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Bruschini L, Canzi P, Canale A, Covelli E, Laborai A, Monteforte M, Cinquini M, Barbara M, Beltrame MA, Bovo R, Castigliano B, De Filippis C, Della Volpe A, Dispenza F, Marsella P, Mainardi A, Orzan E, Piccirillo E, Ricci G, Quaranta N, Cuda D. Implantable hearing devices in clinical practice. Systematic review and consensus statements. Acta Otorhinolaryngol Ital 2024; 44:52-67. [PMID: 38165206 PMCID: PMC10914359 DOI: 10.14639/0392-100x-n2651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/21/2023] [Indexed: 01/03/2024]
Abstract
Objective Implantable hearing devices represent a modern and innovative solution for hearing restoration. Over the years, these high-tech devices have increasingly evolved but their use in clinical practice is not universally agreed in the scientific literature. Congresses, meetings, conferences, and consensus statements to achieve international agreement have been made. This work follows this line and aims to answer unsolved questions regarding examinations, selection criteria and surgery for implantable hearing devices. Materials and methods A Consensus Working Group was established by the Italian Society of Otorhinolaryngology. A method group performed a systematic review for each single question to identify the current best evidence on the topic and to guide a multidisciplinary panel in developing the statements. Results Twenty-nine consensus statements were approved by the Italian Society of Otorhinolaryngology. These were associated with 4 key area subtopics regarding pre-operative tests, otological, audiological and surgical indications. Conclusions This consensus can be considered a further step forward to establish realistic guidelines on the debated topic of implantable hearing devices.
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Affiliation(s)
- Luca Bruschini
- Otolaryngology, ENT Audiology and Phoniatrics Unit, University Hospital of Pisa, Pisa, Italy
| | - Pietro Canzi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Canale
- Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Edoardo Covelli
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Andrea Laborai
- Department of Otolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Marta Monteforte
- Laboratory of systematic review methodology and guidelines production, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Michela Cinquini
- Laboratory of systematic review methodology and guidelines production, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Maurizio Barbara
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Millo Achille Beltrame
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Roberto Bovo
- Department of Neuroscience DNS, Otolaryngology Section, Padua University, Padua, Italy
| | - Bruno Castigliano
- Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Cosimo De Filippis
- Department of Neuroscience, Audiology Section, University of Padua, Treviso, Italy
| | - Antonio Della Volpe
- Otology and Cochlear Implant Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - Francesco Dispenza
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, Azienda Ospedaliera Universitaria Policlinico ‘’Paolo Giaccone’’, University of Palermo, Palermo, Italy
| | - Pasquale Marsella
- Audiology and Otosurgery Department, “Bambino Gesù” Children’s Hospital, Rome, Italy
| | - Anna Mainardi
- Department of Otolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Eva Orzan
- ENT and Audiology Unit, Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, Trieste, Italy
| | | | - Giampietro Ricci
- Department of Surgical and Biomedical Sciences, Section of Otorhinolaryngology, University of Perugia, Perugia, Italy
| | - Nicola Quaranta
- Translational Biomedicine and Neurosciences Department, University of Bari, Bari, Italy
| | - Domenico Cuda
- Department of Otolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy
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2
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Wang XY, Ren LJ, Xie YZ, Fu YY, Zhu YY, Li CL, Zhang TY. The Effects of BCDs in Unilateral Conductive Hearing Loss: A Systematic Review. J Clin Med 2023; 12:5901. [PMID: 37762842 PMCID: PMC10532261 DOI: 10.3390/jcm12185901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/21/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Bone conduction devices (BCDs) are widely used in the treatment of conductive hearing loss (CHL), but their applications on unilateral CHL (UCHL) patients remain controversial. To evaluate the effects of BCDs in UCHL, a systematic search was undertaken until May 2023 following the PRISMA guidelines. Among the 391 references, 21 studies met the inclusion criteria and were ultimately selected for review. Data on hearing thresholds, speech recognition, sound localization, and subjective questionnaire outcomes were collected and summarized. Moderate hearing threshold improvements were found in UCHL patients aided with BCDs. Their speech recognition abilities improved significantly. However, sound localization results showed wide individual variations. According to subjective questionnaires, BCDs had an overall positive influence on the daily life of UCHL patients, although several unfavorable experiences were reported by some of them. We concluded that the positive audiological benefits and subjective questionnaire results have made BCDs a credible intervention for UCHL patients. Before final implantations, UCHL patients should first go through a period of time when they were fitted with non-implantable BCDs as a trial.
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Affiliation(s)
- Xin-Yue Wang
- Department of Facial Plastic Reconstructive Surgery, ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai 200031, China; (X.-Y.W.); (L.-J.R.); (Y.-Z.X.); (Y.-Y.F.); (Y.-Y.Z.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Liu-Jie Ren
- Department of Facial Plastic Reconstructive Surgery, ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai 200031, China; (X.-Y.W.); (L.-J.R.); (Y.-Z.X.); (Y.-Y.F.); (Y.-Y.Z.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - You-Zhou Xie
- Department of Facial Plastic Reconstructive Surgery, ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai 200031, China; (X.-Y.W.); (L.-J.R.); (Y.-Z.X.); (Y.-Y.F.); (Y.-Y.Z.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Yao-Yao Fu
- Department of Facial Plastic Reconstructive Surgery, ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai 200031, China; (X.-Y.W.); (L.-J.R.); (Y.-Z.X.); (Y.-Y.F.); (Y.-Y.Z.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Ya-Ying Zhu
- Department of Facial Plastic Reconstructive Surgery, ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai 200031, China; (X.-Y.W.); (L.-J.R.); (Y.-Z.X.); (Y.-Y.F.); (Y.-Y.Z.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Chen-Long Li
- Department of Facial Plastic Reconstructive Surgery, ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai 200031, China; (X.-Y.W.); (L.-J.R.); (Y.-Z.X.); (Y.-Y.F.); (Y.-Y.Z.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Tian-Yu Zhang
- Department of Facial Plastic Reconstructive Surgery, ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai 200031, China; (X.-Y.W.); (L.-J.R.); (Y.-Z.X.); (Y.-Y.F.); (Y.-Y.Z.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
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3
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Josefsson Dahlgren H, Engmér Berglin C, Hultcrantz M, Asp F. A pilot study on spatial hearing in children with congenital unilateral aural atresia. Front Pediatr 2023; 11:1194966. [PMID: 37622080 PMCID: PMC10446965 DOI: 10.3389/fped.2023.1194966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
Despite normal hearing in one ear, individuals with congenital unilateral aural atresia may perceive difficulties in everyday listening conditions typically containing multiple sound sources. While previous work shows that intervention with bone conduction devices may aid spatial hearing for some children, testing conditions are often arranged to maximize any benefit and are not very similar to daily life. The benefit from amplification on spatial tasks has been found to vary between individuals, for reasons not entirely clear. This study has sought to expand on the limited knowledge on how children with unilateral aural atresia recognize speech masked by competing speech, and how horizontal sound localization accuracy is affected by the degree of unilateral hearing loss and by amplification using unilateral bone conduction devices when fitted before 3 years of age. In a within-subject, repeated measures design, including 11 children (mean age = 7.9 years), bone conduction hearing device (BCD) amplification did not negatively affect horizontal sound localization accuracy. The effect on speech recognition scores showed greater inter-individual variability. No benefit from amplification on a group level was found. There was no association between age at fitting and the benefit of the BCD. For children with poor unaided sound localization accuracy, there was a greater BCD benefit. Unaided localization accuracy increased as a function of decreasing hearing thresholds in the atretic ear. While it is possible that low sound levels in the atretic ear provided access to interaural localization cues for the children with the lowest hearing thresholds, the association has to be further investigated in a larger sample of children.
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Affiliation(s)
- Hanna Josefsson Dahlgren
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - Cecilia Engmér Berglin
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - Malou Hultcrantz
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - Filip Asp
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
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Cadre B, Simon F, Célérier C, Coudert C, Flament J, Loundon N, Belhous K, Denoyelle F. Long-term outcomes of retrospective case series of middle ear implantation with Vibrant Soundbridge in children with congenital aural atresia. Eur Arch Otorhinolaryngol 2023; 280:1629-1637. [PMID: 36098862 DOI: 10.1007/s00405-022-07633-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 08/25/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE to assess audiological performance in quiet and noise, quality of life and side effects of Vibrant Soundbridge (VSB) in children with congenital aural atresia (CAA). METHODS A retrospective study including consecutive patients with unilateral or bilateral CAA implanted with VSB from 2009 to 2020 in a tertiary referral centre. RESULTS 18 patients with CAA and a present stapes were included (3 simultaneous bilateral VSB implants) and 21 ears: 17 VSB were attached to the short incus process, and four to the stapes. Age at implantation ranged from 4.7 to 15.8 years. Average follow-up was 6.5 years (± 3.7 years). In unilateral VSB, air conduction pure tone average (ACPTA) thresholds increased from 75.3 ± 15.2 to 32.6 ± 8.3 dB post-operatively (VSB activated) (n = 15; p < 0.01). The speech reception threshold (SRT) and the word recognition score (WRS) were significantly improved from 81.5 ± 10.4 to 43.9 ± 7.6 dB and 0% to 84.8 ± 8.5% postoperatively (n = 15; p < 0.01). The signal to noise ratio (SNR) was significantly improved from 2.1 ± 2.9 dB VSB inactivated to 0.3 ± 2.7 dB VSB activated (n = 15; p < 0.01). There was no significant difference in performance according to floating mass transducer (FMT) placement. 5/15 children were non-users at last follow-up in unilateral VSB and 0/3 in bilateral. CONCLUSIONS CAA ears with VSB activated had a significant improvement of ACPTA, WRS, SRT and SNR. A third of patients with unilateral CAA became non-users at last follow-up. The main challenge is to target the indications for the implantation of the VSB to avoid its discontinuation.
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Affiliation(s)
- Barbara Cadre
- Université Paris Cité, 75006, Paris, France.,Department of Paediatric Otolaryngology, AP-HP, Hôpital Necker-Enfants Malades, 149 rue de Sèvres, 75015, Paris, France
| | - François Simon
- Université Paris Cité, 75006, Paris, France. .,Department of Paediatric Otolaryngology, AP-HP, Hôpital Necker-Enfants Malades, 149 rue de Sèvres, 75015, Paris, France.
| | - Charlotte Célérier
- Department of Paediatric Otolaryngology, AP-HP, Hôpital Necker-Enfants Malades, 149 rue de Sèvres, 75015, Paris, France
| | - Cyrille Coudert
- Department of Paediatric Otolaryngology, AP-HP, Hôpital Necker-Enfants Malades, 149 rue de Sèvres, 75015, Paris, France.,Audika Hearing Expertise Laboratory, 19, avenue des Gobelins, 75005, Paris, France
| | - Jonathan Flament
- Department of Paediatric Otolaryngology, AP-HP, Hôpital Necker-Enfants Malades, 149 rue de Sèvres, 75015, Paris, France.,Audika Hearing Expertise Laboratory, 19, avenue des Gobelins, 75005, Paris, France
| | - Natalie Loundon
- Department of Paediatric Otolaryngology, AP-HP, Hôpital Necker-Enfants Malades, 149 rue de Sèvres, 75015, Paris, France
| | - Kahina Belhous
- Department of Radiology, AP-HP, Hôpital Necker-Enfants Malades, 75015, Paris, France
| | - Françoise Denoyelle
- Université Paris Cité, 75006, Paris, France.,Department of Paediatric Otolaryngology, AP-HP, Hôpital Necker-Enfants Malades, 149 rue de Sèvres, 75015, Paris, France
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5
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Sharma S, H.M. Mens L, F.M. Snik A, van Opstal AJ, van Wanrooij MM. Hearing Asymmetry Biases Spatial Hearing in Bimodal Cochlear-Implant Users Despite Bilateral Low-Frequency Hearing Preservation. Trends Hear 2023; 27:23312165221143907. [PMID: 36605011 PMCID: PMC9829999 DOI: 10.1177/23312165221143907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Many cochlear implant users with binaural residual (acoustic) hearing benefit from combining electric and acoustic stimulation (EAS) in the implanted ear with acoustic amplification in the other. These bimodal EAS listeners can potentially use low-frequency binaural cues to localize sounds. However, their hearing is generally asymmetric for mid- and high-frequency sounds, perturbing or even abolishing binaural cues. Here, we investigated the effect of a frequency-dependent binaural asymmetry in hearing thresholds on sound localization by seven bimodal EAS listeners. Frequency dependence was probed by presenting sounds with power in low-, mid-, high-, or mid-to-high-frequency bands. Frequency-dependent hearing asymmetry was present in the bimodal EAS listening condition (when using both devices) but was also induced by independently switching devices on or off. Using both devices, hearing was near symmetric for low frequencies, asymmetric for mid frequencies with better hearing thresholds in the implanted ear, and monaural for high frequencies with no hearing in the non-implanted ear. Results show that sound-localization performance was poor in general. Typically, localization was strongly biased toward the better hearing ear. We observed that hearing asymmetry was a good predictor for these biases. Notably, even when hearing was symmetric a preferential bias toward the ear using the hearing aid was revealed. We discuss how frequency dependence of any hearing asymmetry may lead to binaural cues that are spatially inconsistent as the spectrum of a sound changes. We speculate that this inconsistency may prevent accurate sound-localization even after long-term exposure to the hearing asymmetry.
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Affiliation(s)
- Snandan Sharma
- Department of Biophysics, Radboud
University, Donders Institute for
Brain, Cognition and Behavior, Nijmegen, The
Netherlands
| | - Lucas H.M. Mens
- Department of Otorhinolaryngology, Radboud University Medical
Centre, Donders Institute for
Brain, Cognition and Behavior, Nijmegen, The
Netherlands
| | - Ad F.M. Snik
- Department of Biophysics, Radboud
University, Donders Institute for
Brain, Cognition and Behavior, Nijmegen, The
Netherlands
| | - A. John van Opstal
- Department of Biophysics, Radboud
University, Donders Institute for
Brain, Cognition and Behavior, Nijmegen, The
Netherlands
| | - Marc M. van Wanrooij
- Department of Biophysics, Radboud
University, Donders Institute for
Brain, Cognition and Behavior, Nijmegen, The
Netherlands
- Marc van Wanrooij, Department of
Biophysics, Radboud University, Donders Institute for Brain, Cognition and
Behavior, The Netherlands.
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6
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Wang J, Lu X, Sang J, Cai J, Zheng C. Effects of Stimulation Position and Frequency Band on Auditory Spatial Perception with Bilateral Bone Conduction. Trends Hear 2022; 26:23312165221097196. [PMID: 35491731 PMCID: PMC9067062 DOI: 10.1177/23312165221097196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Virtual sound localization tests were conducted to examine the effects of stimulation position (mastoid, condyle, supra-auricular, temple, and bone-anchored hearing aid implant position) and frequency band (low frequency, high frequency, and broadband) on bone-conduction (BC) horizontal localization. Non-individualized head-related transfer functions were used to reproduce virtual sound through bilateral BC transducers. Subjective experiments showed that stimulation at the mastoid gave the best performance while the temple gave the worst performance in localization. Stimulation at the mastoid and condyle did not differ significantly from that using air-conduction (AC) headphones in localization accuracy. However, binaural reproduction at all BC stimulation positions led to similar levels of front-back confusion (FBC), which were also comparable to that with AC headphones. Binaural BC reproduction with high-frequency stimulation led to significantly higher localization accuracy than with low-frequency stimulation. When transcranial attenuation (TA) was measured, the attenuation became larger at the condyle and mastoid, and increased at high frequencies. The experiments imply that larger TAs may improve localization accuracy but do not improve FBC. The present study indicates that the BC stimulation at the mastoid and condyle can effectively convey spatial information, especially with high-frequency stimulation.
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Affiliation(s)
- Jie Wang
- School of Electronics and Communication Engineering, Guangzhou University, Guangzhou, China
| | - Xikun Lu
- School of Electronics and Communication Engineering, Guangzhou University, Guangzhou, China
| | - Jinqiu Sang
- Key Laboratory of Noise and Vibration Research, Institute of Acoustics, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Juanjuan Cai
- State Key Laboratory of Media Convergence and Communication, Communication University of China, Beijing, China
| | - Chengshi Zheng
- Key Laboratory of Noise and Vibration Research, Institute of Acoustics, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
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7
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Asp F, Stokroos RJ, Agterberg MJH. Toward Optimal Care for Children With Congenital Unilateral Aural Atresia. Front Neurol 2021; 12:687070. [PMID: 34305795 PMCID: PMC8298319 DOI: 10.3389/fneur.2021.687070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 06/14/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
- Filip Asp
- Scientific Center for Advanced Pediatric Audiology, Division of Ear, Nose, and Throat Diseases, Department of Clinical Science, Intervention and Technology Karolinska Institute, Stockholm, Sweden
| | - Robert J Stokroos
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands.,University Medical Center (UMC) Utrecht Brain Center, Utrecht, Netherlands
| | - Martijn J H Agterberg
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Centre Nijmegen, Nijmegen, Netherlands.,Department of Biophysics, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Nijmegen, Nijmegen, Netherlands
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8
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Snapp H, Vogt K, Agterberg MJ. Bilateral bone conduction stimulation provides reliable binaural cues for localization. Hear Res 2020; 388:107881. [DOI: 10.1016/j.heares.2019.107881] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/25/2019] [Accepted: 12/27/2019] [Indexed: 11/22/2022]
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9
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Asp F, Reinfeldt S. Horizontal sound localisation accuracy in individuals with conductive hearing loss: effect of the bone conduction implant. Int J Audiol 2018; 57:657-664. [DOI: 10.1080/14992027.2018.1470337] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Filip Asp
- Division of Signal Processing and Biomedical Engineering, Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
- Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology Karolinska Institutet, Stockholm, Sweden
| | - Sabine Reinfeldt
- Division of Signal Processing and Biomedical Engineering, Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
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10
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Nelissen RC, Agterberg MJH, Hol MKS, Snik AFM. Three-year experience with the Sophono in children with congenital conductive unilateral hearing loss: tolerability, audiometry, and sound localization compared to a bone-anchored hearing aid. Eur Arch Otorhinolaryngol 2016; 273:3149-56. [PMID: 26924741 PMCID: PMC5014896 DOI: 10.1007/s00405-016-3908-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 01/20/2016] [Indexed: 11/11/2022]
Abstract
Bone conduction devices (BCDs) are advocated as an amplification option for patients with congenital conductive unilateral hearing loss (UHL), while other treatment options could also be considered. The current study compared a transcutaneous BCD (Sophono) with a percutaneous BCD (bone-anchored hearing aid, BAHA) in 12 children with congenital conductive UHL. Tolerability, audiometry, and sound localization abilities with both types of BCD were studied retrospectively. The mean follow-up was 3.6 years for the Sophono users (n = 6) and 4.7 years for the BAHA users (n = 6). In each group, two patients had stopped using their BCD. Tolerability was favorable for the Sophono. Aided thresholds with the Sophono were unsatisfactory, as they did not reach under a mean pure tone average of 30 dB HL. Sound localization generally improved with both the Sophono and the BAHA, although localization abilities did not reach the level of normal hearing children. These findings, together with previously reported outcomes, are important to take into account when counseling patients and their caretakers. The selection of a suitable amplification option should always be made deliberately and on individual basis for each patient in this diverse group of children with congenital conductive UHL.
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Affiliation(s)
- Rik C Nelissen
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, Netherlands.
| | - Martijn J H Agterberg
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, Netherlands.,Department of Biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Myrthe K S Hol
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, Netherlands
| | - Ad F M Snik
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, Netherlands.,Department of Biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
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11
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Snik A, Agterberg M, Bosman A. How to quantify binaural hearing in patients with unilateral hearing using hearing implants. Audiol Neurootol 2015; 20 Suppl 1:44-7. [PMID: 25997479 DOI: 10.1159/000380747] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Application of bilateral hearing devices in bilateral hearing loss and unilateral application in unilateral hearing loss (second ear with normal hearing) does not a priori lead to binaural hearing. An overview is presented on several measures of binaural benefits that have been used in patients with unilateral or bilateral deafness using one or two cochlear implants, respectively, and in patients with unilateral or bilateral conductive/mixed hearing loss using one or two percutaneous bone conduction implants (BCDs), respectively. Overall, according to this overview, the most significant and sensitive measure is the benefit in directional hearing. Measures using speech (viz. binaural summation, binaural squelch or use of the head shadow effect) showed minor benefits, except for patients with bilateral conductive/mixed hearing loss using two BCDs. Although less feasible in daily practise, the binaural masking level difference test seems to be a promising option in the assessment of binaural function.
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Affiliation(s)
- Ad Snik
- Department of Otorhinolaryngology, Radboud University Centre Nijmegen, Nijmegen, The Netherlands
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Morimoto C, Nishimura T, Hosoi H, Saito O, Fukuda F, Shimokura R, Yamanaka T. Sound transmission by cartilage conduction in ear with fibrotic aural atresia. ACTA ACUST UNITED AC 2014; 51:325-32. [DOI: 10.1682/jrrd.2013.05.0128] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 09/18/2013] [Indexed: 11/05/2022]
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Keating P, King AJ. Developmental plasticity of spatial hearing following asymmetric hearing loss: context-dependent cue integration and its clinical implications. Front Syst Neurosci 2013; 7:123. [PMID: 24409125 PMCID: PMC3873525 DOI: 10.3389/fnsys.2013.00123] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 12/12/2013] [Indexed: 11/23/2022] Open
Abstract
Under normal hearing conditions, comparisons of the sounds reaching each ear are critical for accurate sound localization. Asymmetric hearing loss should therefore degrade spatial hearing and has become an important experimental tool for probing the plasticity of the auditory system, both during development and adulthood. In clinical populations, hearing loss affecting one ear more than the other is commonly associated with otitis media with effusion, a disorder experienced by approximately 80% of children before the age of two. Asymmetric hearing may also arise in other clinical situations, such as after unilateral cochlear implantation. Here, we consider the role played by spatial cue integration in sound localization under normal acoustical conditions. We then review evidence for adaptive changes in spatial hearing following a developmental hearing loss in one ear, and show that adaptation may be achieved either by learning a new relationship between the altered cues and directions in space or by changing the way different cues are integrated in the brain. We next consider developmental plasticity as a source of vulnerability, describing maladaptive effects of asymmetric hearing loss that persist even when normal hearing is provided. We also examine the extent to which the consequences of asymmetric hearing loss depend upon its timing and duration. Although much of the experimental literature has focused on the effects of a stable unilateral hearing loss, some of the most common hearing impairments experienced by children tend to fluctuate over time. We therefore propose that there is a need to bridge this gap by investigating the effects of recurring hearing loss during development, and outline recent steps in this direction. We conclude by arguing that this work points toward a more nuanced view of developmental plasticity, in which plasticity may be selectively expressed in response to specific sensory contexts, and consider the clinical implications of this.
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Affiliation(s)
- Peter Keating
- Department of Physiology, Anatomy and Genetics, University of OxfordOxford, UK
| | - Andrew J. King
- Department of Physiology, Anatomy and Genetics, University of OxfordOxford, UK
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