamburg, Germany.,Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Plastic Surgery, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Attila Ovari
- Asklepios Medical School, Semmelweis University, Hamburg, Germany. .,Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Plastic Surgery, Asklepios Klinik St. Georg, Hamburg, Germany. .,Department of Oto-Rhino-Laryngology, Head and Neck Surgery, "Otto Koerner", University Medical Center, Rostock, Germany.
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Canzi P, Avato I, Beltrame M, Bianchin G, Perotti M, Tribi L, Gioia B, Aprile F, Malpede S, Scribante A, Manfrin M, Benazzo M. Retrosigmoidal placement of an active transcutaneous bone conduction implant: surgical and audiological perspectives in a multicentre study. ACTA ACUST UNITED AC 2021; 41:91-99. [PMID: 33746228 PMCID: PMC7982754 DOI: 10.14639/0392-100x-n0609] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/10/2020] [Indexed: 11/25/2022]
Abstract
Introduction The retrosigmoidal (RS) placement of the Bonebridge system (BB) has been advocated for cases of unfavourable anatomical or clinical conditions which contraindicate transmastoid-presigmoidal positioning. However, these disadvantageous conditions, combined with the considerable dimensions of the implant, may represent a challenge, especially for surgeons with no skull base experience. Moreover, the literature reports only limited experience concerning RS implantation of the BB system. Methods A multicentre, retrospective study was conducted to analyse the surgical and functional outcomes of a wide population of patients undergoing RS placement of the BB system by means of a surgical technique specifically developed to overcome the intraoperative issues related to this surgery. Twenty patients with conductive or mixed hearing loss and single sided deafness were submitted to RS implantation of the BB system. Results Audiological assessment concerning the measurement of the functional and effective gain by pure-tone audiometry (28 dB HL and -12.25 dB HL, respectively) and speech audiometry (24.7 dB HL and -21 dB HL, respectively) was conducted. A high overall subjective improvement of quality of life was recorded with the Glasgow Benefit Inventory questionnaire. No major complications, such as device extrusions or other conditions requiring revision surgery, were reported during the follow-up period (median: 42 months). Conclusions In our study, which has one of the largest cohort of patients reported in the literature, RS placement of the BB system was safe and effective. Our functional results showed comparable hearing outcomes with presigmoidal placement. The effective gain, rarely investigated in this field, may be the object of further research to improve our understanding of bone conduction mechanisms exploited by bone conduction hearing implants.
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Affiliation(s)
- Pietro Canzi
- Department of Otorhinolaryngology, University of Pavia, Foundation IRCCS Policlinico "San Matteo", Pavia, Italy
| | - Irene Avato
- Department of Otorhinolaryngology, University of Pavia, Foundation IRCCS Policlinico "San Matteo", Pavia, Italy.,PhD in Experimental Medicine, University of Pavia, Italy
| | - Millo Beltrame
- Department of Otorhinolaryngology, University of Pavia, Foundation IRCCS Policlinico "San Matteo", Pavia, Italy
| | - Giovanni Bianchin
- Department of Otolaryngology and Audiology, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Marco Perotti
- Otorhinolaryngology Unit, Ospedale Civile "SS Antonio Biagio and C. Arrigo", Alessandria, Italy
| | - Lorenzo Tribi
- Department of Otolaryngology and Audiology, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Barbara Gioia
- Otorhinolaryngology Unit, Ospedale Civile "SS Antonio Biagio and C. Arrigo", Alessandria, Italy
| | - Federico Aprile
- Department of Otorhinolaryngology, University of Pavia, Foundation IRCCS Policlinico "San Matteo", Pavia, Italy
| | - Stefano Malpede
- Department of Otorhinolaryngology, University of Pavia, Foundation IRCCS Policlinico "San Matteo", Pavia, Italy
| | - Andrea Scribante
- Unit of Orthodontics and Paediatric Dentistry-Section of Dentistry-Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Marco Manfrin
- Department of Otorhinolaryngology, University of Pavia, Foundation IRCCS Policlinico "San Matteo", Pavia, Italy
| | - Marco Benazzo
- Department of Otorhinolaryngology, University of Pavia, Foundation IRCCS Policlinico "San Matteo", Pavia, Italy
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Active Versus Passive Transcutaneous Bone Conduction Hearing Devices: A Systematic Review and Meta-Analysis. Ear Hear 2021; 43:32-40. [PMID: 34191755 DOI: 10.1097/aud.0000000000001088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Active and passive transcutaneous devices (tBCHDs) have been introduced in an effort to address complication concerns with percutaneous devices. Direct comparison of active and passive devices through evidence synthesis practices is incomplete. This systematic review and meta-analysis sought to synthesize and compare available evidence on audiological, quality of life, and complication-related outcomes of active and passive tBCHDs. DESIGN MEDLINE, EMBASE, CINAHL, and Cochrane CENTRAL were searched from inception to September 23, 2019. Observational and experimental studies investigating active or passive tBCHDs in adults were eligible. Studies were screened independently in duplicate. This study is reported in accordance with the PRISMA guidelines. Risk of bias and quality assessments were completed using the Newcastle-Ottawa Scale and the Quality Appraisal Tool for Case Series. Meta-analysis was performed with random-effects models. Audiological outcomes included changes in pure-tone average, functional hearing, and high-frequency hearing. Quality of life outcomes included patient-reported results. Complications included minor, major, and total complications experienced. RESULTS One thousand five hundred forty-two nonduplicate articles were screened. Twenty-eight studies were included. Quality of included studies was low overall. The pooled complication rate for active devices was 14.8% (95% confidence interval: 0.09-0.21, I2: 0%). The pooled improvement in functional hearing for active devices among those with mixed or conductive hearing loss was 31.8 dB (95% confidence interval: 27.7-35.9, I2: 44.6). Improvement in functional hearing ranged from 25.2 to 44.3 dB for passive devices. Active devices provided improved high-frequency hearing compared to passive devices: the weighted average hearing gains at 2, 3, 4, and 6 kHz were 26.5, 25.7, 31.8, and 34.3 dB for active devices and 26.2, 21.1, 16.8, and 6.4 dB for passive devices, respectively. Both device types demonstrated improvement in ease of communication, reverberation, and understandability in background noise. CONCLUSIONS Both active and passive tBCHDs demonstrate acceptable safety profiles and QoL improvements. Active devices may provide better hearing outcomes, especially in high frequencies, but high-quality comparative studies are lacking. Future work is needed in this regard.
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Willenborg K, Avallone E, Maier H, Lenarz T, Busch S. A New Active Osseointegrated Implant System in Patients with Single-Sided Deafness. Audiol Neurootol 2021; 27:83-92. [PMID: 33902037 DOI: 10.1159/000515489] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 01/04/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The Cochlear™ Osia® System (Osia) is an active transcutaneous bone conduction implant system intended for patients with conductive and mixed hearing loss but can also be used in cases of single-sided deafness (SSD) for the contralateral routing of signal (CROS). The Osia implant is placed subcutaneously under the intact skin behind the ear with the piezoelectric actuator connected to an osseointegrated BI300 implant - a titanium screw used for a 2-stage Baha surgery - on the mastoid. The external processor is magnetically attached to the subcutaneous implant receiver coil. As the Osia has recently been CE certified and is new on the market, with limited patient outcome data for SSD available, the objective of this study was the evaluation of surgical procedure, audiological results, and patient satisfaction for the Osia in SSD patients. STUDY DESIGN In a prospective, monocentric clinical observation study, 6 patients (18 years of age or older) with SSD and bone conduction thresholds pure tone average 0.5, 1, 2, and 4 kHz ≤25 dB HL on the contralateral side were implanted with an Osia. Analysis of clinical outcome data with respect to surgical technique, adverse events, audiological measurement, and subjective benefit for SSD patients was conducted. Audiological measurements performed included hearing thresholds, sound field thresholds, word recognition scores (WRS; in %) in quiet, and speech recognition thresholds in noise (in dB SNR). All tests were performed unaided and aided with the Osia. The subjective benefit with the Osia was determined by using 2 questionnaires; the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Bern Benefit in Single-Sided Deafness (BBSSD). RESULTS Preliminary results indicate a straightforward surgical procedure with a low rate of complications and an improvement in speech perception in quiet, listening performance in everyday situations and patient satisfaction. However, in one of 6 subjects, a revision surgery had to be performed. CONCLUSION Provided that SSD patients are open for CROS hearing, they can benefit from the Osia by reduced head shadow effects and better speech recognition. Special caution should be given to the skin at the site of implantation to avoid complications.
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Affiliation(s)
- Kerstin Willenborg
- Department of Otorhinolaryngology, Medical University Hannover, Hannover, Germany
| | - Emilio Avallone
- Department of Otorhinolaryngology, Medical University Hannover, Hannover, Germany
| | - Hannes Maier
- Department of Otorhinolaryngology, Medical University Hannover, Hannover, Germany.,Cluster of Excellence Hearing4all, Medical University Hannover, Hannover, Germany
| | - Thomas Lenarz
- Department of Otorhinolaryngology, Medical University Hannover, Hannover, Germany.,Cluster of Excellence Hearing4all, Medical University Hannover, Hannover, Germany
| | - Susan Busch
- Department of Otorhinolaryngology, Medical University Hannover, Hannover, Germany.,Cluster of Excellence Hearing4all, Medical University Hannover, Hannover, Germany
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Dahm V, Traxler S, Liepins R, Auinger AB, Sterrer E, Kaider A, Riss D, Arnoldner C. Performance With an Adhesive Bone Conduction Device in Active Transcutaneous Bone Conduction Implant Users. Otol Neurotol 2021; 42:510-516. [PMID: 33443975 DOI: 10.1097/mao.0000000000003045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the performance and limits of an adhesive bone conduction hearing aid in patients implanted with an active transcutaneous bone conduction implant. Therefore, hearing performance and subjective benefit of patients with mixed and conductive hearing loss were assessed with both bone conduction devices. STUDY DESIGN AND PATIENTS This cohort study was conducted at a tertiary care center. Fifteen subjects, who had been implanted with an active transcutaneous device previously, were included and used the adhesive hearing device for 3 weeks instead of the implant. Subjects underwent two sets of audiological tests as well as assessments of quality of life at the beginning and at the end of the testing period. RESULTS Audiological results showed a significantly greater improvement in regards to functional hearing gain and word recognition scores with the transcutaneous bone conduction device than the nonimplantable adhesive device. Regression analysis showed a trend toward greater improvement with the transcutaneous device compared with the adhesive device in patients with an increasing bone conduction threshold. Hearing-specific and general quality-of-life questionnaires revealed no significant difference between the two devices. CONCLUSION Patients with mixed or conductive hearing loss experience hearing gain with both, the adhesive device and the active transcutaneous device. The adhesive device may be a valuable alternative to the active transcutaneous device, depending on the individual bone conduction threshold.
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Affiliation(s)
- Valerie Dahm
- Department of Otorhinolaryngology, Medical University of Vienna
| | | | - Rudolfs Liepins
- Department of Otorhinolaryngology, Medical University of Vienna
| | - Alice B Auinger
- Department of Otorhinolaryngology, Medical University of Vienna
| | | | - Alexandra Kaider
- Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Dominik Riss
- Department of Otorhinolaryngology, Medical University of Vienna
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Katiri R, Hall DA, Killan CF, Smith S, Prayuenyong P, Kitterick PT. Systematic review of outcome domains and instruments used in designs of clinical trials for interventions that seek to restore bilateral and binaural hearing in adults with unilateral severe to profound sensorineural hearing loss ('single-sided deafness'). Trials 2021; 22:220. [PMID: 33743802 PMCID: PMC7981927 DOI: 10.1186/s13063-021-05160-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/27/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND This systematic review aimed to identify, compare and contrast outcome domains and outcome instruments reported in studies investigating interventions that seek to restore bilateral (two-sided) and/or binaural (both ears) hearing in adults with single-sided deafness (SSD). Findings can inform the development of evidence-based guidance to facilitate design decisions for confirmatory trials. METHODS Records were identified by searching MEDLINE, EMBASE, PubMed, CINAHL, ClinicalTrials.gov, ISRCTN, CENTRAL, WHO ICTRP and the NIHR UK clinical trials gateway. The search included records published from 1946 to March 2020. Included studies were those as follows: (a) recruiting adults aged 18 years or older diagnosed with SSD of average threshold severity worse than 70 dB HL in the worse-hearing ear and normal (or near-normal) hearing in the better-hearing ear, (b) evaluating interventions to restore bilateral and/or binaural hearing and (c) enrolling those adults in a controlled trial, before-and-after study or cross-over study. Studies that fell just short of the participant eligibility criteria were included in a separate sensitivity analysis. RESULTS Ninety-six studies were included (72 full inclusion, 24 sensitivity analysis). For fully included studies, 37 exclusively evaluated interventions to re-establish bilateral hearing and 29 exclusively evaluated interventions to restore binaural hearing. Overall, 520 outcome domains were identified (350 primary and 170 secondary). Speech-related outcome domains were the most common (74% of studies), followed by spatial-related domains (60% of studies). A total of 344 unique outcome instruments were reported. Speech-related outcome domains were measured by 73 different instruments and spatial-related domains by 43 different instruments. There was considerable variability in duration of follow-up, ranging from acute (baseline) testing to 10 years after the intervention. The sensitivity analysis identified no additional outcome domains. CONCLUSIONS This review identified large variability in the reporting of outcome domains and instruments in studies evaluating the therapeutic benefits and harms of SSD interventions. Reports frequently omitted information on what domains the study intended to assess, and on what instruments were used to measure which domains. TRIAL REGISTRATION The systematic review protocol is registered on PROSPERO (International Prospective Register of Systematic Reviews): Registration Number CRD42018084274 . Registered on 13 March 2018, last revised on 7th of May 2019.
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Affiliation(s)
- Roulla Katiri
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Department of Audiology, Mater Misericordiae University Hospital, Dublin, D07 R2WY Ireland
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
| | - Deborah A. Hall
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
- University of Nottingham Malaysia, Jalan Broga, 43500 Semenyih, Selangor Darul Ehsan Malaysia
| | - Catherine F. Killan
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
- Yorkshire Auditory Implant Service, Bradford Teaching Hospitals Foundation NHS Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
| | - Sandra Smith
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
| | - Pattarawadee Prayuenyong
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Pádraig T. Kitterick
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU UK
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH UK
- Nottingham University Hospitals NHS Trust, Queen’s Medical Centre, Derby Road, Nottingham, NG7 2UH UK
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Seiwerth I, Fröhlich L, Schilde S, Götze G, Plontke SK, Rahne T. Clinical and functional results after implantation of the bonebridge, a semi-implantable, active transcutaneous bone conduction device, in children and adults. Eur Arch Otorhinolaryngol 2021; 279:101-113. [PMID: 33674927 PMCID: PMC8738362 DOI: 10.1007/s00405-021-06626-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 01/15/2021] [Indexed: 11/28/2022]
Abstract
Purpose Aim of the study was to evaluate the surgical, clinical and audiological outcome of 32 implantations of the Bonebridge, a semi-implantable transcutaneous active bone conduction implant. Methods In a retrospective cohort study, we analyzed data for 32 implantations in 31 patients (one bilateral case; seven age < 16 years) with conductive or mixed hearing loss, malformations, after multiple ear surgery, or with single-sided deafness as contralateral routing of signal (CROS). Results Four implantations were done as CROS. Five cases were simultaneously planned with ear prosthesis anchors, and 23 implantations (72%) were planned through three-dimensional (3D) “virtual surgery.” In all 3D-planned cases, the implant could be placed as expected. For implant-related complications, rates were 12.5% for minor and 3.1% for major complications. Implantation significantly improved mean sound field thresholds from a preoperative 60 dB HL (SD 12) to 33 dB HL (SD 6) at 3 postoperative months and 34 dB HL (SD 6) at > 11 postoperative months (p < 0.0001). Word recognition score in quiet at 65 dB SPL improved from 11% (SD 20) preoperatively to 74% (SD 19) at 3 months and 83% (SD 15) at > 11 months (p < 0.0001). The speech reception threshold in noise improved from − 1.01 dB unaided to − 2.69 dB best-aided (p = 0.0018). Conclusion We found a clinically relevant audiological benefit with Bonebridge. To overcome anatomical challenges, we recommend preoperative 3D planning in small and hypoplastic mastoids, children, ear malformation, and simultaneous implantation of ear prosthesis anchors and after multiple ear surgery.
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Affiliation(s)
- Ingmar Seiwerth
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle, Germany.
| | - Laura Fröhlich
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle, Germany
| | - Sebastian Schilde
- Department of Orthopedics, Trauma and Reconstructive Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle (Saale), Halle, Germany
| | - Gerrit Götze
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle, Germany
| | - Stefan K Plontke
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle, Germany
| | - Torsten Rahne
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle, Germany
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13
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Wang D, Ren R, Chen P, Yang J, Gao M, Liu Y, Zhao S. Application of retrosigmoid sinus approach in Bonebridge implantation. Acta Otolaryngol 2021; 141:129-134. [PMID: 33140681 DOI: 10.1080/00016489.2020.1832702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Bonebridge is an suitable option for conductive hearing loss, however, the traditional approach cannot accomplished a satisfying implantation for patients with congenital malformation or radical mastoidectomy. OBJECTIVES To evaluate the clinical application of retrosigmoid sinus approach in Bonebridge implantation and postoperative evaluation. MATERIALS AND METHODS 11 patients who underwent retrosigmoid sinus approach Bonebridge implantation from March 2016 to September 2019 were retrospectively analyzed, including 6 males and 5 females, aged 12-54 years old (30.6 in average). Among them, 4 cases had undergone bilateral radical mastoidectomy, 6 cases had bilateral congenital aural atresia or stenosis, and 1 case had unilateral congenital aural atresia. RESULTS All patients underwent Bonebridge implantation through retrosigmoid sinus approach according to the preoperative image reconstruction and plan. There was no surgical injury of sigmoid sinus or cerebrospinal fluid leakage during the operation. The aided threshold obtained an increase of 32.32 dB HL; the speech recognition rates of bisyllabic words, monosyllabic words and sentence were 79.6%, 67.8% and 75.0%, respectively. After 11-53 months of follow-up, the hearing effect was stable and no long-term complications occurred. CONCLUSION The retrosigmoid sinus approach is an effective surgical approach for patients with congenital ear deformities or radical cavity after mastoidectomy.
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Affiliation(s)
- Danni Wang
- Department of Otolaryngology – Head and Neck Surgery, Beijing Tongren Hospital, Key Laboratory of Otolaryngology – Head and Neck Surgery, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
| | - Ran Ren
- Department of Otolaryngology – Head and Neck Surgery, Beijing Tongren Hospital, Key Laboratory of Otolaryngology – Head and Neck Surgery, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
| | - Peiwei Chen
- Department of Otolaryngology – Head and Neck Surgery, Beijing Tongren Hospital, Key Laboratory of Otolaryngology – Head and Neck Surgery, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
| | - Jinsong Yang
- Department of Otolaryngology – Head and Neck Surgery, Beijing Tongren Hospital, Key Laboratory of Otolaryngology – Head and Neck Surgery, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
| | - Mengdie Gao
- Department of Otolaryngology – Head and Neck Surgery, Beijing Tongren Hospital, Key Laboratory of Otolaryngology – Head and Neck Surgery, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
| | - Yujie Liu
- Department of Otolaryngology – Head and Neck Surgery, Beijing Tongren Hospital, Key Laboratory of Otolaryngology – Head and Neck Surgery, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
| | - Shouqin Zhao
- Department of Otolaryngology – Head and Neck Surgery, Beijing Tongren Hospital, Key Laboratory of Otolaryngology – Head and Neck Surgery, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
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14
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Hundertpfund J, Meyer JE, Óvári A. Patient-reported long-term benefit with an active transcutaneous bone-conduction device. PLoS One 2020; 15:e0241247. [PMID: 33137128 PMCID: PMC7605656 DOI: 10.1371/journal.pone.0241247] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 10/11/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose To evaluate the long-term benefits in hearing-related quality of life, patient satisfaction and wearing time of patients rehabilitated with an active transcutaneous bone-conduction device. Adverse events and audiological outcomes are reported as secondary outcomes. Methods This retrospective, mono-centric cohort analysis involves 16 adults with conductive or mixed hearing loss with a mean device experience of 51.25 months. Patient-reported outcome measures were assessed using the short version of the Speech, Spatial and Qualities of Hearing Scale (SSQ12-B) and the German version of the Audio Processor Satisfaction Questionnaire (APSQ). Audiological outcomes as well as incidence of adverse events were obtained from patients´ charts. Results The hearing-related quality of life improved significantly within all subscales of the SSQ12-B scoring a mean overall of 2.95 points. Patient satisfaction measured with the APSQ scored 8.8 points on average. Wearing times differed considerably and patients with lower levels of education seemed to use their device longer compared to patients with academic education. Eight minor adverse events were documented, all of which resolved during follow-up. The mean gain in word recognition score at the last follow-up measured at 65 dB was 75.9%, while speech reception threshold was lowered by 35.1 dB. Conclusion Even after several years, patients report significant benefits in hearing-related quality of life and device satisfaction. In combination with a low rate of minor adverse events and significantly improved audiological outcomes, the device is considered as a comfortable and effective option in hearing rehabilitation.
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Affiliation(s)
| | - Jens Eduard Meyer
- Asklepios Medical School, Semmelweis University, Hamburg, Germany
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Plastic Surgery, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Attila Óvári
- Asklepios Medical School, Semmelweis University, Hamburg, Germany
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Plastic Surgery, Asklepios Klinik St. Georg, Hamburg, Germany
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery “Otto Koerner”, University Medical Center, Rostock, Germany
- * E-mail:
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15
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Jones S, Spielmann P. Device profile of the Bonebridge bone conduction implant system in hearing loss: an overview of its safety and efficacy. Expert Rev Med Devices 2020; 17:983-992. [PMID: 33050771 DOI: 10.1080/17434440.2020.1834845] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The Bonebridge is an active transcutaneous semi-implantable bone conduction hearing device suitable for several types of hearing loss. It has unique benefits over some more established technologies. It consists of an internal active implant and an external sound processor. It was first launched in 2012, with a newer model released in late 2019. AREAS COVERED The structure and features of the device are described. Indications, audiological criteria, and contraindications to implantation are discussed. The planning and procedure of implantation surgery are also described. Research outlining the outcomes of implant use and risk of adverse events is highlighted. EXPERT OPINION The evidence included in this article demonstrates the successful audiological outcomes and patient satisfaction with Bonebridge implantation. The rate of adverse events following surgery is low and compares well with other devices which may be considered for Bonebridge candidates. The device should be considered as an option for suitable candidates and in many cases may be the better option available, given the low incidence of skin complications and the absence of a skin penetrating abutment. Future advances are likely to affect sound processor technology, connectivity, and possibly further reduction in implant size and gain.
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Affiliation(s)
- Stephen Jones
- Department of Otolaryngology, Ninewells Hospital & Medical School , Dundee, UK
| | - Patrick Spielmann
- Department of Otolaryngology, Ninewells Hospital & Medical School , Dundee, UK
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16
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Pepe G, Negri M, Falcioni M, Di Lella F, Vincenti V. Bonebridge implantation for mixed hearing loss in a patient with Kabuki syndrome. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020079. [PMID: 32921775 PMCID: PMC7717021 DOI: 10.23750/abm.v91i3.8257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 03/01/2019] [Indexed: 11/23/2022]
Abstract
The high prevalence of middle ear disease with related hearing loss in Kabuki syndrome requires the diagnostic and treatment expertise of otologists. This case report describes outcomes and changes in the quality of life of a patient affected by Kabuki syndrome with a history of recalcitrant chronic otitis media and mixed hearing loss who had undergone several unsuccessful surgical procedures before solving his problems by means of subtotal petrosectomy and active middle ear implant.
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Affiliation(s)
- Giovanni Pepe
- Otolaryngology and Otoneurosurgery Department, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43126 Parma, Italy..
| | - Maurizio Negri
- Department of Otorhinolaryngology, Ospedale Ramazzini, Carpi, Italy.
| | - Maurizio Falcioni
- Otolaryngology and Otoneurosurgery Department, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43126 Parma, Italy..
| | - Filippo Di Lella
- Otolaryngology and Otoneurosurgery Department, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43126 Parma, Italy.
| | - Vincenzo Vincenti
- Otolaryngology and Otoneurosurgery Department, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43126 Parma, Italy.
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17
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Almuhawas F, Alzhrani F, Saleh S, Alsanosi A, Yousef M. Auditory Performance and Subjective Satisfaction with the ADHEAR System. Audiol Neurootol 2020; 26:1-10. [PMID: 32544908 DOI: 10.1159/000507775] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 04/06/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The ADHEAR device, a new nonsurgical bone conduction hearing device, has been developed for patients with conductive hearing loss. OBJECTIVES This study aims to assess the impact of the ADHEAR device on the audiological performance and satisfaction level in subjects with conductive hearing loss. METHODS Twelve patients with conductive hearing loss were included. All patients received the device for 3 months. The audiological outcomes were determined using basic audiological assessments, including pure tone audiometry and sound field measurements of pure tone and speech audiometry with the contralateral ear occluded with a specific earplug. Additionally, the patients were subjectively evaluated using (1) the Speech, Spatial, and Qualities Questionnaire (SSQ), and (2) the custom-made ADHEAR questionnaire. RESULTS Analysis of the measured audiological outcomes revealed an average improvement in pure tone thresholds (functional gain) of 23 (± 4.4) dB HL when the ADHEAR system was used compared to the unaided condition in the sound field. Moreover, speech reception thresholds improved by an average of 23 (± 15.3) dB SPL in the aided condition with plugged contralateral ear. Additionally, when using ADHEAR in the sound field, subjects' speech recognition scores improved by 32% (± 17.7) in quiet and 21% (± 15.1) in the presence of interfering noise. The average SSQ questionnaire scores improved from 3.9 at the study initiation to 6.6 after 3 months of device usage. ADHEAR custom questionnaire assessments revealed high satisfaction and acceptance of the device with no pain or skin irritation. CONCLUSION During the study period, this new adhesive system yielded improved audiological outcomes with high patient satisfaction and acceptance and no reported skin irritation or pain.
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Affiliation(s)
- Fida Almuhawas
- ORL Department, King Abdullah Ear Specialist Center, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia,
| | - Farid Alzhrani
- ORL Department, King Abdullah Ear Specialist Center, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Shaza Saleh
- Audiology Unit, King Abdullah Ear Specialist Center, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman Alsanosi
- ORL Department, King Abdullah Ear Specialist Center, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Medhat Yousef
- Audiology Unit, King Abdullah Ear Specialist Center, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia.,Audiology Unit, ENT Department, Menoufia University, Menoufia, Egypt
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18
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Abstract
Supplemental Digital Content is available in the text To evaluate the long-term outcomes of three different types of bone conduction hearing implants (BCHI)—BAHA, Ponto, and Bonebridge—in Mandarin-speaking patients with bilateral microtia-atresia.
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19
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Ghoncheh M, Lenarz T, Maier H. A Precision Driver Device for Intraoperative Stimulation of a Bone Conduction Implant. Sci Rep 2020; 10:1797. [PMID: 32019957 PMCID: PMC7000405 DOI: 10.1038/s41598-020-58512-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/13/2020] [Indexed: 11/25/2022] Open
Abstract
Semi-implantable bone conduction implants (BCI) and active middle ear implants (AMEI) for patients with sensorineural, conductive or mixed hearing loss commonly use an amplitude modulation technology to transmit power and sound signals from an external audio processor to the implant. In patients, the distance dependence of the signal amplitude is of minor importance as the skin thickness is constant and only varies between 3–7 mm. In this range, critical coupling transmission technique sufficiently reduces the variability in amplitude, but fails to provide well-defined amplitudes in many research and clinical applications such as intraoperative integrity tests where the distance range is exceeded by using sterile covers. Here we used the BCI Bonebridge (BB, Med-El, Austria) as an example to develop and demonstrate a system that synthesizes the transmission signal, determines the distance between the transmitter and the receiver implant coil and compensates transmission losses. When compared to an external audio processor (AP304) on an artificial mastoid, our system mainly decreased amplitude variability from over 11 dB to less than 3 dB for audio frequencies (0.1–10 kHz) at distances up to 15 mm, making it adequate for intraoperative and audiometric tests.
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Affiliation(s)
- Mohammad Ghoncheh
- Cluster of Excellence Hearing4all, Hannover, Germany. .,Department of Otolaryngology and Institute of Audioneurotechnology (VIANNA), Hannover Medical School, Hannover, Germany.
| | - Thomas Lenarz
- Cluster of Excellence Hearing4all, Hannover, Germany.,Department of Otolaryngology and Institute of Audioneurotechnology (VIANNA), Hannover Medical School, Hannover, Germany
| | - Hannes Maier
- Cluster of Excellence Hearing4all, Hannover, Germany.,Department of Otolaryngology and Institute of Audioneurotechnology (VIANNA), Hannover Medical School, Hannover, Germany
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20
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Chang Y, Stenfelt S. Characteristics of Bone-Conduction Devices Simulated in a Finite-Element Model of a Whole Human Head. Trends Hear 2019; 23:2331216519836053. [PMID: 30880644 PMCID: PMC6423684 DOI: 10.1177/2331216519836053] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Nowadays, many different kinds of bone-conduction devices (BCDs) are available
for hearing rehabilitation. Most studies of these devices fail to compare the
different types of BCDs under the same conditions. Moreover, most results are
between two BCDs in the same subject, or two BCDs in different subjects failing
to provide an overview of the results between several of the BCDs. Another issue
is that some BCDs require surgical procedures that prevent comparison of the
BCDs in the same persons. In this study, four types of skin-drive BCDs, three
direct-drive BCDs, and one oral device were evaluated in a finite-element model
of the human head that was able to simulate all BCDs under the same conditions.
The evaluation was conducted using both a dynamic force as input and an electric
voltage to a model of a BCD vibrator unit. The results showed that the
direct-drive BCDs and the oral device gave vibration responses within 10 dB at
the cochlea. The skin-drive BCDs had similar or even better cochlear vibration
responses than the direct-drive BCDs at low frequencies, but the direct-drive
BCDs gave up to 30 dB higher cochlear vibration responses at high frequencies.
The study also investigated the mechanical point impedance at the interface
between the BCD and the head, providing information that explains some of the
differences seen in the results. For example, when the skin-drive BCD attachment
area becomes too small, the transducer cannot provide an output force similar to
the devices with larger attachment surfaces.
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Affiliation(s)
- You Chang
- 1 Department of Clinical and Experimental Medicine, Linköping University, Sweden
| | - Stefan Stenfelt
- 1 Department of Clinical and Experimental Medicine, Linköping University, Sweden
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21
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You P, Siegel LH, Kassam Z, Hebb M, Parnes L, Ladak H, Agrawal SK. Response to commentary on "the middle fossa approach with self-drilling screws: a novel technique for BONEBRIDGE implantation". J Otolaryngol Head Neck Surg 2019; 48:57. [PMID: 31690345 PMCID: PMC6833272 DOI: 10.1186/s40463-019-0375-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 09/21/2019] [Indexed: 11/18/2022] Open
Abstract
The aim of this letter is to respond to a commentary on a published article on the middle fossa approach to BONEBRIDGE implantation with self-drilling screws published by the senior authors.
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Affiliation(s)
- Peng You
- Department of Otolaryngology-Head and Neck Surgery, London Health Science Centre, Schulich School of Medicine & Dentistry, Western University, Room B1-333, London Health Sciences Centre - University Hospital 339 Windermere Road, London, Ontario, N6A 5A5, Canada
| | - Lauren H Siegel
- Department of Otolaryngology-Head and Neck Surgery, London Health Science Centre, Schulich School of Medicine & Dentistry, Western University, Room B1-333, London Health Sciences Centre - University Hospital 339 Windermere Road, London, Ontario, N6A 5A5, Canada
| | - Zahra Kassam
- Department of Medical Imaging, St. Joseph's Health Care London, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Matthew Hebb
- Department of Clinical Neurological Sciences, London Health Science Centre, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Lorne Parnes
- Department of Otolaryngology-Head and Neck Surgery, London Health Science Centre, Schulich School of Medicine & Dentistry, Western University, Room B1-333, London Health Sciences Centre - University Hospital 339 Windermere Road, London, Ontario, N6A 5A5, Canada
| | - Hanif Ladak
- Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Sumit Kishore Agrawal
- Department of Otolaryngology-Head and Neck Surgery, London Health Science Centre, Schulich School of Medicine & Dentistry, Western University, Room B1-333, London Health Sciences Centre - University Hospital 339 Windermere Road, London, Ontario, N6A 5A5, Canada.
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22
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Outcome prediction for Bonebridge candidates based on audiological indication criteria. Auris Nasus Larynx 2019; 46:681-686. [DOI: 10.1016/j.anl.2018.12.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/01/2018] [Accepted: 12/26/2018] [Indexed: 11/17/2022]
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Magele A, Schoerg P, Stanek B, Gradl B, Sprinzl GM. Active transcutaneous bone conduction hearing implants: Systematic review and meta-analysis. PLoS One 2019; 14:e0221484. [PMID: 31525208 PMCID: PMC6746395 DOI: 10.1371/journal.pone.0221484] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 08/07/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In July 2018 the active transcutaneous bone conduction hearing implant received FDA approval in the US (for patients 12 years and older with conductive and/or mixed hearing loss or single-sided deafness), reflecting the current trend of moving away from percutaneous hearing solutions towards intact skin systems. OBJECTIVES To critically assess the current literature on safety, efficacy and subjective benefit after implantation with an active transcutaneous bone conduction hearing device. DATA SOURCES Literature investigation was performed by electronic database search including PubMed and Cochrane Central Register of Controlled Trials, and manual search of relevant journals and reference lists of included studies. STUDY ELIGIBILITY CRITERIA Randomized controlled trials, clinical controlled trials and cohort studies, case series and case reports investigating subjective and objective outcomes. STUDY APPRAISAL AND SYNTHESIS METHODS Retrieved literature was screened and extracted by two reviewers independently. Subgroup analysis of indications (conductive and/or mixed hearing loss, single-sided deafness) and participant ages (pediatric vs. adults) was conducted on patients with active transcutaneous bone conduction devices. Sensitivity analysis was performed to test the stability of the results in meta-analysis. RESULTS 39 citations reporting on pre- and postoperative audiological results, speech performance in quiet and in noise, localization testing as well as subjective outcomes were included in this systematic review. Functional gain as well as word recognition score outcomes could be further investigated via meta-analysis. All outcomes reported and summarized here reflect beneficial audiological performance and high patient satisfaction, accompanied with a low complications rate (minor event incidence rate: 9.9 person-years; major incidence rate: 148.9 person-years) for the indications of conductive and mixed hearing loss as well as in individuals suffering from single-sided deafness for all age groups of subjects who underwent active transcutaneous bone conduction hearing device implantation. LIMITATIONS A limiting factor of this systematic review was the Level of Evidence of the reviewed literature, comprising 2a/3a studies (cohort studies and case-control studies). Furthermore, the reporting standards, especially in outcomes such as word recognition scores in quiet and in noise, vary across study cites from various countries, which impedes comparisons. Last but not least, no other comparable other device was retrieved as the active transcutaneous bone conduction hearing device is the only available at the moment. CONCLUSION The device's transcutaneous technology results in a minor event incidence rate of one in 9.9 person-years and a major incidence rate of one in 148.9 person-years. Based on the audiological outcomes, high patient satisfaction as well as the low complication rate, the authors recommend the active transcutaneous bone conduction hearing device as a safe and effective treatment for patients suffering from hearing loss within the device's indication criteria (conductive and/or mixed hearing loss or single-sided deafness).
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Affiliation(s)
- Astrid Magele
- University Clinic St. Poelten, Department of Otorhinolaryngology, Head & Neck Surgery, St. Poelten, Austria
- Karl Landsteiner Institute of Implantable Hearing Devices, St. Poelten, Austria
| | - Philipp Schoerg
- University Clinic St. Poelten, Department of Otorhinolaryngology, Head & Neck Surgery, St. Poelten, Austria
- Karl Landsteiner Institute of Implantable Hearing Devices, St. Poelten, Austria
| | - Barbara Stanek
- University Clinic St. Poelten, Department of Otorhinolaryngology, Head & Neck Surgery, St. Poelten, Austria
| | - Bernhard Gradl
- University Clinic St. Poelten, Department of Otorhinolaryngology, Head & Neck Surgery, St. Poelten, Austria
| | - Georg Mathias Sprinzl
- University Clinic St. Poelten, Department of Otorhinolaryngology, Head & Neck Surgery, St. Poelten, Austria
- Karl Landsteiner Institute of Implantable Hearing Devices, St. Poelten, Austria
- * E-mail:
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24
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Oh SJ, Goh EK, Choi SW, Lee S, Lee HM, Lee IW, Kong SK. Audiologic, surgical and subjective outcomes of active transcutaneous bone conduction implant system (Bonebridge). Int J Audiol 2019; 58:956-963. [DOI: 10.1080/14992027.2019.1657242] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Se-Joon Oh
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Eui-Kyung Goh
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Sung-Won Choi
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Seokhwan Lee
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Hyun-Min Lee
- Department of Otorhinolaryngology and Biomedical Research Institute, Yangsan Pusan National University Hospital, Yangsan, Republic of Korea
| | - Il-Woo Lee
- Department of Otorhinolaryngology and Biomedical Research Institute, Yangsan Pusan National University Hospital, Yangsan, Republic of Korea
| | - Soo-Keun Kong
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
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Alzhrani F. Objective and subjective results of the Bonebridge transcutaneous active direct-drive bone conduction hearing implant. Saudi Med J 2019; 40:797-801. [PMID: 31423516 PMCID: PMC6718859 DOI: 10.15537/smj.2019.8.24383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: To investigate the effectiveness of a bone-anchored hearing implant system (Bonebridge implant technology) as a rehabilitation treatment for individuals with conductive or mixed hearing losses. Methods: This is a retrospective cohort study. Twelve implanted ears with conductive or mixed hearing losses were implanted with this device at a tertiary university hospital between 2012 and 2016. Audiological tests included pure tone air conduction (AC) and bone conduction (BC) measurements and unaided and aided sound-field thresholds. To evaluate the speech intelligibility in a quiet environment, the speech discrimination score (SDS) was tested using Arabic monosyllabic words, and the speech reception threshold (SRT) was measured using Arabic disyllabic words spoken in front of them. The subjective sound quality was assessed with the Hearing Implant Sound Quality Index (HISQUI). Results: In comparison with the unaided condition, there was a significant improvement in the aided thresholds, SDS, and SRT. Comparing the aided and unaided thresholds, the average AC threshold improved with an average functional gain of 40±6.3dB. The unaided SRT improved from 72.5 dB hearing levels (HL)(median) to 27.5 dB HL (median) when aided, and patients performed 71% better, on average, based on the SDS with the help of the device. The HISQUI questionnaire revealed high satisfaction with the device sound quality. Conclusion: Patients with conductive and mixed hearing loss substantially benefit from the Bonebridge active transcutaneous BC hearing implant.
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Affiliation(s)
- Farid Alzhrani
- King Abdullah Ear Specialist Center, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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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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Audiological effectiveness of Bonebridge implantation for bilateral congenital malformation of the external and middle ear. Eur Arch Otorhinolaryngol 2019; 276:2755-2762. [DOI: 10.1007/s00405-019-05533-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 06/25/2019] [Indexed: 10/26/2022]
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Comparison of Satisfaction Between Patients Using Percutaneous and Transcutaneous Bone Conduction Devices. Otol Neurotol 2019; 40:651-657. [PMID: 31083093 DOI: 10.1097/mao.0000000000002203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Bone conduction devices are widely used to treat conductive and mixed hearing loss as well as single-sided deafness (SSD). A transcutaneous system was introduced recently with the clear advantage of fewer local reactions. Our goal was to evaluate and compare the satisfaction of patients with percutaneous and transcutaneous bone conduction devices. METHODS We divided a cohort of 72 patients into groups by type of hearing loss and their relation to the use of the percutaneous or transcutaneous system. The Glasgow Benefit Inventory (GBI) questionnaire, adapted for hearing aids, was employed to assess patient satisfaction, along with an additional questionnaire covering the general usefulness of the devices. RESULTS Overall median daily wearing time was 12 hours for the percutaneous and seven for the transcutaneous groups (p < 0.001). We found no correlation between the bone conduction level at any frequency and the GBI satisfaction score. The median total GBI score of the entire patient cohort was 30.1; median values for general, social support, and physical health subscales were 0, 37.5, and 16.7, respectively. People suffering from SSD had the lowest satisfaction rates, and these were significantly lower for the patients who used transcutaneous aids than for those with percutaneous devices (p = 0.033). Similarly, the percutaneous system brought more satisfaction to combined hearing loss patients than did the transcutaneous (p = 0.010). CONCLUSION Both types of bone conduction devices provide a safe and efficient way to improve hearing for candidates within correct indications. Our study revealed that patients wore the transcutaneous device less than they did the percutaneous. Satisfaction was the lowest among SSD patients who used the transcutaneous device; hence it is especially important to carry out preoperative counseling for such patients.
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Fan X, Chen Y, Niu X, Wang Y, Fan Y, Chen X. Outcomes of the Baha Attract System combined with auricle reconstruction in mandarin speaking patients with bilateral microtia-atresia. Acta Otolaryngol 2019; 139:425-431. [PMID: 30806113 DOI: 10.1080/00016489.2019.1571284] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND A transcutaneous bone-conduction hearing device (tBCHD), the Baha Attract System has been recently introduced to China, and very few studies have assessed the efficacy of this system in speakers of mandarin. OBJECTIVES This study aims to analyze the functional and cosmetic outcomes of this system. MATERIALS AND METHODS This prospective study included 11 patients (nine males, two females), of mean age 16 years (range 9-32 years). Seven patients were conducted the implantation simultaneously with auricle reconstruction, and the other four were before it. Auditory results were compared between unaided patients and implanted patients. Subjective satisfaction was analyzed using three questionnaires. RESULTS The mean sound field thresholds were 65.9 ± 5.1 dB SPL unaided and 30.9 ± 4.7 dB SPL with an implanted Baha Attract System, resulting in a mean hearing gain of 35.0 ± 6.7 dB. The mean WRS scores were 47.8 ± 8.7% unaided and 92.1 ± 2.0% with the Baha Attract System, resulting in a mean improvement of 47.8 ± 8.7%. No adverse events were reported and questionnaires showed good patients satisfaction. CONCLUSIONS The transcutaneous Baha Attract System is effective in mandarin speaking patients, and the combination of hearing rehabilitation and auricle reconstruction surgery is promising for patients with bilateral microtia-atresia.
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Affiliation(s)
- Xinmiao Fan
- Department of Otolaryngology, Peking Union Medical College Hospital, Beijing, PR China
| | - Yu Chen
- Department of Radiology, Peking Union Medical College Hospital, Beijing, PR China
| | - Xiaomin Niu
- Department of Otolaryngology, Peking Union Medical College Hospital, Beijing, PR China
| | - Yibei Wang
- Department of Otolaryngology, Peking Union Medical College Hospital, Beijing, PR China
| | - Yue Fan
- Department of Otolaryngology, Peking Union Medical College Hospital, Beijing, PR China
| | - Xiaowei Chen
- Department of Otolaryngology, Peking Union Medical College Hospital, Beijing, PR China
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The Bonebridge active bone conduction system: a fast and safe technique for a middle fossa approach. The Journal of Laryngology & Otology 2019; 133:344-347. [PMID: 30932803 DOI: 10.1017/s0022215119000501] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The transmastoid pre-sigmoid approach is always the preferred choice for implantation of the Bonebridge active bone conduction system in patients with a normal anatomy. When an anatomical variant exists or a previous surgery has been performed, a retrosigmoid approach or middle fossa approach can be performed. METHODS The preferred surgical technique for a middle fossa approach is described. A 14 mm drill head (Neuro Drill) was used to create the bed at the squamous portion of the temporal bone. Surgical time and complication rate were analysed. RESULTS The surgical time was shorter than 30 minutes in all cases, and only 14 seconds were needed to create a 14 mm bone bed. No complications were observed during the follow-up period (6-45 months). CONCLUSION Use of the Neuro Drill for the middle fossa approach is an easy technique. It significantly decreases the surgical time, without increasing the complication rate.
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Lin J, Chen S, Zhang H, Xiong H, Zhang Z, Liang M, Zhang X, Ye H, Zheng Y. Application of Implantable Hearing Aids and Bone Conduction Implant System in patients with bilateral congenital deformation of the external and middle ear. Int J Pediatr Otorhinolaryngol 2019; 119:89-95. [PMID: 30690308 DOI: 10.1016/j.ijporl.2018.12.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 12/18/2018] [Accepted: 12/19/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To determine the efficacy of the application of the Implantable Hearing Aids and Bone Conduction Implant System in patients with bilateral congenital deformation of the external and middle ear. METHODS twenty patients with bilateral congenital malformation of the external and middle ear were included in the study. Implantable Hearing Aids implantation was performed in ten patients, and Bone Conduction Implant System implantation was performed in ten patients. Audiometric tests, including pure-tone audiometry and speech discrimination in the free field were performed pre-operatively and post-operatively. RESULTS Implantable Hearing Aids and Bone Conduction Implant System implantation were performed successfully in all patients. The mean pure-tone threshold improvement with Implantable Hearing Aids or Bone Conduction Implant System activation in the free filed pure tone audiometry was 25 dB and ranged from 0.25 to 4 kHz. Mean free field speech discrimination in quiet was 80% at 65 dB compared to 18% pre-operatively. The mean pure-tone threshold improvement with Bone Conduction Implant System was 25.5 dB better than 18.2 dB with Implantable Hearing Aids. The mean free filed speech discrimination in quite improvement with Bone Conduction Implant System was 66% better than 58% with Implantable Hearing Aids. CONCLUSION Implantable Hearing Aids or Bone Conduction Implant System are effective options for improving hearing in patients with bilateral congenital deformation of the external and middle ear. The procedure is safe and effective, and its indications are wider than those of tympanoplasty for such cases. Furthermore, the Bone Conduction Implant System is better than Implantable Hearing Aids, tympanoplasty and hearing aids.
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Affiliation(s)
- Junfeng Lin
- Departments of a Otolaryngology, Sun Yat-sen Memorial Hospital, Xinhua College, Sun Yat-Sen University, Guangzhou, China
| | - Suijun Chen
- Departments of a Otolaryngology, Sun Yat-sen Memorial Hospital, Xinhua College, Sun Yat-Sen University, Guangzhou, China; Institute of Hearing and Speech-Language Science, Xinhua College, Sun Yat-Sen University, Guangzhou, China; Department of Hearing and Speech Science, Xinhua College, Sun Yat-Sen University, Guangzhou, China.
| | - Huasong Zhang
- Departments of a Otolaryngology, Sun Yat-sen Memorial Hospital, Xinhua College, Sun Yat-Sen University, Guangzhou, China
| | - Hao Xiong
- Departments of a Otolaryngology, Sun Yat-sen Memorial Hospital, Xinhua College, Sun Yat-Sen University, Guangzhou, China; Department of Hearing and Speech Science, Xinhua College, Sun Yat-Sen University, Guangzhou, China
| | - Zhigang Zhang
- Departments of a Otolaryngology, Sun Yat-sen Memorial Hospital, Xinhua College, Sun Yat-Sen University, Guangzhou, China
| | - Maojin Liang
- Departments of a Otolaryngology, Sun Yat-sen Memorial Hospital, Xinhua College, Sun Yat-Sen University, Guangzhou, China
| | - Xueyuan Zhang
- Departments of a Otolaryngology, Sun Yat-sen Memorial Hospital, Xinhua College, Sun Yat-Sen University, Guangzhou, China
| | - Haiwen Ye
- Departments of a Otolaryngology, Sun Yat-sen Memorial Hospital, Xinhua College, Sun Yat-Sen University, Guangzhou, China
| | - Yiqing Zheng
- Departments of a Otolaryngology, Sun Yat-sen Memorial Hospital, Xinhua College, Sun Yat-Sen University, Guangzhou, China; Institute of Hearing and Speech-Language Science, Xinhua College, Sun Yat-Sen University, Guangzhou, China; Department of Hearing and Speech Science, Xinhua College, Sun Yat-Sen University, Guangzhou, China.
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Giannantonio S, Scorpecci A, Pacifico C, Marsella P. A functional and anatomical comparison between two passive transcutaneous bone conduction implants in children. Int J Pediatr Otorhinolaryngol 2018; 108:202-207. [PMID: 29605355 DOI: 10.1016/j.ijporl.2018.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 03/07/2018] [Accepted: 03/10/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare anatomical and functional outcomes of two passive transcutaneous bone conduction implant systems: Sophono™ and BAHA Attract™. MATERIALS AND METHODS Twenty patients, affected by bilateral conductive hearing loss, underwent unilateral transcutaneous bone conduction implant surgery. Ten children received a Sophono™ implant (6 males, 4 females, mean age 11 years, mean unaided Pure Tone Average (PTA) 0.25-4kHz = 69.70dB HL) and 10 a BAHA Attract™ system (7 males, 3 females, mean age 19 years, mean unaided PTA0.25-4kHz = 66.40dB HL). The following outcomes were considered: incidence of local complications, hearing aid benefit, hearing aid gain and changes in quality of life (QOL), as measured by the Glasgow Children's Benefit Inventory (GCBI). RESULTS One patient in the Sophono group experienced magnet-related skin decubitus, while two patients (one per group) had skin hyperemia in the area overlying the magnet. The mean BAHA-aided threshold was 23.70dB, whereas the mean Sophono-aided threshold was 31.60dB. The mean gain was significantly different for lower frequencies, the BAHA having better functional outcomes. All patients reported an improvement in their QOL. CONCLUSION Given the lower thickness of the internal magnet, the Sophono™ system might be more suitable for younger children, whereas BAHA offered better functional results. Both systems can be considered valid and safe options for the functional rehabilitation of conductive hearing loss in children, provided that precautions are observed, such as a gradual use of the device and use of the least powerful magnets in the first months after the activation.
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Affiliation(s)
- Sara Giannantonio
- Audiology and Otosurgery Unit, "Bambino Gesù" Children's Hospital, Rome, Italy.
| | | | - Concettina Pacifico
- Audiology and Otosurgery Unit, "Bambino Gesù" Children's Hospital, Rome, Italy
| | - Pasquale Marsella
- Audiology and Otosurgery Unit, "Bambino Gesù" Children's Hospital, Rome, Italy
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Positioning a Novel Transcutaneous Bone Conduction Hearing Implant: a Systematic Anatomical and Radiological Study to Standardize the Retrosigmoid Approach, Correlating Navigation-guided, and Landmark-based Surgery. Otol Neurotol 2018; 39:458-466. [DOI: 10.1097/mao.0000000000001734] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zanetti D, Di Berardino F. A Bone Conduction Implantable Device as a Functional Treatment Option in Unilateral Microtia with Bilateral Stapes Ankylosis: A Report of Two Cases. AMERICAN JOURNAL OF CASE REPORTS 2018; 19:82-89. [PMID: 29358571 PMCID: PMC5789751 DOI: 10.12659/ajcr.904907] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Implantable devices have been proposed as an alternative to hearing aids and auditory canal reconstruction in patients with microtia (congenital aural atresia), which includes a malformation of the external and middle ear. This report is of two rare cases of microtia associated with congenital stapes ankylosis treated with an implantable device and describes the treatment outcomes. CASE REPORT Two siblings from Ecuador, a 29-year-old woman, and her 35-year-old brother, were born with unilateral type II microtia with bilateral external auditory canal atresia and conductive hearing loss. Pre-operatively, high-resolution computed tomography (HRCT) imaging was performed using FastView software to allow placement of a bone conduction-floating mass transducer (BC-FMT) to couple a Bonebridge bone conduction implant (BCI) system in both patients. Pure-tone audiometry (PTA) testing and speech audiology were performed. The Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Speech, Spatial and Qualities (SSQ) of hearing scale questionnaires and scoring systems were used. Following activation of the implantable device, both patients achieved improved bilateral conductive hearing with sound-field (field-free) thresholds >25 dB, and speech recognition scores >90%. In both cases, hearing improvement remained at three years following surgery. CONCLUSIONS To our knowledge, these are the first reported cases of microtia with congenital stapes ankylosis successfully treated with a bone conduction implantable device. Patients with microtia and stapes ankylosis who are reluctant to undergo surgery may benefit from unilateral or bilateral, short-term or long-term use of a Bonebridge bone conduction implantable device.
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Affiliation(s)
- Diego Zanetti
- Audiology Unit, Department of Clinical Science and Community Health, University of Milano, IRCCS Fondazione Cà Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Federica Di Berardino
- Audiology Unit, Department of Clinical Science and Community Health, University of Milano, IRCCS Fondazione Cà Granda, Ospedale Maggiore Policlinico, Milano, Italy
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Tisch M. Implantable hearing devices. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2017; 16:Doc06. [PMID: 29279724 PMCID: PMC5738935 DOI: 10.3205/cto000145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Combined hearing loss is an essential indication for implantable hearing systems. Depending on the bone conduction threshold, various options are available. Patients with mild sensorineural deafness usually benefit from transcutaneous bone conduction implants (BCI), while percutaneous BCI systems are recommended also for moderate hearing loss. For combined hearing losses with moderate and high-grade cochlear hearing loss, active middle ear implants are recommended. For patients with incompatibilities or middle ear surgery, implants are a valuable and proven addition to the therapeutic options.
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Affiliation(s)
- Matthias Tisch
- Department of Otolaryngology, Head & Neck Surgery, Bundeswehrkrankenhaus Ulm, Germany
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Preliminary audiologic and peri-operative outcomes of the Sophono™ transcutaneous bone conduction device: A systematic review. Int J Pediatr Otorhinolaryngol 2017; 101:196-203. [PMID: 28964294 DOI: 10.1016/j.ijporl.2017.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/11/2017] [Accepted: 08/13/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To delineate the auditory functional improvement and peri-operative outcomes of the Sophono™ transcutaneous bone conduction device. METHODS Eligible articles presenting patients implanted with the Sophono™ were identified through a comprehensive search of PubMed and Embase electronic databases. All relevant articles were reviewed to justify inclusion independently by 2 authors. Studies that successfully passed critical appraisal for directness of evidence and risk of bias were included. RESULTS From a total of 125 articles, 8 studies encompassing 86 patients using 99 implants were selected. Most patients (79.1%) were children. Ear atresia (67.5%) was the most frequently reported indication for Sophono™ implantation. Overall pure tone average auditory improvement was 31.10 (±8.29) decibel. During a mean follow-up time of 12.48 months, 25 patients (29%) presented with post-operative complications from which 3 were deemed as serious implant-related adverse events (3.5%). CONCLUSIONS The Sophono™ transcutaneous bone conduction device shows promising functional improvement, no intra-operative complications and minor post-operative skin related complications. If suitable, the device could be a proposed solution for the rehabilitation of hearing in children meeting eligibility criteria. A wearing schedule must be implemented in order to reduce magnet-related skin complications.
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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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Sound Localization in Patients With Congenital Unilateral Conductive Hearing Loss With a Transcutaneous Bone Conduction Implant. Otol Neurotol 2017; 38:318-324. [PMID: 28079678 DOI: 10.1097/mao.0000000000001328] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE There is no consensus regarding the benefit of implantable hearing aids in congenital unilateral conductive hearing loss (UCHL). This study aimed to measure sound source localization performance in patients with congenital UCHL and contralateral normal hearing who received a new bone conduction implant. STUDY DESIGN Evaluation of within-subject performance differences for sound source localization in a horizontal plane. SETTING Tertiary referral center. PATIENTS Five patients with atresia of the external auditory canal and contralateral normal hearing implanted with transcutaneous bone conduction implant at the Medical University of Vienna were tested. INTERVENTION Activated/deactivated implant. MAIN OUTCOME MEASURE Sound source localization test; localization performance quantified using the root mean square (RMS) error. RESULTS Sound source localization ability was highly variable among individual subjects, with RMS errors ranging from 21 to 40 degrees. Horizontal plane localization performance in aided conditions showed statistically significant improvement compared with the unaided conditions, with RMS errors ranging from 17 to 27 degrees. The mean RMS error decreased by a factor of 0.71 (p < 0.001). CONCLUSION Analysis revealed improved sound localization performance in a horizontal plane with the activated transcutaneous bone conduction implant. Some patients with congenital UCHL might be capable of developing improved horizontal plane localization abilities with the binaural cues provided by this device.
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Bravo-Torres S, Der-Mussa C, Fuentes-López E. Active transcutaneous bone conduction implant: audiological results in paediatric patients with bilateral microtia associated with external auditory canal atresia. Int J Audiol 2017; 57:53-60. [PMID: 28857620 DOI: 10.1080/14992027.2017.1370137] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To describe, in terms of functional gain and word recognition, the audiological results of patients under 18 years of age implanted with the active bone conduction implant, Bonebridge™. DESIGN Retrospective case studies conducted by reviewing the medical records of patients receiving implants between 2014 and 2016 in the public health sector in Chile. STUDY SAMPLE All patients implanted with the Bonebridge were included (N = 15). Individuals who had bilateral conductive hearing loss, secondary to external ear malformations, were considered as candidates. RESULTS The average hearing threshold one month after switch on was 25.2 dB (95%CI 23.5-26.9). Hearing thresholds between 0.5 and 4 kHz were better when compared with bone conduction hearing aids. Best performance was observed at 4 kHz, where improvements to hearing were observed throughout the adaptation process. There was evidence of a significant increase in the recognition of monosyllables. CONCLUSIONS The Bonebridge implant showed improvements to hearing thresholds and word recognition in paediatric patients with congenital conductive hearing loss.
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Affiliation(s)
- Sofía Bravo-Torres
- a Unidad de Otorrinolaringologia, Servicio de Cirugia , Hospital Dr. Luis Calvo Mackenna , Santiago , Chile.,b Carrera de Fonoaudiologia , Facultad de Ciencias de la Rehabilitacion, Universidad Andres Bello , Santiago , Chile
| | - Carolina Der-Mussa
- a Unidad de Otorrinolaringologia, Servicio de Cirugia , Hospital Dr. Luis Calvo Mackenna , Santiago , Chile.,c Clinica Alemana de Santiago , Facultad de Medicina Universidad del Desarrollo , Santiago , Chile
| | - Eduardo Fuentes-López
- d Programa de Doctorado en Salud Pública, Escuela de Salud Pública , Universidad de Chile , Santiago , Chile , and.,e Carrera de Fonoaudiología, Departamento de Ciencias de la Salud, Facultad de Medicina , Pontificia Universidad Católica de Chile , Santiago , Chile
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Influence of Floating-Mass Transducer Coupling Efficiency for Active Middle-Ear Implants on Speech Recognition. Otol Neurotol 2017; 38:809-814. [DOI: 10.1097/mao.0000000000001412] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Weiss BG, Bertlich M, Scheele R, Canis M, Jakob M, Sohns JM, Ihler F. Systematic radiographic evaluation of three potential implantation sites for a semi-implantable bone conduction device in 52 patients after previous mastoid surgery. Eur Arch Otorhinolaryngol 2017; 274:3001-3009. [DOI: 10.1007/s00405-017-4609-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 05/10/2017] [Indexed: 11/25/2022]
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Image-guided implantation of the Bonebridge™ with a surgical navigation: A feasibility study. Int J Surg Case Rep 2016; 30:112-117. [PMID: 28012324 PMCID: PMC5192035 DOI: 10.1016/j.ijscr.2016.11.057] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 11/28/2016] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To access a method of fitting a designated location on the patient's temporal bone by surgically navigating to the Bonebridge implantation. STUDY DESIGN A patient with unilateral profound hearing loss received early intervention with the Bonebridge implant for binaural hearing. The optimal implant site was determined from computed tomography (CT) images using a three-dimensional (3D) simulation software program before the surgery. The pre-calculated coordinates from the 3D simulation software program were moved to the Scopis Hybrid Navigation System. After using the surgical navigation system for the surgery, we evaluated the degree of mismatch of the center of the bone conduction-floating mass transducer (BC-FMT) between the computer simulation and the actual drilling. RESULTS The time required to determine the implant location on the surface of the patient's temporal bone was shortened, and the accuracy of the implantation was high. The coordinates on the 3D simulation system were comparable to the surgical navigation system. The predicted coordinates were replicated exactly upon actual drilling during the surgery, and we could confirm this in preoperative and postoperative images. CONCLUSIONS Using an image-guided surgical navigation system to aid in the placement of the BC-FMT on the simulated location is a simple procedure and is more effective that finding the exact coordinates. It also shortens the decision time for applying the implant.
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Vyskocil E, Riss D, Arnoldner C, Hamzavi J, Liepins R, Kaider A, Honeder C, Fumicz J, Gstoettner W, Baumgartner W. Dura and sinus compression with a transcutaneous bone conduction device - hearing outcomes and safety in 38 patients. Clin Otolaryngol 2016; 42:1033-1038. [DOI: 10.1111/coa.12793] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2016] [Indexed: 11/28/2022]
Affiliation(s)
- E. Vyskocil
- Department of Otorhinolaryngology; Medical University of Vienna; Wien Austria
| | - D. Riss
- Department of Otorhinolaryngology; Medical University of Vienna; Wien Austria
| | - C. Arnoldner
- Department of Otorhinolaryngology; Medical University of Vienna; Wien Austria
| | - J.S. Hamzavi
- Department of Otorhinolaryngology; Medical University of Vienna; Wien Austria
| | - R. Liepins
- Department of Otorhinolaryngology; Medical University of Vienna; Wien Austria
| | - A. Kaider
- Center for Medical Statistics, Informatics, and Intelligent Systems; Medical University of Vienna; Wien Austria
| | - C. Honeder
- Department of Otorhinolaryngology; Medical University of Vienna; Wien Austria
| | - J. Fumicz
- Department of Otorhinolaryngology; Medical University of Vienna; Wien Austria
| | - W. Gstoettner
- Department of Otorhinolaryngology; Medical University of Vienna; Wien Austria
| | - W.D. Baumgartner
- Department of Otorhinolaryngology; Medical University of Vienna; Wien Austria
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Ihler F, Blum J, Berger MU, Weiss BG, Welz C, Canis M. The Prediction of Speech Recognition in Noise With a Semi-Implantable Bone Conduction Hearing System by External Bone Conduction Stimulation With Headband: A Prospective Study. Trends Hear 2016; 20:2331216516669330. [PMID: 27698259 PMCID: PMC5051673 DOI: 10.1177/2331216516669330] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 08/24/2016] [Accepted: 08/24/2016] [Indexed: 02/05/2023] Open
Abstract
Semi-implantable transcutaneous bone conduction devices are treatment options for conductive and mixed hearing loss (CHL/MHL). For counseling of patients, realistic simulation of the functional result is desirable. This study compared speech recognition in noise with a semi-implantable transcutaneous bone conduction device to external stimulation with a bone conduction device fixed by a headband. Eight German-language adult patients were enrolled after a semi-implantable transcutaneous bone conduction device (Bonebridge, Med-El) was implanted and fitted. Patients received a bone conduction device for external stimulation (Baha BP110, Cochlear) fixed by a headband for comparison. The main outcome measure was speech recognition in noise (Oldenburg Sentence Test). Pure-tone audiometry was performed and subjective benefit was assessed using the Glasgow Benefit Inventory and Abbreviated Profile of Hearing Aid Benefit questionnaires. Unaided, patients showed a mean signal-to-noise ratio threshold of 4.6 ± 4.2 dB S/N for speech recognition. The aided results were -3.3 ± 7.2 dB S/N by external bone conduction stimulation and -1.2 ± 4.0 dB S/N by the semi-implantable bone conduction device. The difference between the two devices was not statistically significant, while the difference was significant between unaided and aided situation for both devices. Both questionnaires for subjective benefit favored the semi-implantable device over external stimulation. We conclude that it is possible to simulate the result of speech recognition in noise with a semi-implantable transcutaneous bone conduction device by external stimulation. This should be part of preoperative counseling of patients with CHL/MHL before implantation of a bone conduction device.
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Affiliation(s)
- Friedrich Ihler
- Department of Otorhinolaryngology, University Medical Center Göttingen, Georg-August-University Göttingen, Germany
| | - Jenny Blum
- Department of Otorhinolaryngology, University Medical Center Göttingen, Georg-August-University Göttingen, Germany
| | - Max-Ulrich Berger
- Department of Otorhinolaryngology, University Medical Center Göttingen, Georg-August-University Göttingen, Germany Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Hamburg-Eppendorf (UKE), University of Hamburg, Germany
| | - Bernhard G Weiss
- Department of Otorhinolaryngology, University Medical Center Göttingen, Georg-August-University Göttingen, Germany
| | - Christian Welz
- Department of Otorhinolaryngology, University Medical Center Göttingen, Georg-August-University Göttingen, Germany
| | - Martin Canis
- Department of Otorhinolaryngology, University Medical Center Göttingen, Georg-August-University Göttingen, Germany
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Safety and effectiveness of the Bonebridge transcutaneous active direct-drive bone-conduction hearing implant at 1-year device use. Eur Arch Otorhinolaryngol 2016; 274:1835-1851. [DOI: 10.1007/s00405-016-4228-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 07/23/2016] [Indexed: 10/21/2022]
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Comparison of Audiological Results Between a Transcutaneous and a Percutaneous Bone Conduction Instrument in Conductive Hearing Loss. Otol Neurotol 2016; 37:685-91. [DOI: 10.1097/mao.0000000000001010] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pai I, Rojas P, Jiang D, Obholzer R, Coward T. The use of 3D printed external and internal templates for Bonebridge implantation - technical note. Clin Otolaryngol 2016; 42:1118-1120. [DOI: 10.1111/coa.12599] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 11/29/2022]
Affiliation(s)
- I. Pai
- St. Thomas' Hearing Implant Centre; St. Thomas' Hospital; London UK
| | - P. Rojas
- Academic Centre of Reconstructive Science; Kings College London Dental Institute; Guy's Hospital; London UK
| | - D. Jiang
- St. Thomas' Hearing Implant Centre; St. Thomas' Hospital; London UK
| | - R. Obholzer
- St. Thomas' Hearing Implant Centre; St. Thomas' Hospital; London UK
| | - T. Coward
- Academic Centre of Reconstructive Science; Kings College London Dental Institute; Guy's Hospital; London UK
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Objective and Subjective Outcome of a New Transcutaneous Bone Conduction Hearing Device. Otol Neurotol 2016; 37:267-75. [DOI: 10.1097/mao.0000000000000969] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sprinzl G, Wolf-Magele A. The Bonebridge Bone Conduction Hearing Implant: indication criteria, surgery and a systematic review of the literature. Clin Otolaryngol 2016; 41:131-43. [DOI: 10.1111/coa.12484] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2015] [Indexed: 11/28/2022]
Affiliation(s)
- G.M. Sprinzl
- Department of Otorhinolaryngology; Karl Landsteiner Private University; St. Poelten Austria
| | - A. Wolf-Magele
- Department of Otorhinolaryngology; Karl Landsteiner Private University; St. Poelten Austria
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Abstract
Introduction Bone conduction implants are indicated for patients with conductive and mixed hearing loss, as well as for patients with single-sided deafness (SSD). The transcutaneous technology avoids several complications of the percutaneous bone conduction implants including skin reaction, skin growth over the abutment, and wound infection. The Bonebridge (MED-EL, Austria) prosthesis is a semi-implantable hearing system: the BCI (Bone Conduction Implant) is the implantable part that contains the Bone Conduction-Floating Mass Transducer (BC-FMT), which applies the vibrations directly to the bone; the external component is the audio processor Amadé BB (MED-EL, Austria), which digitally processes the sound and sends the information through the coil to the internal part. Bonebridge may be implanted through three different approaches: the transmastoid, the retrosigmoid, or the middle fossa approach. Objective This systematic review aims to describe the world́s first active bone conduction implant system, Bonebridge, as well as describe the surgical techniques in the three possible approaches, showing results from implant centers in the world in terms of functional gain, speech reception thresholds and word recognition scores. Data Synthesis The authors searched the MEDLINE database using the key term Bonebridge. They selected only five publications to include in this systematic review. The review analyzes 20 patients that received Bonebridge implants with different approaches and pathologies. Conclusion Bonebridge is a solution for patients with conductive/mixed hearing loss and SSD with different surgical approaches, depending on their anatomy. The system imparts fewer complications than percutaneous bone conduction implants and shows proven benefits in speech discrimination and functional gain.
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Affiliation(s)
- Mario E Zernotti
- Department of Otolaryngology, Catholic University of Córdoba, Córdoba, Argentina
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