1
|
Rasse T, Niederwanger L, Hornung J, Taha L, Arndt S, Offergeld C, Beutner D, Bevis N, Lenarz T, Teschner M, Schimanski E, Georg Sprinzl, Magele A, Skarżyński PH, Plichta Ł, Arnoldner C, Riss D, Loader B, Windisch F, Rubicz N, Zwittag PM. Short-term safety and effectiveness of the mCLIP partial prosthesis. Eur Arch Otorhinolaryngol 2024; 281:2353-2363. [PMID: 38133806 PMCID: PMC11024005 DOI: 10.1007/s00405-023-08359-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE This multicentric, retrospective study aimed to analyze the short-term safety and effectiveness of the mCLIP Partial Prosthesis. METHODS Patients underwent tympanoplasty with implantation of a mCLIP Partial Prosthesis. Follow-up examination included ear microscopy and pure-tone audiometry to determine the post-operative pure tone average of the frequencies 0.5, 1, 2 and 3 kHz (PTA4). The post-operative PTA4 air bone gap (ABG) was used to evaluate the audiological outcome. A post-operative minimum and maximum follow-up period was not defined. Thus, the follow-up times of each study center were different, which resulted in different follow-up times for the audiological analysis and for adverse events (AE). RESULTS 72 (66 adults, 6 children) patients were implanted with the mCLIP Partial Prosthesis. 68 (62 adults, 6 children) patients underwent audiological examination; all 72 patients were examined for adverse events. All patients (N = 68): 72.1% of the patients showed a PTA4 ABG of ≤ 20 dB. Individual post-operative bone conduction (BC) PTA4 thresholds were stable in 67 patients. The mean post-operative follow-up time was 78 ± 46 days. Children (N = 6): 5 out of 6 children showed a PTA4 ABG of ≤ 20 dB. None of the children reported a BC PTA4 deterioration of > 10 dB HL after the implantation. The mean post-operative follow-up time was 101 ± 45 days. Adverse events (all patients, N = 72): 15 (14 adults, 1 child) patients had AEs (27 AEs and 2 Follow-Ups). The mean post-operative follow-up time was 375 days. CONCLUSION Clinical data show satisfactory audiological parameters after implantation of the mCLIP Partial Prosthesis. The prosthesis is safe and effective for implantation in children and adults. TRIAL REGISTRATION NUMBER NCT05565339, 09 September 2022, retrospectively registered.
Collapse
Affiliation(s)
- Thomas Rasse
- Department of Otorhinolaryngology, Klinikum Wels-Grieskirchen, 4600, Wels, Austria
| | - Lisa Niederwanger
- Department of Otorhinolaryngology, Klinikum Wels-Grieskirchen, 4600, Wels, Austria
| | - Joachim Hornung
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, 91054, Erlangen, Germany
| | - Lava Taha
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, 91054, Erlangen, Germany
| | - Susan Arndt
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Medical Center, University of Freiburg, 79106, Freiburg, Germany
| | - Christian Offergeld
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Medical Center, University of Freiburg, 79106, Freiburg, Germany
| | - Dirk Beutner
- Department of Otolaryngology, University of Goettingen, 37075, Göttingen, Germany
| | - Nicholas Bevis
- Department of Otolaryngology, University of Goettingen, 37075, Göttingen, Germany
| | - Thomas Lenarz
- Department of Otolaryngology, Hannover Medical School, 30625, Hannover, Germany
| | - Magnus Teschner
- Department of Otolaryngology, Hannover Medical School, 30625, Hannover, Germany
- Department of Otolaryngology, Head and Neck Surgery, Stiftungsklinikum Proselis, Prosper-Hospital Recklinghausen, Recklinghausen, Germany
| | - Esther Schimanski
- Zentrum Fuer Mittelohrchirurgie (Centre for Middle Ear Surgery), ENT Practice, 44536, Luenen, Germany
| | - Georg Sprinzl
- Department of Otorhinolaryngology, Head and Neck Surgery, University Clinic St. Poelten, 3100, St. Pölten, Austria
| | - Astrid Magele
- Department of Otorhinolaryngology, Head and Neck Surgery, University Clinic St. Poelten, 3100, St. Pölten, Austria
| | - Piotr H Skarżyński
- Clinical Trials Department, Center of Hearing and Speech MEDINCUS, Kayetany, Poland
- Department of Teleaudiology and Screening, World Hearing Center of the Institute of Physiology and Pathology of Hearing, Kajetany, Poland
- Institute of Sensory Organs, Kajetany, Poland
- Faculty of Dental Medicine, Heart Failure and Cardiac Rehabilitation Department, Medical University of Warsaw, Warsaw, Poland
| | - Łukasz Plichta
- World Hearing Center of the Institute of Physiology and Pathology of Hearing, Kajetany, Poland
| | - Christoph Arnoldner
- Department of Otorhinolaryngology, Medical University of Vienna, 1090, Vienna, Austria
| | - Dominik Riss
- Department of Otorhinolaryngology, Medical University of Vienna, 1090, Vienna, Austria
| | - Benjamin Loader
- Department of Otorhinolaryngology, Head and Neck Surgery, 1030 Wiener Gesundheitsverbund, Klinik Landstraße, 1030, Vienna, Austria
| | - Franz Windisch
- Department of Otorhinolaryngology, Head and Neck Surgery, 1030 Wiener Gesundheitsverbund, Klinik Landstraße, 1030, Vienna, Austria
| | - Nina Rubicz
- Department of Otorhinolaryngology, Head and Neck Surgery, Kepler University Hospital GmbH, Krankenhausstrasse 9, 4020, Linz, Austria
- Medical Faculty, Johannes Kepler University Linz, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Paul Martin Zwittag
- Department of Otorhinolaryngology, Head and Neck Surgery, Kepler University Hospital GmbH, Krankenhausstrasse 9, 4020, Linz, Austria.
- Medical Faculty, Johannes Kepler University Linz, Altenbergerstrasse 69, 4040, Linz, Austria.
| |
Collapse
|
2
|
Magele A, Wirthner B, Schoerg P, Sprinzl GM. Effects of Musical Training in Music Therapy Following Cochlear Implantation-A Case Report. Audiol Res 2024; 14:217-226. [PMID: 38525681 PMCID: PMC10961688 DOI: 10.3390/audiolres14020020] [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] [Received: 11/30/2023] [Revised: 01/26/2024] [Accepted: 02/18/2024] [Indexed: 03/26/2024] Open
Abstract
The most prevalent sensory impairment impacting the elderly is age-related hearing loss (HL), which affects around 65% of individuals over the age of 60 years. This bilateral, symmetrical sensorineural impairment profoundly affects auditory perception, speech discrimination, and the overall understanding of auditory signals. Influenced by diverse factors, age-related HL can substantially influence an individual's quality of life and mental health and can lead to depression. Cochlear implantation (CI) stands as a standard intervention, yet despite advancements, music perception challenges persist, which can be addressed with individualized music therapy. This case report describes the journey of an 81-year-old musician through profound sensorineural hearing loss, cochlear implantation, and rehabilitative music therapy. Auditory evaluations, musical exercises, and quality of life assessments highlighted meaningful improvements in music perception, auditory skills, and overall satisfaction post-implantation. Music therapy facilitated emotional, functional, and musical levels of engagement, notably enhancing his ability to perceive melody, rhythm, and different instruments. Moreover, subjective assessments and audiograms indicated marked improvements in auditory differentiation, music enjoyment, and overall hearing thresholds. This comprehensive approach integrating bilateral CIs and music therapy showcased audiological and quality of life enhancements in an elderly individual with profound hearing loss, emphasizing the efficacy of this combined treatment approach.
Collapse
Affiliation(s)
- Astrid Magele
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, Dunant-Platz 1, 3100 St. Poelten, Austria; (B.W.); (P.S.); (G.M.S.)
- Karl Landsteiner Institute of Implantable Hearing Devices, 3100 St. Poelten, Austria
- Department of Medicine, Karl Landsteiner Private University of Health Science Krems, 3500 Krems an der Donau, Austria
| | - Bianca Wirthner
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, Dunant-Platz 1, 3100 St. Poelten, Austria; (B.W.); (P.S.); (G.M.S.)
| | - Philipp Schoerg
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, Dunant-Platz 1, 3100 St. Poelten, Austria; (B.W.); (P.S.); (G.M.S.)
- Karl Landsteiner Institute of Implantable Hearing Devices, 3100 St. Poelten, Austria
| | - Georg M. Sprinzl
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, Dunant-Platz 1, 3100 St. Poelten, Austria; (B.W.); (P.S.); (G.M.S.)
- Karl Landsteiner Institute of Implantable Hearing Devices, 3100 St. Poelten, Austria
- Department of Medicine, Karl Landsteiner Private University of Health Science Krems, 3500 Krems an der Donau, Austria
| |
Collapse
|
3
|
Muck S, Magele A, Wirthner B, Schoerg P, Sprinzl GM. Effects of Auditory Training on Speech Recognition in Children with Single-Sided Deafness and Cochlea Implants Using a Direct Streaming Device: A Pilot Study. J Pers Med 2023; 13:1688. [PMID: 38138915 PMCID: PMC10744358 DOI: 10.3390/jpm13121688] [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] [Received: 10/25/2023] [Revised: 11/24/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
Treating individuals with single-sided deafness (SSD) with a cochlear implant (CI) offers significant benefits for speech perception in complex spatial listening environments. After implantation, training without involvement of the normal-hearing ear is essential. Therefore, the AudioLink streaming device (MED-EL GmbH, Austria) can be used to connect the externally worn audio processor to media devices; thus, the auditory stimuli are directly streamed to the implanted ear. The aim was to test whether children with SSD, aged 5-12 years, accept this training method and whether auditory training, streamed directly via AudioLink using the Tiptoi device (Ravensburger GmbH., Ravensburg, Germany), improves speech recognition. A total of 12 children with SSD and implanted with a CI received Tiptoi training via AudioLink and were asked to practice daily for 10 min over a period of one month. All participants completed the training. The measurements employed to assess improvement included speech audiometry, speech, spatial, and quality of hearing scale for parents (SSQ P), and specially designed tasks crafted for this study. Daily training of 9.93 min was reported. The word recognition score (WRS) at 65 dB and 80 dB in aided condition significantly improved and the WRS streamed via AudioLink was significantly better after training. The speech, spatial, and qualities of hearing scale for parents (SSQ P questionnaire) showed significant improvement in the dimension of quality of hearing and overall gain. The outcomes of the Tiptoi tasks resulted in a significant benefit in both categories of the "recognition of sounds" and "understanding of sentences". The results are very encouraging and do not only show the positive uptake of daily training at home but also how this resulted in a significant improvement in subjective and objective measures for this rather short training period of one month only.
Collapse
Affiliation(s)
- Stefanie Muck
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, 3100 St. Poelten, Austria; (S.M.); (A.M.); (B.W.); (P.S.)
| | - Astrid Magele
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, 3100 St. Poelten, Austria; (S.M.); (A.M.); (B.W.); (P.S.)
- Karl Landsteiner Institute of Implantable Hearing Devices, 3100 St. Poelten, Austria
| | - Bianca Wirthner
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, 3100 St. Poelten, Austria; (S.M.); (A.M.); (B.W.); (P.S.)
| | - Philipp Schoerg
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, 3100 St. Poelten, Austria; (S.M.); (A.M.); (B.W.); (P.S.)
| | - Georg Mathias Sprinzl
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, 3100 St. Poelten, Austria; (S.M.); (A.M.); (B.W.); (P.S.)
- Karl Landsteiner Institute of Implantable Hearing Devices, 3100 St. Poelten, Austria
| |
Collapse
|
4
|
Lassaletta L, Calvino M, Sanchez-Cuadrado I, Skarzynski PH, Cywka KB, Czajka N, Kutyba J, Tavora-Vieira D, Van de Heyning P, Mertens G, Staecker H, Humphrey B, Zernotti M, Zernotti M, Magele A, Ploder M, Zabeu JS. QoL, CIs, QALYs, and Individualized Rehabilitation: The Clinical and Practical Benefits of Regularly Assessing the Quality of Life of Adult Cochlear Implant Recipients. Int J Environ Res Public Health 2023; 20:6906. [PMID: 37887644 PMCID: PMC10605987 DOI: 10.3390/ijerph20206906] [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: 05/03/2023] [Revised: 08/24/2023] [Accepted: 10/01/2023] [Indexed: 10/28/2023]
Abstract
This study aimed to report quality of life (QoL) scores in unilateral cochlear implant (CI) users and to generate guidance for clinicians on using QoL measures to individualize CI counselling and rehabilitation and to increase access to CIs as a mode of rehabilitation. Participants (n = 101) were unilateral CI users with single-sided deafness (SSD; n = 17), asymmetrical hearing loss (AHL; n = 26), or bilateral hearing loss (Uni; n = 58). Generic QoL was assessed via the Health Utilities Index (HUI-3), and disease-specific QoL was assessed via the Speech, Spatial, and Qualities of Hearing scale (SSQ12) and Nijmegen CI Questionnaire (NCIQ) at preimplantation and at 6 and 12 months of CI use. All groups had significantly increased HUI-3 scores at both intervals. The SSD group showed significant benefit on the SSQ12 at visit 3, the AHL group showed significant benefit on the SSQ12 and most NCIQ subdomains at both intervals, and the Uni group showed significant benefit with both tests at both intervals. Unilateral CI recipients demonstrate improved QoL within the first 12 months of device use. Regular assessment with generic and disease-specific questionnaires has the potential to play an important role in personalizing treatment and possibly in increasing access to CI provision.
Collapse
Affiliation(s)
- Luis Lassaletta
- Department of Otorhinolaryngology, Hospital La Paz. IdiPAZ Research Institute, 28046 Madrid, Spain; (M.C.); (I.S.-C.)
- Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, (CIBERER-U761), 28029 Madrid, Spain
| | - Miryam Calvino
- Department of Otorhinolaryngology, Hospital La Paz. IdiPAZ Research Institute, 28046 Madrid, Spain; (M.C.); (I.S.-C.)
- Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, (CIBERER-U761), 28029 Madrid, Spain
| | - Isabel Sanchez-Cuadrado
- Department of Otorhinolaryngology, Hospital La Paz. IdiPAZ Research Institute, 28046 Madrid, Spain; (M.C.); (I.S.-C.)
| | - Piotr Henryk Skarzynski
- Institute of Physiology and Pathology of Hearing, World Hearing Center, 05-830 Kajetany, Poland; (P.H.S.); (K.B.C.); (N.C.); (J.K.)
| | - Katarzyna B. Cywka
- Institute of Physiology and Pathology of Hearing, World Hearing Center, 05-830 Kajetany, Poland; (P.H.S.); (K.B.C.); (N.C.); (J.K.)
| | - Natalia Czajka
- Institute of Physiology and Pathology of Hearing, World Hearing Center, 05-830 Kajetany, Poland; (P.H.S.); (K.B.C.); (N.C.); (J.K.)
| | - Justyna Kutyba
- Institute of Physiology and Pathology of Hearing, World Hearing Center, 05-830 Kajetany, Poland; (P.H.S.); (K.B.C.); (N.C.); (J.K.)
| | | | - Paul Van de Heyning
- Department of Otorhinolaryngology, Antwerp University Hospital, 2650 Antwerp, Belgium; (P.V.d.H.); (G.M.)
| | - Griet Mertens
- Department of Otorhinolaryngology, Antwerp University Hospital, 2650 Antwerp, Belgium; (P.V.d.H.); (G.M.)
| | - Hinrich Staecker
- ENT Department, University of Kansas Medical Centre, Kansas City, KS 66160, USA; (H.S.); (B.H.)
| | - Bryan Humphrey
- ENT Department, University of Kansas Medical Centre, Kansas City, KS 66160, USA; (H.S.); (B.H.)
| | - Mario Zernotti
- Department of Otorhinolaryngology, Sanatorio Allende de Córdoba, Córdoba 5000, Argentina; (M.Z.); (M.Z.)
| | - Maximo Zernotti
- Department of Otorhinolaryngology, Sanatorio Allende de Córdoba, Córdoba 5000, Argentina; (M.Z.); (M.Z.)
| | - Astrid Magele
- ENT Department, Universitätsklinikum St. Pölten, 3100 St. Pölten, Austria; (A.M.)
| | - Marlene Ploder
- ENT Department, Universitätsklinikum St. Pölten, 3100 St. Pölten, Austria; (A.M.)
| | - Julia Speranza Zabeu
- Hospital de Reabilitacão de Anomalias Craniofaciais da Universidade de Sao Paulo, Campus Bauru, Bauru 17012-230, Brazil;
| |
Collapse
|
5
|
Sprinzl G, Toner J, Koitschev A, Berger N, Keintzel T, Rasse T, Baumgartner WD, Honeder C, Magele A, Plontke S, Götze G, Schmutzhard J, Zelger P, Corkill S, Lenarz T, Salcher R. Multicentric study on surgical information and early safety and performance results with the Bonebridge BCI 602: an active transcutaneous bone conduction hearing implant. Eur Arch Otorhinolaryngol 2023; 280:1565-1579. [PMID: 36625869 PMCID: PMC9988757 DOI: 10.1007/s00405-022-07792-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/10/2022] [Indexed: 01/11/2023]
Abstract
AIM This European multicentric study aimed to prove safety and performance of the Bonebridge BCI 602 in children and adults suffering from either conductive hearing loss (CHL), mixed hearing loss (MHL), or single-sided sensorineural deafness (SSD). METHODS 33 patients (13 adults and 10 children with either CHL or MHL and 10 patients with SSD) in three study groups were included. Patients were their own controls (single-subject repeated measures), comparing the unaided or pre-operative to the 3-month post-operative outcomes. Performance was evaluated by sound field thresholds (SF), word recognition scores (WRS) and/or speech reception thresholds in quiet (SRT) and in noise (SNR). Safety was demonstrated with a device-specific surgical questionnaire, adverse event reporting and stable pure-tone measurements. RESULTS The Bonebridge BCI 602 significantly improved SF thresholds (+ 25.5 dB CHL/MHL/SSD), speech intelligibility in WRS (+ 68.0% CHL/MHL) and SRT in quiet (- 16.5 dB C/MHL) and in noise (- 3.51 dB SNR SSD). Air conduction (AC) and bone conduction (BC) thresholds remained stable over time. All adverse events were resolved, with none unanticipated. Mean audio processor wearing times in hours [h] per day for the CHL/MHL group were ~ 13 h for adults, ~ 11 h for paediatrics and ~ 6 h for the SSD group. The average surgical length was 57 min for the CHL/MHL group and 42 min for the SSD group. The versatility of the BCI 602 (reduced drilling depth and ability to bend the transition for optimal placement) allows for treatment of normal, pre-operated and malformed anatomies. All audiological endpoints were reached. CONCLUSIONS The Bonebridge BCI 602 significantly improved hearing thresholds and speech understanding. Since implant placement follows the patient's anatomy instead of the shape of the device and the duration of surgery is shorter than with its predecessor, implantation is easier with the BCI 602. Performance and safety were proven for adults and children as well as for the CHL/MHL and SSD indications 3 months post-operatively.
Collapse
Affiliation(s)
- Georg Sprinzl
- Hals-Nasen-Ohren-Abteilung, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften und Karl-Landsteiner Institut für Implantierbare Hörsysteme, Universitätsklinikum St. Pölten, Dunant-Platz 1, 3100 St. Pölten, Austria
| | - Joseph Toner
- Regional Auditory Implant Centre, Beech Hall Centre, Belfast, Northern Ireland, UK
| | - Assen Koitschev
- Klinik für HNO-Krankheiten, Plastische Operationen, Klinikum Stuttgart, Olgahospital, Stuttgart, Germany
| | - Nadine Berger
- Klinik für HNO-Krankheiten, Plastische Operationen, Klinikum Stuttgart, Olgahospital, Stuttgart, Germany
| | - Thomas Keintzel
- Abteilung für Hals-, Nasen-, Ohrenkrankheiten, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Thomas Rasse
- Abteilung für Hals-, Nasen-, Ohrenkrankheiten, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Wolf-Dieter Baumgartner
- Allgemeines Krankenhaus der Stadt Wien, Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Vienna, Austria
| | - Clemens Honeder
- Allgemeines Krankenhaus der Stadt Wien, Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Vienna, Austria
| | - Astrid Magele
- Hals-Nasen-Ohren-Abteilung, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften und Karl-Landsteiner Institut für Implantierbare Hörsysteme, Universitätsklinikum St. Pölten, Dunant-Platz 1, 3100 St. Pölten, Austria
| | - Stefan Plontke
- Department of Otorhinolaryngology, Head and Neck Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Gerrit Götze
- Department of Otorhinolaryngology, Head and Neck Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Joachim Schmutzhard
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde Innsbruck, Medizinische Universität Innsbruck, Innsbruck, Austria
| | - Philipp Zelger
- Universitätsklinik für Hör-, Stimm- und Sprachstörungen, Medizinische Universität Innsbruck, Innsbruck, Austria
| | - Stephanie Corkill
- Regional Auditory Implant Centre, Beech Hall Centre, Belfast, Northern Ireland, UK
| | - Thomas Lenarz
- Medizinische Hochschule Hannover, Klinik und Poliklinik für HNO-Heilkunde, Hannover, Germany
| | - Rolf Salcher
- Medizinische Hochschule Hannover, Klinik und Poliklinik für HNO-Heilkunde, Hannover, Germany
| |
Collapse
|
6
|
Sprinzl GM, Magele A, Schoerg P, Hagen R, Rak K, Kurz A, Van de Heyning P, Calvino M, Lassaletta L, Gavilán J. A Novel Representation of Audiological and Subjective Findings for Acoustical, Bone Conduction and Direct Drive Hearing Solutions. J Pers Med 2023; 13:jpm13030462. [PMID: 36983644 PMCID: PMC10058515 DOI: 10.3390/jpm13030462] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/15/2022] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Background: The benefit of hearing rehabilitation is often measured using audiological tests or subjective questionnaires/interviews. It is important to consider both aspects in order to evaluate the overall benefits. Currently, there is no standardized method for reporting combined audiological and patient reported subjective outcome measures in clinical practice. Therefore, this study focuses on showing the patient’s audiological, as well as subjective outcomes in one graph using data from an existing study. Method: The present paper illustrated a graph presenting data on four quadrants with audiological and subjective findings. These quadrants represented speech comprehension in quiet (unaided vs. aided) as WRS% at 65 dB SPL, speech recognition in noise (unaided vs. aided) as SRT dB SNR, sound field threshold (unaided vs. aided) as PTA4 in dB HL, wearing time and patient satisfaction questionnaire results. Results: As an example, the HEARRING graph in this paper represented audiological and subjective datasets on a single patient level or a cohort of patients for an active bone conduction hearing implant solution. The graph offered the option to follow the user’s performance in time. Conclusion: The HEARRING graph allowed representation of a combination of audiological measures with patient reported outcomes in one single graph, indicating the overall benefit of the intervention. In addition, the correlation and consistency between some results (e.g., aided threshold and aided WRS) can be better visualized. Those users who lacked performance benefits on one or more parameters and called for further insight could be visually identified.
Collapse
Affiliation(s)
- Georg Mathias Sprinzl
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, Dunant-Platz 1, 3100 St. Pölten, Austria
- Karl Landsteiner Institute of Implantable Hearing Devices, 3100 St. Pölten, Austria
- Correspondence: ; Tel.: +43-2742-9004-11500
| | - Astrid Magele
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, Dunant-Platz 1, 3100 St. Pölten, Austria
- Karl Landsteiner Institute of Implantable Hearing Devices, 3100 St. Pölten, Austria
| | - Philipp Schoerg
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, Dunant-Platz 1, 3100 St. Pölten, Austria
- Karl Landsteiner Institute of Implantable Hearing Devices, 3100 St. Pölten, Austria
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - Anja Kurz
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - Paul Van de Heyning
- ENT Department, Antwerp University Hospital, Wilrijkstraat 10, 2650 Antwerp, Belgium
| | - Miryam Calvino
- Department of Otolaryngology, La Paz University Hospital, 28046 Madrid, Spain
| | - Luis Lassaletta
- Department of Otolaryngology, La Paz University Hospital, 28046 Madrid, Spain
| | - Javier Gavilán
- Department of Otolaryngology, La Paz University Hospital, 28046 Madrid, Spain
| |
Collapse
|
7
|
Sprinzl GM, Magele A. Personalized Medicine in Otolaryngology: Special Topic Otology. J Pers Med 2022; 12:jpm12111820. [PMID: 36579531 PMCID: PMC9697707 DOI: 10.3390/jpm12111820] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Globally, more than 1.5 billion people experience some degree of hearing loss [...].
Collapse
Affiliation(s)
- Georg Mathias Sprinzl
- University Clinic St. Poelten, Department of Otorhinolaryngology, Head & Neck Surgery, Dunant-Platz 1, 3100 St. Pölten, Austria
- Karl Landsteiner Institute of Implantable Hearing Devices, Henri Dunant Platz 1, 3100 St. Pölten, Austria
- Correspondence: ; Tel.: +43-2742-9004-11500
| | - Astrid Magele
- University Clinic St. Poelten, Department of Otorhinolaryngology, Head & Neck Surgery, Dunant-Platz 1, 3100 St. Pölten, Austria
- Karl Landsteiner Institute of Implantable Hearing Devices, Henri Dunant Platz 1, 3100 St. Pölten, Austria
| |
Collapse
|
8
|
Sprinzl GM, Schörg P, Edlinger S, Ploder M, Magele A. Clinical feasibility of a novel test setup for objective measurements using the VIBRANT SOUNDBRIDGE. Laryngoscope Investig Otolaryngol 2022; 7:1113-1119. [PMID: 36000035 PMCID: PMC9392414 DOI: 10.1002/lio2.839] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Received: 02/24/2022] [Accepted: 03/23/2022] [Indexed: 12/04/2022] Open
Abstract
Objectives The VIBRANT SOUNDBRIDGE is a widely used active middle ear implant to treat hearing loss. The floating mass transducer is surgically coupled to the ossicles, the round or oval window. A reliable method to monitor the coupling efficiency intraoperatively is highly desired. Research groups have developed several methods, but limitations remain. This study aims to evaluate the clinical feasibility of a new research setup for auditory brainstem response measurement to evaluate the coupling efficiency. Method In 14 subjects, the new tool was used to record VSB‐evoked ABR thresholds during surgery. The intra‐op ABR thresholds were compared to pre‐op bone conduction (BC) thresholds and post‐op vibrogram thresholds to evaluate the feasibility of the method as a tool to monitor coupling efficiency. Results The mean pre‐op BC threshold average at 1, 2, and 4 kHz (PTA3) was 47 dB HL, the mean intra‐op ABR threshold was 54 dB nHL, and the mean post‐op vibrogram PTA3 was 60 dB HLeq. ABR was measurable in all subjects using the new tool. Correlation between pre‐op BC thresholds and intra‐op ABR thresholds was statistically significant; however, one outlier was present. Conclusion Intra‐op hearing threshold detection through ABR and direct stimulation of the VSB implant was reliable using this new tool. Despite some individual variability, first results correlate well with pre‐op BC and post‐op vibrogram thresholds.
Collapse
Affiliation(s)
- Georg Mathias Sprinzl
- Department of Otorhinolaryngology, Head & Neck Surgery University Clinic St. Poelten St. Poelten Austria
- Karl Landsteiner University of Health Sciences Krems Austria
| | - Philipp Schörg
- Department of Otorhinolaryngology, Head & Neck Surgery University Clinic St. Poelten St. Poelten Austria
- Karl Landsteiner University of Health Sciences Krems Austria
| | - Stefan Edlinger
- Department of Otorhinolaryngology, Head & Neck Surgery University Clinic St. Poelten St. Poelten Austria
- Karl Landsteiner University of Health Sciences Krems Austria
| | - Marlene Ploder
- Department of Otorhinolaryngology, Head & Neck Surgery University Clinic St. Poelten St. Poelten Austria
| | - Astrid Magele
- Department of Otorhinolaryngology, Head & Neck Surgery University Clinic St. Poelten St. Poelten Austria
- Karl Landsteiner University of Health Sciences Krems Austria
| |
Collapse
|
9
|
Van de Heyning P, Roland P, Lassaletta L, Agrawal S, Atlas M, Baumgartner WD, Brown K, Caversaccio M, Dazert S, Gstoettner W, Hagen R, Hagr A, Jablonski GE, Kameswaran M, Kuzovkov V, Leinung M, Li Y, Loth A, Magele A, Mlynski R, Mueller J, Parnes L, Radeloff A, Raine C, Rajan G, Schmutzhard J, Skarzynski H, Skarzynski PH, Sprinzl G, Staecker H, Stöver T, Tavora-Viera D, Topsakal V, Usami SI, Van Rompaey V, Weiss NM, Wimmer W, Zernotti M, Gavilan J. Suitable Electrode Choice for Robotic-Assisted Cochlear Implant Surgery: A Systematic Literature Review of Manual Electrode Insertion Adverse Events. Front Surg 2022; 9:823219. [PMID: 35402479 PMCID: PMC8987358 DOI: 10.3389/fsurg.2022.823219] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Received: 11/26/2021] [Accepted: 02/09/2022] [Indexed: 12/05/2022] Open
Abstract
Background and Objective The cochlear implant (CI) electrode insertion process is a key step in CI surgery. One of the aims of advances in robotic-assisted CI surgery (RACIS) is to realize better cochlear structure preservation and to precisely control insertion. The aim of this literature review is to gain insight into electrode selection for RACIS by acquiring a thorough knowledge of electrode insertion and related complications from classic CI surgery involving a manual electrode insertion process. Methods A systematic electronic search of the literature was carried out using PubMed, Scopus, Cochrane, and Web of Science to find relevant literature on electrode tip fold over (ETFO), electrode scalar deviation (ESD), and electrode migration (EM) from both pre-shaped and straight electrode types. Results A total of 82 studies that include 8,603 ears implanted with a CI, i.e., pre-shaped (4,869) and straight electrodes (3,734), were evaluated. The rate of ETFO (25 studies, 2,335 ears), ESD (39 studies, 3,073 ears), and EM (18 studies, 3,195 ears) was determined. An incidence rate (±95% CI) of 5.38% (4.4–6.6%) of ETFO, 28.6% (26.6–30.6%) of ESD, and 0.53% (0.2–1.1%) of EM is associated with pre-shaped electrodes, whereas with straight electrodes it was 0.51% (0.1–1.3%), 11% (9.2–13.0%), and 3.2% (2.5–3.95%), respectively. The differences between the pre-shaped and straight electrode types are highly significant (p < 0.001). Laboratory experiments show evidence that robotic insertions of electrodes are less traumatic than manual insertions. The influence of round window (RW) vs. cochleostomy (Coch) was not assessed. Conclusion Considering the current electrode designs available and the reported incidence of insertion complications, the use of straight electrodes in RACIS and conventional CI surgery (and manual insertion) appears to be less traumatic to intracochlear structures compared with pre-shaped electrodes. However, EM of straight electrodes should be anticipated. RACIS has the potential to reduce these complications.
Collapse
Affiliation(s)
- Paul Van de Heyning
- Department of Otorhinolaryngology Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
- Department of Translational Neurosciences, University of Antwerp, Antwerp, Belgium
- *Correspondence: Paul Van de Heyning
| | - Peter Roland
- Department of Otolaryngology, Head & Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Luis Lassaletta
- Hospital Universitario La Paz, Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Sumit Agrawal
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada
| | - Marcus Atlas
- Ear Sciences Institute Australia, Lions Hearing Clinic, Perth, WA, Australia
| | | | - Kevin Brown
- UNC Ear and Hearing Center at Chapel Hill School of Medicine, Chapel Hill, NC, United States
| | - Marco Caversaccio
- Department for ENT, Head and Neck Surgery, Bern University Hospital, Bern, Switzerland
| | - Stefan Dazert
- Department of Otorhinolaryngology-Head and Neck Surgery, Ruhr-University Bochum, St. Elisabeth University Hospital Bochum, Bochum, Germany
| | | | - Rudolf Hagen
- Würzburg ENT University Hospital, Würzburg, Germany
| | - Abdulrahman Hagr
- King Abdullah Ear Specialist Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Greg Eigner Jablonski
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Otorhinolaryngology & Head and Neck Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | | | - Vladislav Kuzovkov
- St. Petersburg ENT and Speech Research Institute, St. Petersburg, Russia
| | - Martin Leinung
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Yongxin Li
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Andreas Loth
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Astrid Magele
- Ear, Nose and Throat Department, University Clinic St. Poelten, Karl Landsteiner Private University, St. Poelten, Austria
| | - Robert Mlynski
- Department of Otorhinolaryngology, Head and Neck Surgery, “Otto Körner” Rostock University Medical Center, Rostock, Germany
| | - Joachim Mueller
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Ludwig-Maximilians-Universitat Munchen, Munchen, Germany
| | - Lorne Parnes
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada
| | - Andreas Radeloff
- Division of Oto-Rhino-Laryngology, Evangelisches Krankenhaus Oldenburg, Research Center of Neurosensory Sciences, University Oldenburg, Oldenburg, Germany
| | - Chris Raine
- Bradford Royal Infirmary Yorkshire Auditory Implant Center, Bradford, United Kingdom
| | - Gunesh Rajan
- Department of Otolaryngology, Head and Neck Surgery, Luzerner Kantonsspital, Luzern, Medical Sciences Department of Health Sciences and Medicine. University of Lucerne, Luzern, Switzerland. Otolaryngology, Head & Neck Surgery, Medical School University of Western Australia, Perth, WA, Australia
| | - Joachim Schmutzhard
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - Henryk Skarzynski
- Department of Teleaudiology and Screening, World Hearing Center of the Institute of Physiology and Pathology of Hearing, Kajetany, Poland
| | - Piotr H. Skarzynski
- Department of Teleaudiology and Screening, World Hearing Center of the Institute of Physiology and Pathology of Hearing, Kajetany, Poland
| | - Georg Sprinzl
- Ear, Nose and Throat Department, University Clinic St. Poelten, Karl Landsteiner Private University, St. Poelten, Austria
| | - Hinrich Staecker
- Kansas University Center for Hearing and Balance Disorders, Kansas City, KS, United States
| | - Timo Stöver
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | | | - Vedat Topsakal
- Department of ENT HNS, University Hospital Brussels, Brussels, Belgium
| | - Shin-Ichi Usami
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Nagano, Japan
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
- Department of Translational Neurosciences, University of Antwerp, Antwerp, Belgium
| | - Nora M. Weiss
- Department of Otorhinolaryngology-Head and Neck Surgery, Ruhr-University Bochum, St. Elisabeth University Hospital Bochum, Bochum, Germany
| | - Wilhelm Wimmer
- Department for ENT, Head and Neck Surgery, Bern University Hospital, Bern, Switzerland
| | - Mario Zernotti
- Catholic University of Córdoba and National University of Córdoba, Córdoba, Argentina
| | - Javier Gavilan
- Hospital Universitario La Paz, Institute for Health Research (IdiPAZ), Madrid, Spain
| |
Collapse
|
10
|
Sprinzl G, Lenarz T, Hagen R, Baumgartner WD, Keintzel T, Keck T, Riechelmann H, Magele A, Salcher R, Maier H, Mlynski R, Radeloff A, Rak K, Riss D, Liepins R, Hamzavi S, Rasse T, Potzinger P, Schmutzhard J, Zorowka P, Mittmann P, Böheim K, Todt I. Long-Term, Multicenter Results With the First Transcutaneous Bone Conduction Implant. Otol Neurotol 2021; 42:858-866. [PMID: 33989254 DOI: 10.1097/mao.0000000000003159] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Investigation of long-term safety and performance of an active, transcutaneous bone conduction implant in adults and children up to 36 months post-implantation. STUDY DESIGN Prospective, single-subject repeated-measures design. SETTING Otolaryngology departments of eight German and Austrian hospitals.∗†‡§||¶#∗∗†† Affiliations listed above that did not participate in the study.‡‡§§||||¶¶. PATIENTS Fifty seven German-speaking patients (49 adults and eight children) suffering from conductive or mixed hearing loss, with an upper bone conduction threshold limit of 45 dB HL at frequencies between 500 and 3000 Hz. INTERVENTION Implantation of the Bonebridge transcutaneous bone conduction hearing implant (tBCI). MAIN OUTCOME MEASURES Patients' audiometric pure tone averages (PTA4) (0.5, 1, 2, 4 kHz) thresholds (air conduction, bone conduction, and sound field) and speech perception (word recognition scores [WRS] and speech reception thresholds [SRT50%]) were tested preoperatively and up to 36 months postoperatively. Patients were also monitored for adverse events and administered quality-of-life questionnaires. RESULTS Speech perception (WRS: pre-op: 17.60%, initial activation [IA]: 74.23%, 3M: 83.65%, 12M: 83.46%, 24M: 84.23%, 36M: 84.42%; SRT50%: pre-op: 65.56 dB SPL, IA: 47.67 dB SPL, 3M: 42.61 dB SPL, 12M: 41.11 dB SPL, 24M: 41.74 dB SPL, 36M: 42.43 dB SPL) and sound field thresholds (pre-op: 57.66 dB HL, IA: 33.82 dB HL, 3M: 29.86 dB HL, 12M: 28.40 dB HL, 24M: 28.22 dB HL, 36M: 28.52 dB HL) improved significantly at all aided postoperative visits. Air and bone conduction thresholds showed no significant changes, confirming preservation of patients' residual unaided hearing. All adverse events were resolved by the end of the study. CONCLUSIONS Safety and performance of the tBCI was demonstrated in children and adults 36 months postoperatively.
Collapse
Affiliation(s)
- Georg Sprinzl
- Ear, Nose and Throat Department, University Clinic St. Poelten, Karl Landsteiner Private University, St. Poelten
- Ear, Nose and Throat Department, University Clinic Innsbruck, Innsbruck
| | - Thomas Lenarz
- Department of Otorhinolaryngology, Hannover Medical School, Hannover
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University of Würzburg, Würzburg
| | | | - Thomas Keintzel
- Ear, Nose and Throat Department, Klinikum Wels-Grieskirchen, Wels
| | - Tilmann Keck
- Ear, Nose and Throat Department, Elisabethinen Hospital, Graz
| | | | - Astrid Magele
- Ear, Nose and Throat Department, University Clinic St. Poelten, Karl Landsteiner Private University, St. Poelten
- Ear, Nose and Throat Department, University Clinic Innsbruck, Innsbruck
| | - Rolf Salcher
- Department of Otorhinolaryngology, Hannover Medical School, Hannover
| | - Hannes Maier
- Department of Otorhinolaryngology, Hannover Medical School, Hannover
| | - Robert Mlynski
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University of Würzburg, Würzburg
- Department of Otorhinolaryngology, University Medical Center Rostock, Rostock, Germany
| | - Andreas Radeloff
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University of Würzburg, Würzburg
- Ear, Nose and Throat Department, University Clinic Oldenburg, Oldenburg
| | - Kristen Rak
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University of Würzburg, Würzburg
| | - Dominik Riss
- Ear, Nose and Throat Department, University Clinic Vienna
| | | | - Sasan Hamzavi
- Ear, Nose and Throat Department, University Clinic Vienna
- Institute for Head and Neck Diseases, Lutheran Hospital Vienna, Vienna, Austria
| | - Thomas Rasse
- Ear, Nose and Throat Department, Klinikum Wels-Grieskirchen, Wels
| | - Peter Potzinger
- Ear, Nose and Throat Department, Elisabethinen Hospital, Graz
| | | | - Patrick Zorowka
- Ear, Nose and Throat Department, University Clinic Innsbruck, Innsbruck
- Department for Hearing, Speech and Voice Disorders, University Clinic Innsbruck, Innsbruck
| | - Philipp Mittmann
- Department of Otolaryngology at UKB, Hospital of the University of Berlin, Charité Medical School, Berlin
| | - Klaus Böheim
- Ear, Nose and Throat Department, University Clinic St. Poelten, Karl Landsteiner Private University, St. Poelten
| | - Ingo Todt
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Bielefeld, Bielefeld, Germany
| |
Collapse
|
11
|
Edlinger SH, Hasenzagl M, Schoerg P, Muck S, Magele A, Sprinzl GM. Long-Term Safety and Quality of Life after Vibroplasty in Sensorineural Hearing Loss: Short/Long Incus Process Coupler. Audiol Neurootol 2021; 27:175-183. [PMID: 34044387 DOI: 10.1159/000516144] [Citation(s) in RCA: 5] [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: 01/26/2021] [Accepted: 03/17/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The study shows the long-term effectiveness, safety, and quality of life after Vibrant Soundbridge (VSB) implantation in sensorineural hearing loss (SNHL) using the short process coupler (SP) or the long process coupler (LP). METHODS This retrospective study evaluated 77 VSB cases. Follow-up (F/U) time-dependent objective measurements (audiological outcomes), subjective data collection (quality-of-life questionnaire), and safety measures are presented. RESULTS Sixty-two ears were included in the analysis with up to 116 months of postsurgical F/U data (mean 32.15 ± 37.97 months LP and SP coupler). Fifty-three ears (13 bilateral cases) received the LP coupler and 9 subjects the SP coupler. The post-operative bone conduction thresholds remained stable and, in both groups, <10 dB. The benefit in word recognition scores measured at 65 dB SPL and 80 dB SPL showed no significant difference between the couplers (p = 0.559 and p = 0.088, respectively). The functional gain was not significantly different (p > 0.05) with a mean of 20.91 ± 9.77 and 17.19 ± 5.75 for LP and SP coupler, respectively. The utility score deciphered from the Assessment of Quality-of-life Questionnaire-8 dimensions revealed a mean score of 0.75 ± 0.16 which is not significantly different to the age- and sex-matched healthy control group with 0.81 ± 0.02 (p = 0.3547). CONCLUSION The Incus Vibroplasty utilizing both couplers is a safe and effective method to treat mild-to-severe SNHL. Both fixation methods of the floating mass transducer exhibit good clinical and audiological outcomes with high patient quality of life. The SP coupling method can be a good alternative when the long process is anatomically inaccessible, or the approach is limited due to anatomical reasons.
Collapse
Affiliation(s)
- Stefan Herwig Edlinger
- Department of Otorhinolaryngology, University Hospital St. Pölten, St. Poelten, Austria.,Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Martin Hasenzagl
- Department of Otorhinolaryngology, University Hospital St. Pölten, St. Poelten, Austria
| | - Philipp Schoerg
- Department of Otorhinolaryngology, University Hospital St. Pölten, St. Poelten, Austria.,Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Stefanie Muck
- Department of Otorhinolaryngology, University Hospital St. Pölten, St. Poelten, Austria
| | - Astrid Magele
- Department of Otorhinolaryngology, University Hospital St. Pölten, St. Poelten, Austria.,Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Georg Mathias Sprinzl
- Department of Otorhinolaryngology, University Hospital St. Pölten, St. Poelten, Austria.,Karl Landsteiner University of Health Sciences, Krems, Austria
| |
Collapse
|
12
|
Sprinzl GM, Schoerg P, Muck S, Jesenko M, Speiser S, Ploder M, Edlinger SH, Magele A. Long-Term Stability and Safety of the Soundbridge Coupled to the Round Window. Laryngoscope 2020; 131:E1434-E1442. [PMID: 33210744 PMCID: PMC8246711 DOI: 10.1002/lary.29269] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 09/01/2020] [Revised: 10/30/2020] [Accepted: 11/03/2020] [Indexed: 11/13/2022]
Abstract
Objective The objective of the study was to demonstrate the long‐term outcomes of patients implanted with the active middle ear implant (AMEI) Vibrant Soundbridge (VSB) through coupling the floating mass transducer (FMT) to the round window (RW). Methods This retrospective study evaluated the short‐ and long‐term clinical performance (audiological outcomes) and safety (revisions/explantations) of the VSB coupled to the RW between 2013 and 2019 at the St. Pölten University Hospital, Austria. For the outcome analysis, the sample was divided into a short‐term examination group followed up for less than 12 months (<12 months) and a long‐term examination group followed up for more than 12 months (>12 months). Cumulative survival outcomes were separately analyzed for subjects with and without cholesteatoma. Results 46 patients with an average long‐term follow‐up period of 31.43 months (13–75 months) were investigated. Complications requiring revision surgery were reported in total in seven patients with cholesteatoma (15.2%) and none in subjects without cholesteatoma (0%). Residual hearing was not affected by VSB surgery. Word understanding on the Freiburger monosyllabic speech test improved significantly at 65 dB (P < .0001) and 80 dB (P < .0001), and these outcomes were stable for long‐term follow up. Conclusion The VSB coupled to the RW is a safe implantation method for patients with conductive or mixed hearing loss. Hearing improvement was stable for the long‐term follow‐up up to 74 months. The revision rates are directly related to the underlying pathology of cholesteatoma (with radical cavity); thus, this special cohort requires additional counseling on potential complications. Level of Evidence 4 (Case‐series) Laryngoscope, 131:E1434–E1442, 2021
Collapse
Affiliation(s)
- Georg Mathias Sprinzl
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, St. Poelten, Austria.,Karl Landsteiner Institute of Implantable Hearing Devices, St. Poelten, Austria
| | - Philipp Schoerg
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, St. Poelten, Austria.,Karl Landsteiner Institute of Implantable Hearing Devices, St. Poelten, Austria
| | - Stefanie Muck
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, St. Poelten, Austria
| | - Max Jesenko
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, St. Poelten, Austria
| | - Sophie Speiser
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, St. Poelten, Austria
| | - Marlene Ploder
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, St. Poelten, Austria.,Karl Landsteiner Institute of Implantable Hearing Devices, St. Poelten, Austria
| | - Stefan Herwig Edlinger
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, St. Poelten, Austria.,Karl Landsteiner Institute of Implantable Hearing Devices, St. Poelten, Austria
| | - Astrid Magele
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, St. Poelten, Austria.,Karl Landsteiner Institute of Implantable Hearing Devices, St. Poelten, Austria
| |
Collapse
|
13
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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).
Collapse
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:
| |
Collapse
|
14
|
Maier H, Baumann U, Baumgartner WD, Beutner D, Caversaccio MD, Keintzel T, Kompis M, Lenarz T, Magele A, Mewes T, Müller A, Rader T, Rahne T, Schraven SP, Schwab B, Sprinzl GM, Strauchmann B, Todt I, Wesarg T, Wollenberg B, Plontke SK. Minimal Reporting Standards for Active Middle Ear Hearing Implants. Audiol Neurootol 2018; 23:105-115. [PMID: 30196279 DOI: 10.1159/000490878] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 11/01/2017] [Accepted: 06/13/2018] [Indexed: 11/19/2022] Open
Abstract
There is currently no standardized method for reporting audiological, surgical and subjective outcome measures in clinical trials with active middle ear implants (AMEIs). It is often difficult to compare studies due to data incompatibility and to perform meta-analyses across different centres is almost impossible. A committee of ENT and audiological experts from Germany, Austria and Switzerland decided to address this issue by developing new minimal standards for reporting the outcomes of AMEI clinical trials. The consensus presented here aims to provide a recommendation to enable better inter-study comparability.
Collapse
Affiliation(s)
- Hannes Maier
- Department of Otorhinolaryngology, Hannover Medical School, Hannover, Germany
| | - Uwe Baumann
- University Hospital Frankfurt, ENT/Audiological Acoustics, Frankfurt, Germany
| | | | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Marco D Caversaccio
- University Hospital, Inselspital Department of ORL, Head and Neck Surgery, Bern, Switzerland
| | - Thomas Keintzel
- Department of Otorhinolaryngology, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Martin Kompis
- University Hospital, Inselspital Department of ORL, Head and Neck Surgery, Bern, Switzerland
| | - Thomas Lenarz
- Department of Otorhinolaryngology, Hannover Medical School, Hannover, Germany
| | | | - Torsten Mewes
- Helios Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany
| | - Alexander Müller
- Vivantes Hearing Center, ORL Department Friedrichshain Clinic, Berlin, Germany
| | - Tobias Rader
- Department of Otolaryngology and Head and Neck Surgery, Audiological Acoustics, University of Mainz, Mainz, Germany
| | - Torsten Rahne
- Department of Otolaryngology and Head and Neck Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Sebastian P Schraven
- Department of Otorhinolaryngology, Head and Neck Surgery "Otto Koerner", University Medical Center Rostock, Rostock, Germany
| | | | | | - Bernd Strauchmann
- Department of Otorhinolaryngology, UniversityHospital Zürich, Head and Neck Surgery, Zürich, Switzerland
| | - Ingo Todt
- Department of Otolaryngology, Klinikum Bielefeld, Head and Neck Surgery, Bielefeld, Germany
| | - Thomas Wesarg
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Freiburg Medical Center, Freiburg, Germany
| | - Barbara Wollenberg
- Clinic for Otorhinolaryngology, Head and Neck Surgery, University Clinic Schleswig Holstein, Campus Lübeck, Lübeck, Germany
| | - Stefan K Plontke
- Department of Otolaryngology and Head and Neck Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| |
Collapse
|