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Távora-Vieira D, Marino R, Kuthubutheen J, Broadbent C, Acharya A. Decision making in bone conduction and active middle ear implants - hearing outcomes and experiences over a 10-year period. Cochlear Implants Int 2023:1-7. [PMID: 37846847 DOI: 10.1080/14670100.2023.2267900] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
OBJECTIVES To review the decision-making paradigm in the recommendations of BCI and aMEI overlapping candidacy for patients with conductive or mixed HL, and to determine if there are differences in hearing and quality of life outcomes between these implantable hearing devices. METHODS Retrospective data from patients receiving BCI or aMEI in the past decade were analysed. Patients were grouped into: 1. BCI candidates, 2. BCI or aMEI candidates, and 3. aMEI candidates. We compared outcomes and examined the impact of BC threshold, age at implantation, and duration of hearing loss on candidacy. RESULTS 89 participants were included: 30 BCI, 37 aMEI, and 22 BCI or aMEI candidates. All groups performed similarly in aided sound field threshold testing. BCI group had lower speech scores in quiet compared to 'BCI or aMEI.' No significant differences were found in APHAB global scores. BC threshold, duration of hearing loss, and age at implantation had no significant effects. DISCUSSION Outcomes were generally similar across groups, except for higher effective gain in the aMEI group. CONCLUSION Our proposed patient pathway and decision-making approach facilitate candidate selection for aMEI and BCI, aiming to optimise outcomes.
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Affiliation(s)
- Dayse Távora-Vieira
- Audiology Department, Fiona Stanley Fremantle Hospitals Group, Perth/Western Australia, Australia
- Medical School, The University of Western Australia, Perth/Western Australia, Australia
- School of Occupational Therapy, Social Work and Speech Pathology Faculty of Health Sciences, Curtin University, Perth/Western Australia, Australia
| | - Roberta Marino
- Audiology Department, Fiona Stanley Fremantle Hospitals Group, Perth/Western Australia, Australia
- Medical School, The University of Western Australia, Perth/Western Australia, Australia
| | - Jafri Kuthubutheen
- Audiology Department, Fiona Stanley Fremantle Hospitals Group, Perth/Western Australia, Australia
- Medical School, The University of Western Australia, Perth/Western Australia, Australia
| | - Christopher Broadbent
- Audiology Department, Fiona Stanley Fremantle Hospitals Group, Perth/Western Australia, Australia
| | - Aanand Acharya
- Audiology Department, Fiona Stanley Fremantle Hospitals Group, Perth/Western Australia, Australia
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Liu H, Xue L, Yang J, Cheng G, Zhou L, Huang X. Effect of ossicular chain deformity on reverse stimulation considering the overflow characteristics of third windows. Comput Methods Biomech Biomed Engin 2021; 25:257-272. [PMID: 34229548 DOI: 10.1080/10255842.2021.1948023] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Stimulating the round window membrane via an active actuator of the middle ear implant, named the reverse stimulation, has become an option to help patients with ossicular chain deformity (OCD) to restore hearing. However, there is still no concise description of how OCD affects reverse stimulation considering the overflow characteristics of third windows. In the present study, an impedance model considering the vestibular and cochlear aqueducts was used to investigate the dynamic response of the cochlea to reverse stimulation under OCD. First, a finite-element (FE) model of the middle ear and the ear canal was used to estimate the changes in reverse middle-ear impedance caused by ossicular chain fixation and ossicular chain interruption. Then, the impedance model was used to predict the reverse transfer function, which characterizes the effect of OCD on the dynamic response of the cochlea. The results show that ossicular chain fixation reduces the reverse stimulation's performance. Moreover, the existence of the third windows complicates the effect of ossicular chain fixation on the reverse stimulation and boosts obviously the reverse stimulation's performance at low frequencies. In contrast, regardless of the existence of third windows, ossicular chain interruption enhances the effect of reverse stimulation.
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Affiliation(s)
- Houguang Liu
- School of Mechatronic Engineering, China University of Mining and Technology, Xuzhou, China
| | - Lin Xue
- School of Mechatronic Engineering, China University of Mining and Technology, Xuzhou, China
| | - Jianhua Yang
- School of Mechatronic Engineering, China University of Mining and Technology, Xuzhou, China
| | - Gang Cheng
- School of Mechatronic Engineering, China University of Mining and Technology, Xuzhou, China
| | - Lei Zhou
- Department of Otorhinolaryngology-Head and Neck Surgery, Shanghai Zhongshan Hospital affiliated to Fudan University, Shanghai, China
| | - Xinsheng Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Shanghai Zhongshan Hospital affiliated to Fudan University, Shanghai, China
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van de Heyning P, Mertens G, Topsakal V, de Brito R, Wimmer W, Caversaccio MD, Dazert S, Volkenstein S, Zernotti M, Parnes LS, Staecker H, Bruce IA, Rajan G, Atlas M, Friedland P, Skarzynski PH, Sugarova S, Kuzovkov V, Hagr A, Mlynski R, Schmutzhard J, Usami SI, Lassaletta L, Gavilán J, Godey B, Raine CH, Hagen R, Sprinzl GM, Brown K, Baumgartner WD, Karltorp E. Two-phase survey on the frequency of use and safety of MRI for hearing implant recipients. Eur Arch Otorhinolaryngol 2021; 278:4225-4233. [PMID: 33788034 PMCID: PMC8486706 DOI: 10.1007/s00405-020-06525-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 11/26/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Magnetic resonance imaging (MRI) is often used to visualize and diagnose soft tissues. Hearing implant (HI) recipients are likely to require at least one MRI scan during their lifetime. However, the MRI scanner can interact with the implant magnet, resulting in complications for the HI recipient. This survey, which was conducted in two phases, aimed to evaluate the safety and performance of MRI scans for individuals with a HI manufactured by MED-EL (MED-EL GmbH, Innsbruck, Austria). METHODS A survey was developed and distributed in two phases to HEARRING clinics to obtain information about the use of MRI for recipients of MED-EL devices. Phase 1 focused on how often MRI is used in diagnostic imaging of the head region of the cochlear implant (CI) recipients. Phase 2 collected safety information about MRI scans performed on HI recipients. RESULTS 106 of the 126 MRI scans reported in this survey were performed at a field strength of 1.5 T, on HI recipients who wore the SYNCHRONY CI or SYNCHRONY ABI. The head and spine were the most frequently imaged regions. 123 of the 126 scans were performed without any complications; two HI recipients experienced discomfort/pain. One recipient required reimplantation after an MRI was performed using a scanner that had not been approved for that implant. There was only one case that required surgical removal of the implant to reduce the imaging artefact. CONCLUSION Individuals with either a SYNCHRONY CI or SYNCHRONY ABI from MED-EL can safely undergo a 1.5 T MRI when it is performed according to the manufacturer's safety policies and procedures.
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Affiliation(s)
| | - Griet Mertens
- ENT Department, Antwerp University Hospital (UZA), Edegem/Antwerp, Belgium
| | - Vedat Topsakal
- ENT Department, Antwerp University Hospital (UZA), Edegem/Antwerp, Belgium
| | - Ruben de Brito
- Hospital for Rehabilitation of Cranio-Facial Anomalies, Bauru-Sao Paulo, Brazil
| | - Wilhelm Wimmer
- Department for ENT, Head and Neck Surgery, Bern University Hospital, Bern, Switzerland
| | - Marco D Caversaccio
- Department for ENT, Head and Neck Surgery, Bern University Hospital, Bern, Switzerland
| | - Stefan Dazert
- Bochum St. Elisabeth University Hospital, Bochum, Germany
| | | | - Mario Zernotti
- Córdoba Sanatorium Allende, Servicio de Otorrinolaryingologia (Servicio ORL), Córdoba, Argentina
| | - Lorne S Parnes
- London Health Sciences Center-University Hospital, London, Ontario, Canada
| | - Hinrich Staecker
- Department of Otorinolaryngology, Kansas University Center for Hearing and Balance Disorders, Kansas City, USA
| | - Iain A Bruce
- Pediatric ENT Department, Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Gunesh Rajan
- University of Western Australia, Crawley, Perth, Australia.,Department of Otolaryngology, Head and Neck Surgery, Luzerner Kantonsspital, Luzern, Switzerland
| | - Marcus Atlas
- Ear Sciences Center, Lions Hearing Clinic, Subiaco, Australia
| | - Peter Friedland
- Ear Sciences Center, Lions Hearing Clinic, Subiaco, Australia
| | - Piotr H Skarzynski
- Institute of Sensory Organs, Nadarzyn/Kajetany, Poland.,Department of Teleaudiology and Screening, World Hearing Center of the Institute of Physiology and Pathology of Hearing, Kajetany, Poland
| | - Serafima Sugarova
- St. Petersburg ENT and Speech Research Institute, St. Petersburg, Russia
| | - Vladislav Kuzovkov
- St. Petersburg ENT and Speech Research Institute, St. Petersburg, Russia
| | - Abdulrahman Hagr
- King Abdullah Ear Specialist Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Robert Mlynski
- Universität Rostock "Otto Körner", Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Rostock, Germany
| | | | | | | | | | - Benoit Godey
- Centre Hospitalier Universitaire (CHU) de Rennes, Rennes, France
| | | | - Rudolf Hagen
- Würzburg ENT University Hospital, Würzburg, Germany
| | | | - Kevin Brown
- UNC Ear and Hearing Center at Chapel Hill School of Medicine, Chapel Hill, NC, USA
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Dalgic A, Atsal G, Olgun L, Kirazli T. Long term results and evaluation of device satisfaction in patients used the vibrant sound bridge (VSB). Acta Otolaryngol 2021; 141:256-260. [PMID: 33528309 DOI: 10.1080/00016489.2020.1843708] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Patients' satisfaction with the device is as important as the audiological gains in patients using these devices. OBJECTIVE In this study, we aimed to evaluate the hearing aid satisfaction of individuals using The Vibrant Sound Bridge (VSB) (Vibrant Med-El, Innsbruck, Austria) and to compare this result with audiologic results with and without devices. MATERIAL AND METHODS Patients who were using VSB were included in the study. Preoperative and postoperative pure tone averages and demographic datas of the patients to be included in the study were recorded. A shortened version of Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, was used to evaluate patients' device satisfaction. RESULTS Fifteen patients with VSB were included in the study. The mean follow-up was 9.13 years. The preoperative air conduction threshold and the air-bone gap in all frequencies were significantly higher than postoperative values (p < .05). The functional gain was found as 28 dB. In the APHAB questionnaire, there was a significant difference between total score results and EC, BN, RV subscales in the patients using the device (p < .01). CONCLUSION AND SIGNIFICANCE Patients with VSB give satisfactory results in auditory gains. In particular, good indication and long-term use of the device increases the suitability and satisfaction of the patients.
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Affiliation(s)
- Abdullah Dalgic
- Department of Otolaryngology, University of Health Sciences Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - Gorkem Atsal
- Department of Otolaryngology, University of Health Sciences Izmir Bozyaka Education and Research Hospital, Izmir, Turkey
| | - Levent Olgun
- Department of Otorhinolaryngology, Izmir Baskent Zubeyde Hanım Training and Research Hospital, Izmir, Turkey
| | - Tayfun Kirazli
- Department of Otolaryngology, Ege University School of Medicine, Izmir, Turkey
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Lau K, Scotta G, Barauna I, da Silva VC, Peixoto MC, Ray J. Surgical and audiological outcomes of a fully implantable middle ear implant: early results from a retrospective multicentre study. Eur Arch Otorhinolaryngol 2020; 277:2721-2727. [PMID: 32372259 DOI: 10.1007/s00405-020-05986-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/23/2020] [Accepted: 04/15/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE This paper reports the surgical and audiological outcomes of a large series of patients who received a fully implantable middle ear implant (MEI): carina (Cochlear, Australia). METHODS This is a multicentre retrospective study involving three tertiary referral centres. Patient data were collected for the first 42 consecutive patients who were fitted with the MEI between 2014 and 2019 (Sheffield from February 2017 to January 2019; São Paulo from April 2015 to September 2017; Porto from December 2014 to May 2017). The main outcome measures included surgical results, free field speech testing with speech recognition thresholds (SRT) and audiological gain. RESULTS There was one major complication due to infection resulting in a brain abscess and explantation of the device. Three other patients had minor skin infections; no other complications were reported. Results show a functional gain of 19.5 dB (p < 0.05) with the MEI versus unaided condition. SRT improved from 57.4 dB to 44.6 dB with the MEI (p < 0.05). CONCLUSIONS This fully implanable active MEI offers a reliable option for patients with moderate-to-severe sensorineural or mixed hearing losses especially for those do not tolerate or cannot use conventional hearing aids. It provides significant improvement in hearing as shown in the audiological outcomes. The surgery is relatively straightforward but there is a steep learning curve. The devices are well tolerated by all patients.
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Affiliation(s)
- Kimberley Lau
- Department of Otolaryngology, Sheffield Teaching Hospitals, Sheffield, UK. .,ENT Department, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK.
| | - Gianluca Scotta
- Department of Otolaryngology, Sheffield Teaching Hospitals, Sheffield, UK.,ENT Department, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK
| | | | - Victor Correia da Silva
- Auditory Implant Unit, Department of Otorhinolaryngology, Hospital CUF Porto, Porto, Portugal
| | - Maria Conceição Peixoto
- Auditory Implant Unit, Department of Otorhinolaryngology, Hospital CUF Porto, Porto, Portugal
| | - Jaydip Ray
- Department of Otolaryngology, Sheffield Teaching Hospitals, Sheffield, UK.,ENT Department, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK
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Abstract
Active auditory implants, such as the Maxum, provide significantly improved hearing function compared to hearing aids in patients with moderate to severe hearing loss who are not reaching their cochlear hearing potential. The speech perception gap (SPG), defined as PB Max (phonetically balanced maximum) minus word recognition score with hearing aid, is a useful measure of inadequate hearing aid performance. The Maxum middle ear implant provides significantly improved performance over hearing aids in patients with significant SPG because of superior high frequency gain. Patients with PB Max 60% or greater with SPG are possible candidates for the implant.
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Affiliation(s)
- C Y Joseph Chang
- Texas Ear Center, 7900 Fannin, Suite 1800, Houston, TX 77054, USA; Department of Otorhinolaryngology-Head and Neck Surgery, University of Texas McGovern Medical School, Houston, TX, USA.
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7
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Abstract
Hearing rehabilitation has been recognized as a crucial tool to maintain communicative and social skills. The availability of hearing aids and auditory implants ought not be limited to the wealthy and to those who can afford them. Multidisciplinary efforts in reducing costs are necessary and include reduction of the item costs, insurance coverage, and the ability to perform certain procedures in an office setting, eliminating hospital and facilities fees and anesthesia bills.
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Affiliation(s)
- Jack Wazen
- Department of Surgery, Division of Otolaryngology Head and Neck Surgery, Sarasota Memorial Hospital, 1901 Floyd street, Sarasota, Florida 34239, USA; Silverstein Institute, 1901 Floyd Street, Sarasota, FL 34239, USA.
| | - Joshua Smith
- Otology, Silverstein Institute, 1901 Floyd Street, Sarasota, FL 34239, USA
| | - Julie Daugherty
- Research for the Ear Research Foundation, Silverstein Institute, 1901 Floyd Street, Sarasota, FL 34239, USA
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Lee JM, Jeon JH, Moon IS, Choi JY. Benefits of active middle ear implants over hearing aids in patients with sloping high tone hearing loss: comparison with hearing aids. Acta Otorhinolaryngol Ital 2018; 37:218-223. [PMID: 28516965 PMCID: PMC5463512 DOI: 10.14639/0392-100x-1146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 01/15/2017] [Indexed: 11/24/2022]
Abstract
In this retrospective chart review we compared the subjective and objective benefits of active middle ear implants (AMEIs) with conventional hearing aids (HAs) in patients with sloping high tone hearing loss. Thirty-four patients with sensorineural hearing loss were treated with AMEIs. Of these, six had sloping high tone hearing loss and had worn an HA for more than 6 months. Objective assessments, a pure-tone audiogram, as well as a word recognition test, and the Korean version of the Hearing in Noise Test (K-HINT), and a subjective assessment, the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, were performed. Tests were conducted under three circumstances: 1) the unaided state before surgery; 2) the HA-aided state before surgery; and 3) the AMEI-aided state 3 months after surgery. The average high-frequency hearing gain (≥ 2 kHz) was significantly better with AMEIs than with HAs. Although the result had no statistical significance, AMEIs showed a superior word recognition score (WRS) compared to HAs. However, the most comfortable hearing level at which the WRS was tested was significantly decreased with an AMEI compared to an HA. In the K-HINT, patients with an AMEI showed greater recognition than those fitted with an HA under both quiet and noisy conditions. The APAHB scores revealed that patients were more satisfied with an AMEI rather than an HA on all subscales. The use of vibroplasty in patients with sloping high tone loss resulted in positive hearing outcomes when compared to conventional HAs. Based on the data from this study, AMEIs provided better objective and subjective results and could, therefore, be a better alternative for the treatment of sloping hearing loss.
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Affiliation(s)
- J M Lee
- Department of Otorhinolaryngology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - J H Jeon
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - I S Moon
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - J Y Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
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Vickers D, Canas A, Degun A, Briggs J, Bingham M, Toner J, Cooper H, Rogers S, Cooper S, Irving R, Spielman P, Batty S, Jones S, Asher A, Chung M, Donnelly N, Skibinska A, Gardner R, Raine C, Andrew R, Green K, Ghulam H, Nunn T, Jiang D, Fürhapter S, Urban M, Hanvey K, Flynn S, Lovegrove D, Saeed S. Evaluating the effectiveness and reliability of the Vibrant Soundbridge and Bonebridge auditory implants in clinical practice: Study design and methods for a multi-centre longitudinal observational study. Contemp Clin Trials Commun 2018; 10:137-140. [PMID: 30023447 PMCID: PMC6046512 DOI: 10.1016/j.conctc.2018.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 03/03/2018] [Accepted: 03/14/2018] [Indexed: 11/25/2022] Open
Abstract
Background The Vibrant Soundbridge middle ear implant and the Bonebridge bone conducting hearing device are hearing implants that use radio frequency transmission to send information from the sound processor to the internal transducer. This reduces the risk of skin problems and infection but requires a more involved surgical procedure than competitor skin penetrating devices. It is not known whether more complex surgery will lead to additional complications. There is little information available on the reliability of these systems and adverse medical or surgical events. The primary research question is to determine the reliability and complication rate for the Vibrant Soundbridge and Bonebridge. The secondary research question explores changes in quality of life following implantation of the devices. The tertiary research question looks at effectiveness via changes in auditory performance. Method The study was designed based on a combination of a literature search, two clinician focus groups and expert review.A multi-centre longitudinal observational study was designed. There are three study groups, two will have been implanted prior to the start of the study and one group, the prospective group, will be implanted after initiation of the study. Outcomes are surgical questionnaires, measures of quality of life, user satisfaction and speech perception tests in quiet and in noise. Conclusion This is the first multi-centre study to look at these interventions and includes follow up over time to understand effectiveness, reliability, quality of life and complications.
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Affiliation(s)
| | - Angela Canas
- Faculty of Brain Sciences, University College London, UK
| | - Aneeka Degun
- Faculty of Brain Sciences, University College London, UK.,Royal National Throat, Nose and Ear Hospital, University College London Hospital NHS Foundation Trust, UK
| | - John Briggs
- Faculty of Brain Sciences, University College London, UK.,Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, UK.,MED-EL UK Ltd, UK
| | | | | | - Huw Cooper
- Midlands Hearing Implant Programme, Queen Elizabeth Hospital, Birmingham, UK
| | - Sarah Rogers
- Midlands Hearing Implant Programme, Queen Elizabeth Hospital, Birmingham, UK
| | - Stacey Cooper
- Midlands Hearing Implant Programme, Queen Elizabeth Hospital, Birmingham, UK.,Hearing Implant Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Richard Irving
- Midlands Hearing Implant Programme, Queen Elizabeth Hospital, Birmingham, UK
| | - Patrick Spielman
- Department of Otolaryngology, Ninewells Hospital NHS Tayside, Dundee, UK
| | - Samantha Batty
- Department of Otolaryngology, Ninewells Hospital NHS Tayside, Dundee, UK
| | - Stephen Jones
- Department of Otolaryngology, Ninewells Hospital NHS Tayside, Dundee, UK
| | - Abi Asher
- Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, UK
| | - Mark Chung
- Royal National Throat, Nose and Ear Hospital, University College London Hospital NHS Foundation Trust, UK.,Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, UK
| | - Neil Donnelly
- Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, UK
| | - Anna Skibinska
- Yorkshire Auditory Implant Service, Bradford Teaching Hospital NHS Foundation Trust, UK
| | - Robert Gardner
- Yorkshire Auditory Implant Service, Bradford Teaching Hospital NHS Foundation Trust, UK
| | - Chris Raine
- Yorkshire Auditory Implant Service, Bradford Teaching Hospital NHS Foundation Trust, UK
| | - Rachel Andrew
- Audiology (Hearing and Balance) Centre, Central Manchester University Hospital NHS Foundation Trust, UK
| | - Kevin Green
- Audiology (Hearing and Balance) Centre, Central Manchester University Hospital NHS Foundation Trust, UK
| | - Hashmat Ghulam
- Hearing Implant Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Terry Nunn
- Hearing Implant Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Dan Jiang
- Hearing Implant Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Michael Urban
- MED-EL Electromedizinische Geraete, GmbH, Innsbruck, Austria
| | - Kate Hanvey
- Birmingham Children's Hospital NHS Foundation Trust, UK
| | - Sarah Flynn
- University Hospital Southampton NHS Foundation Trust, UK
| | | | - Shakeel Saeed
- Faculty of Brain Sciences, University College London, UK.,Royal National Throat, Nose and Ear Hospital, University College London Hospital NHS Foundation Trust, UK
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10
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McRackan TR, Clinkscales WB, Ahlstrom JB, Nguyen SA, Dubno JR. Factors associated with benefit of active middle ear implants compared to conventional hearing aids. Laryngoscope 2018; 128:2133-2138. [PMID: 29481695 DOI: 10.1002/lary.27109] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 10/19/2017] [Revised: 12/11/2017] [Accepted: 01/02/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Identify factors associated with benefit of middle ear implants (MEIs) as compared to conventional hearing aids (HAs). STUDY DESIGN Independent review of audiological data from a multicenter prospective U.S. Food and Drug Administration (FDA) clinical trial. Preoperative and postoperative earphone, unaided/aided/implanted pure-tone thresholds, and word recognition scores were evaluated. RESULTS Ninety-one subjects were included in this study. Mean word recognition was better with MEIs than with HAs (81.8% ± 12.0% vs. 77.6% ± 14.6%, P = 0.035). Word recognition with MEIs showed a low positive correlation with word recognition measured with earphones (r = 0.25, P = 0.016) and a moderate positive correlation with aided word recognition (r = 0.42, P < 0.001). Earphone word recognition alone was not predictive of MEI benefit over HA benefit (r = 0.09, P = 0.41), unlike differences between scores with earphone and HAs (earphone-aided differences [EAD]) (r = 0.62, P < 0.011). As compared to those with -EADs, subjects with +EADs showed greater improvement in word recognition from unaided to implanted and from HAs to implanted (P < 0.0001). Using the 95% CI for word recognition scores, 16 subjects showed significantly higher scores with the MEI than with HAs. Of those, 14 had +EAD. CONCLUSION Word recognition benefit derived from conventional HAs and MEIs from this large, multi-center FDA trial provides further evidence of the importance of aided word recognition in clinical decision making, such as determining candidacy for and success with MEIs. LEVEL OF EVIDENCE 2b. Laryngoscope, 128:2133-2138, 2018.
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Affiliation(s)
- Theodore R McRackan
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - William B Clinkscales
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Jayne B Ahlstrom
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Judy R Dubno
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
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11
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Abstract
OBJECTIVE To present a historical overview of the Vibrant Soundbridge® (VSB) middle ear implant (MEI), since its beginning in the 1990s to date and to describe its course and contemplate what it might become in the future. HISTORY MEIs started to take form in researchers' mind in the 1930s with the first experiment of Wilska. In the 1970s, several devices, such as the Goode and Perkins', the Maniglia's, or the Hough and Dormer's were created but remained prototypes. It is only in the 1990s the devices that emerged remained on the market. In 1994, Symphonix, Inc. was created and aimed to manufacture and commercialize its semi-implantable MEI, the VSB. The principle of the VSB lies on a direct drive of the sound to a vibratory structure of the middle ear through an electromagnetic transducer, the floating mass transducer (FMT). The particularity of the system VSB is the simplicity of the transducer which is made of both the magnet and the coil; thus, the FMT, fixed on a vibrating middle ear structure, mimics the natural movement of the ossicular chain by moving in the same direction. The goal of the VSB was to give an alternative to patients with mild-to-severe sensorineural hearing loss who could not wear hearing aids (HAs) or who were unsatisfied conventional HA users. Subsequent to Tjellström's experiment in 1997, implantations started to include etiologies such as otosclerosis, radical mastoidectomy, failed ossiculoplasty/tympanoplasty, and atresia. Nowadays, the VSB, with more than 20 years of experience, is the oldest and most used middle ear implant worldwide. It is well acknowledged that the straightforward design and reliability of the transducer have certainly contributed to the success of the device.
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Affiliation(s)
- S Labassi
- a MED-EL France , Sophia Antipolis , France
| | - M Beliaeff
- a MED-EL France , Sophia Antipolis , France
| | - V Péan
- a MED-EL France , Sophia Antipolis , France
| | - P Van de Heyning
- b Department of Otorhinolaryngology, Antwerp University Hospital , University of Antwerp , Antwerp , Belgium
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Dyer RK, Spearman M, Spearman B, McCraney A. Evaluating speech perception of the MAXUM middle ear implant versus speech perception under inserts. Laryngoscope 2017; 128:456-460. [PMID: 28581120 DOI: 10.1002/lary.26605] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 12/20/2016] [Revised: 02/23/2017] [Accepted: 03/09/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS To evaluate the speech perception of the Ototronix MAXUM middle ear implant relative to the cochlear potential for speech perception of patients. STUDY DESIGN Clinical study chart review. METHODS We performed an evaluation of data from a prospective clinical study of 10 MAXUM patients. Primary outcome measures included comparison of word recognition (WR) scores with MAXUM (WRMAXUM ) versus word recognition under inserts (WRinserts ), and the functional gain improvement for pure-tone average (PTA) (0.5, 1, and 2 kHz) and high-frequency pure-tone average (2, 3, and 4 kHz). RESULTS Ten ears in 10 adult patients (six female; average age 68.7 years) were included. The average speech perception gap (difference between WRinserts and WRMAXUM ) with MAXUM was -9.2% (range, -26% to 4%). A negative number indicates that WRMAXUM was higher than the WRinserts . The average PTA with MAXUM was 23.1 dB (range, 18.7-30 dB), a 38.0-dB gain over the preoperative unaided condition (range, 20-53.3 dB). The average high-frequency pure-tone average with MAXUM was 34.4 dB (range, 26-43.3 dB), a 42.8-dB gain over the preoperative unaided condition (range, 32.3-58.7 dB). CONCLUSIONS These data demonstrate that a significant, very strong correlation was observed between WRinserts and WRMAXUM scores (r = 0.86, P = .001), and a patient's WRinserts score may be used to reasonably predict the word recognition outcomes with MAXUM. LEVEL OF EVIDENCE 4. Laryngoscope, 128:456-460, 2018.
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Affiliation(s)
- R Kent Dyer
- Department of Surgery and on the Board of Directors at the Hough Ear Institute, Oklahoma City, Oklahoma, U.S.A
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Koci V, Seebacher J, Weichbold V, Zorowka P, Wolf-Magele A, Sprinzl G, Stephan K. Improvement of sound source localization abilities in patients bilaterally supplied with active middle ear implants. Acta Otolaryngol 2016; 136:692-8. [PMID: 27268944 DOI: 10.3109/00016489.2016.1155232] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS Patients, who are bilaterally supplied with active middle ear implants, perform slightly better in sound localization tasks than when unilaterally aided or unaided. OBJECTIVES To investigate the impact of bilateral use of active middle ear implants on sound source localization in the horizontal plane in patients with a sloping moderate-to-severe hearing loss. METHODS Ten adults supplied with Med-EL Vibrant Soundbridge systems (VSB) in both ears participated in the study. Four listening conditions were tested: unaided, aided with VSB on left or right ear and on both sides. In each condition the subjects had to judge the direction of broadband noises delivered randomly across a semicircular array of 11 loudspeakers arranged in an anechoic chamber. RESULTS When unaided or bilaterally aided, the subjects localized on average 40% of the stimuli correct; when unilaterally aided (left or right), this rate dropped to 20-30% in either condition. Precision of sound localization was highest when bilaterally aided, i.e. the mean RMS angular error was 10°, and lowest when unilaterally aided, i.e. 15°. This is in line with bilateral hearing aid users, who show similar performance in sound localization tasks.
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Affiliation(s)
- Viktor Koci
- a Department for Hearing, Speech and Voice Disorders , Medical University of Innsbruck , Innsbruck , Austria
| | - Josef Seebacher
- a Department for Hearing, Speech and Voice Disorders , Medical University of Innsbruck , Innsbruck , Austria
| | - Viktor Weichbold
- a Department for Hearing, Speech and Voice Disorders , Medical University of Innsbruck , Innsbruck , Austria
| | - Patrick Zorowka
- a Department for Hearing, Speech and Voice Disorders , Medical University of Innsbruck , Innsbruck , Austria
| | - Astrid Wolf-Magele
- b Department of Otorhinolaryngology, University Clinic St. Pölten , St. Pölten , Austria
| | - Georg Sprinzl
- b Department of Otorhinolaryngology, University Clinic St. Pölten , St. Pölten , Austria
| | - Kurt Stephan
- a Department for Hearing, Speech and Voice Disorders , Medical University of Innsbruck , Innsbruck , Austria
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Hunter JB, Carlson ML, Glasscock ME. The ototronix MAXUM middle ear implant for severe high-frequency sensorineural hearing loss: Preliminary results. Laryngoscope 2016; 126:2124-7. [PMID: 26972428 DOI: 10.1002/lary.25872] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 09/23/2015] [Revised: 11/05/2015] [Accepted: 12/10/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS To report the preliminary results of the Ototronix MAXUM middle ear implant for treatment of severe high-frequency sensorineural hearing loss. STUDY DESIGN Case series with chart review. METHODS Six consecutive ears with severe high-frequency sensorineural hearing loss (≥75 dB HL at 2, 3, and 4 kHz) and poor aided word recognition performance (≤60% single words) underwent implantation of the MAXUM system at a single, private otologic referral center. Primary outcome measures included frequency-specific functional gain and word recognition score improvement compared to optimally fitted hearing aids. RESULTS Six ears, in four adult patients (two female; median age 67.5 years) were included. The median unaided preoperative high-frequency pure-tone average (HFPTA) (2, 3, and 4 kHz) was 80.0 dB (range, 75.0-85.0 dB), and the median best-aided word recognition score was 48.0% (range, 24%-60%). The median HFPTA functional gain with the MAXUM system was 47.2 dB, a 25.0 dB improvement (range, 16.7-33.3 dB) (P = .03) over optimally fit hearing aids, and the median word recognition score with MAXUM was 81.5%, a 42.0% improvement (range, 20%-48%) (P = .03) with the MAXUM middle ear implant over optimally fitted hearing aids. CONCLUSIONS These preliminary data demonstrate that the MAXUM middle ear implant provides superior functional gain and word recognition scores in quiet for patients with severe high-frequency sensorineural hearing loss compared to optimally fitted hearing aids. Future studies with greater patient numbers and patient reported outcome measures are needed to confirm these promising but preliminary results. LEVEL OF EVIDENCE 4 Laryngoscope, 126:2124-2127, 2016.
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Affiliation(s)
- Jacob B Hunter
- Otology Group of Vanderbilt University, Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Matthew L Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
| | - Michael E Glasscock
- Otology Group of Vanderbilt University, Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
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Roh KJ, Lee EJ, Choi BI, Son EJ. A Case of Incus Vibroplasty: Postoperative Changes in Residual Hearing. J Audiol Otol 2015; 19:54-7. [PMID: 26185793 PMCID: PMC4491948 DOI: 10.7874/jao.2015.19.1.54] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 11/01/2014] [Accepted: 11/23/2014] [Indexed: 11/22/2022] Open
Abstract
In patients with mild to severe hearing loss, conventional hearing aids offer limited benefits and several problems with feedback and cosmesis. Middle ear implants are a feasible option for patients with moderate to severe hearing loss who are unable to achieve adequate benefit from or cannot tolerate hearing aids for various reasons. Here we present a case of middle ear implant surgery using Vibrant Soundbridge with incus vibroplasty technique, and describe the hearing changes during postoperative follow-up.
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Affiliation(s)
- Kyung Jin Roh
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Jung Lee
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Byung Il Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Jin Son
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
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Yu JK, Tsang WS, Wong TK, Tong MC. Outcome of vibrant soundbridge middle ear implant in cantonese-speaking mixed hearing loss adults. Clin Exp Otorhinolaryngol 2012; 5 Suppl 1:S82-8. [PMID: 22701155 DOI: 10.3342/ceo.2012.5.S1.S82] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Revised: 01/09/2012] [Accepted: 02/02/2012] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To investigate the aided benefits, speech recognition in quiet and in noise, change in hearing and subjective report of satisfaction on mixed hearing loss adults implanted with Vibrant Soundbridge (VSB) middle ear implant. METHODS Eight Cantonese speaking adult patients with mixed hearing loss were enrolled in a single-subject, repeated measures prospective study design. Audiometric testing, including air and bone conduction and word recognition under sound-field were conducted before surgery. Device activation was arranged 8 weeks after operation. Audiometric testing was taken to evaluate the change in hearing. Patients were asked to wear the device and come back for fine tuning as needed. Outcome measurements were undertaken at 3 and 6 months after device activation. The outcome measures included sound-field thresholds, Cantonese Hearing in Noise Test (CHINT), Abbreviated Profile of Hearing Aid Benefit (APHAB) and International Outcome Inventory for Hearing Aids (IOI-HA). RESULTS The application of the VSB improved the aided thresholds and improved speech intelligibility in quiet and noise without significant changes in hearing thresholds. CONCLUSION VSB is considered as a safe, effective and reliable auditory rehabilitation option for Cantonese speaking adults with mixed hearing loss.
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