scholarly journals Identification and Evaluation of Cochlear Implant Candidates with Asymmetrical Hearing Loss

2015 ◽  
Vol 20 (Suppl. 1) ◽  
pp. 87-89 ◽  
Author(s):  
Christophe Vincent ◽  
Susan Arndt ◽  
Jill B. Firszt ◽  
Bernard Fraysse ◽  
Pádraig T. Kitterick ◽  
...  

Objective: Recommendation for cochlear implant (CI) treatment for individuals with severe to profound single-sided deafness (SSD) and asymmetrical hearing loss (AHL) is on the rise. This raises the need for greater consistency in the definition of CI candidacy for these cases and in the assessment methods of patient-related benefits to permit effective comparison and interpretation of the outcomes with both conventional and implantable options across studies. Method: During a dedicated seminar on implant treatment in AHL patients, the panellists of the closing round table reviewed the clinical experience presented with the aim to define clear audiometric characteristics for both AHL and SSD cases, as well as a common data set enabling consistent evaluation of hearing benefits in this population. Conclusions: The panellists agreed on a clear differentiation between AHL and SSD CI candidates, defining average pure-tone thresholds up to 4 kHz for better and poorer ears. Agreement was reached on a minimum set of assessment procedures, and included the necessity of trials with conventional CROS/BICROS hearing aids and bone conduction devices before considering CI treatment. Objective assessment of sound localisation abilities was identified as the most relevant criterion to quantify performance before and after treatment. In parallel, subjective assessment of overall hearing ability was recommended via the Speech, Spatial and Qualities of hearing questionnaire. Longitudinal follow-up of these parameters and the hours of daily use were considered essential to reflect the potential treatment benefits for this population. The consistency in the data collection and its report will further support health authorities in their decision on acceptable gains from available hearing loss treatment options.

2017 ◽  
Vol 96 (7) ◽  
pp. E28-E33 ◽  
Author(s):  
Timothy Mclean ◽  
Irumee Pai ◽  
Andrew Philipatos ◽  
Michael Gordon

We prospectively evaluated the surgical, audiologic, and quality-of-life outcomes in 5 patients—2 men and 3 women, aged 22 to 64 years (mean: 41.8)—who were implanted with the Sophono Alpha 2 MPO Processor. The indications for implantation of this bone-conduction device included recurrent ear canal infections with hearing aids (n = 3), single-sided deafness (n = 1), and patient preference in view of difficulty using a conventional hearing aid (n = 1). In addition to the patient with single-sided deafness, 3 patients had a bilateral mixed hearing loss and 1 had a bilateral conductive hearing loss. Outcomes measures included surgical complications, functional gain (FG), speech discrimination in quiet and noise, and patient satisfaction as determined by the Glasgow Benefit Inventory (GBI) and the Entific Medical Systems bone-anchored hearing aid questionnaire (BAQ). The only postsurgical complication noted was a minor skin reaction and pain in 1 patient that resolved with conservative management. In the 3 patients with the mixed hearing loss, the mean FG was 13.3, 20.0, 11.7, and 11.7 dB at 0.5, 1, 2, and 4 kHz, respectively; in the patient with the bilateral conductive hearing loss, the FG was 10, 25, 10, and 15 dB at the same frequencies. Speech discrimination scores with the Sophono device were comparable to those seen with conventional hearing aids. After implantation, all 5 patients experienced a positive quality-of-life outcome according to the GBI, although 1 of them had only a marginal improvement. On follow-up, all patients reported that they remained satisfied with their implant and that they used their device all day long. We conclude that the Sophono bone-conduction system is a safe and effective option that should be considered for patients with a mixed or conductive hearing loss who are unable to use a conventional hearing aid, as well as for those with single-sided deafness.


2016 ◽  
Vol 21 (6) ◽  
pp. 391-398 ◽  
Author(s):  
Paul Van de Heyning ◽  
Dayse Távora-Vieira ◽  
Griet Mertens ◽  
Vincent Van Rompaey ◽  
Gunesh P. Rajan ◽  
...  

Background: While hearing aids for a contralateral routing of signals (CROS-HA) and bone conduction devices have been the traditional treatment for single-sided deafness (SSD) and asymmetric hearing loss (AHL), in recent years, cochlear implants (CIs) have increasingly become a viable treatment choice, particularly in countries where regulatory approval and reimbursement schemes are in place. Part of the reason for this shift is that the CI is the only device capable of restoring bilateral input to the auditory system and hence of possibly reinstating binaural hearing. Although several studies have independently shown that the CI is a safe and effective treatment for SSD and AHL, clinical outcome measures in those studies and across CI centers vary greatly. Only with a consistent use of defined and agreed-upon outcome measures across centers can high-level evidence be generated to assess the safety and efficacy of CIs and alternative treatments in recipients with SSD and AHL. Methods: This paper presents a comparative study design and minimum outcome measures for the assessment of current treatment options in patients with SSD/AHL. The protocol was developed, discussed, and eventually agreed upon by expert panels that convened at the 2015 APSCI conference in Beijing, China, and at the CI 2016 conference in Toronto, Canada. Results: A longitudinal study design comparing CROS-HA, BCD, and CI treatments is proposed. The recommended outcome measures include (1) speech in noise testing, using the same set of 3 spatial configurations to compare binaural benefits such as summation, squelch, and head shadow across devices; (2) localization testing, using stimuli that rove in both level and spectral content; (3) questionnaires to collect quality of life measures and the frequency of device use; and (4) questionnaires for assessing the impact of tinnitus before and after treatment, if applicable. Conclusion: A protocol for the assessment of treatment options and outcomes in recipients with SSD and AHL is presented. The proposed set of minimum outcome measures aims at harmonizing assessment methods across centers and thus at generating a growing body of high-level evidence for those treatment options.


Author(s):  
Till F. Jakob ◽  
Iva Speck ◽  
Ann-Kathrin Rauch ◽  
Frederike Hassepass ◽  
Manuel C. Ketterer ◽  
...  

Abstract Purpose The aim of the study was to compare long-term results after 1 year in patients with single-sided deafness (SSD) who were fitted with different hearing aids. The participants tested contralateral routing of signals (CROS) hearing aids and bone-anchored hearing systems (BAHS). They were also informed about the possibility of a cochlear implant (CI) and chose one of the three devices. We also investigated which factors influenced the choice of device. Methods Prospective study with 89 SSD participants who were divided into three groups by choosing BAHS, CROS, or CI. All participants received test batteries with both objective hearing tests (speech perception in noise and sound localisation) and subjective questionnaires. Results 16 participants opted for BAHS-, 13 for CROS- and 30 for CI-treatment. The greater the subjective impairment caused by SSD, the more likely patients were to opt for surgical treatment (BAHS or CI). The best results in terms of speech perception in noise (especially when sound reaches the deaf ear and noise the hearing ear), sound localization, and subjective results were achieved with CI. Conclusion The best results regarding the therapy of SSD are achieved with a CI, followed by BAHS. This was evident both in objective tests and in the subjective questionnaires. Nevertheless, an individual decision is required in each case as to which SSD therapy option is best for the patient. Above all, the patient's subjective impairment and expectations should be included in the decision-making process.


2020 ◽  
Vol 24 (4) ◽  
pp. 180-190
Author(s):  
Hyo Jeong Kim ◽  
Jae Hee Lee ◽  
Hyun Joon Shim

Background and Objectives: Although many studies have evaluated the effect of the digital noise reduction (DNR) algorithm of hearing aids (HAs) on speech recognition, there are few studies on the effect of DNR on music perception. Therefore, we aimed to evaluate the effect of DNR on music, in addition to speech perception, using objective and subjective measurements. Subjects and Methods: Sixteen HA users participated in this study (58.00±10.44 years; 3 males and 13 females). The objective assessment of speech and music perception was based on the Korean version of the Clinical Assessment of Music Perception test and word and sentence recognition scores. Meanwhile, for the subjective assessment, the quality rating of speech and music as well as self-reported HA benefits were evaluated. Results: There was no improvement conferred with DNR of HAs on the objective assessment tests of speech and music perception. The pitch discrimination at 262 Hz in the DNR-off condition was better than that in the unaided condition (<i>p</i>=0.024); however, the unaided condition and the DNR-on conditions did not differ. In the Korean music background questionnaire, responses regarding ease of communication were better in the DNR-on condition than in the DNR-off condition (<i>p</i>=0.029). Conclusions: Speech and music perception or sound quality did not improve with the activation of DNR. However, DNR positively influenced the listener’s subjective listening comfort. The DNR-off condition in HAs may be beneficial for pitch discrimination at some frequencies.


2021 ◽  
Vol 75 (4) ◽  
pp. 1-5
Author(s):  
Joanna Marszał ◽  
Renata Gibasiewicz ◽  
Magdalena Błaszczyk ◽  
Maria Gawlowska ◽  
Wojciech Gawęcki

Introduction: Nowadays, there are many options to treat hearing-impaired patients: tympanoplastic surgery, hearing aids and a wide range of implantable devices. Objective: The aim of this study is to present the mid-term audiological and quality of life benefits after the implantation of the Osia®, a new active piezoelectric bone conduction hearing implant. Material and methods: The state of the tissues in implanted area, as well as audiological and quality of life results were analyzed six, nine and twelve months after implantation in a group of four adult patients with bilateral mixed hearing loss. Results: In all the cases, no postoperative complications were found. One year after surgery the mean audiological gain in FF PTA4 (pure tone average for 0.5, 1, 2, and 4 kHz) was 52.2±3.5 dB in comparison to the unaided situation, the mean speech understanding with Osia® in quiet was 90±8.2% for 50dB SPL, 98.8±2.5% for 65dB SPL and 100±0% for 80dB SPL, and mean speech understanding with Osia® in noise was 37.5%±23.6 for 50dB SPL, 93.8±4.8% for 65dB SPL and 98.8±2.5% for 80dB SPL. There was also an evident improvement in the quality of hearing as well as in the quality of life, measured by the APHAB (Abbreviated Profile of Hearing Aid Benefit) and the SSQ (Speech, Spatial and Qualities of Hearing Scale). Conclusions: The Osia® is an effective treatment option for patients with bilateral mixed hearing loss. The mid-term audiological and quality of life results are excellent, but further observations including bigger groups of patients and a longer follow-up are required.


2018 ◽  
Vol 23 (01) ◽  
pp. 012-017 ◽  
Author(s):  
Fayez Bahmad Jr ◽  
Carolina Cardoso ◽  
Fernanda Caldas ◽  
Monique Barreto ◽  
Anacléia Hilgenberg ◽  
...  

Introduction The bone-anchored hearing aid (BAHA) is a bone conduction system that transmits the sound directly to the inner ear by surpassing the skin impedance and the subcutaneous tissue. It is indicated for patients with mixed, conductive and unilateral sensorineural hearing loss who did not benefit from conventional hearing aids (HAs). Although the benefits from BAHA are well demonstrated internationally, this field still lacks studies in Brazil. Objective To assess the auditory rehabilitation process in BAHA users through audiological, speech perception and tinnitus aspects. Methods Individuals with hearing loss were assessed before and after the implantation. The participants were subjected to pure tone audiometry in free field, functional gain audiometry, speech perception tests, tinnitus handicap inventory (THI) in open format, and to the visual analog scale (VAS). Results It was found that the participants benefited from the use of BAHA. The difference in the performance of the participants before and after the BAHA surgery was significant in terms of hearing acuity. There was no statistically significant difference in the speech perception tests. The tinnitus assessment showed that 80% of the participants scored slight tinnitus severity in THI after using a BAHA. Eighty percent of the participants classified their tinnitus as absent to mild in the VAS after the surgery. Conclusion Based on the results of the current study, we can conclude that the participants improved both the auditory perception and the tinnitus handicap.


2020 ◽  
Vol 41 (3) ◽  
pp. 379-385
Author(s):  
Ohad Hilly ◽  
Meirav Sokolov ◽  
Reut Beck Finkel ◽  
Ofir Zavdy ◽  
Rafael Shemesh ◽  
...  

2020 ◽  
Vol 30 (Supplement_2) ◽  
Author(s):  
T Marques ◽  
A Carvalho ◽  
A Miguéis

Abstract Introduction Bone conduction hearing systems can be applied through non-invasive devices, using soft bands that exert pressure on the skin, or they can be surgically implanted (Bone Anchored Hearing Aid - BAHA). However, these bone conduction devices are frequently not well accepted due to the pressure on the head. Therefore, a new non-surgical hearing system was developed not to exert pressure on the skin, the ADHEAR. The bone anchorage in ADHEAR is performed through an adhesive adapter and is indicated for patients with conductive hearing loss and normal inner ear function. Objectives Evaluate the audiological performance with the adhesive bone conduction hearing device (ADHEAR) in a patient with conductive hearing loss. Methodology The study was designed as a prospective single-subject repeated-measure study with the subject serving as his own control. A 29 year old female patient who had a primary surgery due to middle ear cholesteatoma, was adapted with unilateral non-invasive adhesive bone conduction system for the treatment of conductive hearing loss. Air and bone conduction thresholds, word recognition scores (WRS) and speech recognition thresholds (SRT) in quiet and noise were assessed to verify the inclusion criteria of the study. Aided and unaided pure tone audiometry at 0.5, 1, 2 and 4 kHz in free field and speech audiometry in quiet and noise were performed at baseline and after 4 weeks with the ADHEAR. Results The functional gain with the ADHEAR averaged over 0.5, 1, 2, and 4 kHz after 4 weeks of usage of the adhesive hearing system, improved from 55 dB HL to 31dB HL. Speech perception in quiet and noise improved significantly in the aided situation, with SRT in quiet improving from 60 to 35 dB HL, when compared to the unaided condition. Similar results were found in noise. The patient evaluated the ADHEAR system as being useful, and without complaints of skin pressure. There was no adverse skin reaction. Conclusion Hearing performance was significantly better with ADHEAR under all test conditions. Therefore, this transcutaneous hearing system seems to be an excellent alternative for patients who need a hearing solution for conductive hearing loss but for clinical reasons cannot undergo surgery or conventional hearing aids. Furthermore, it preserves skin over the mastoid and reduces the risk of infection. Otherwise it has benefits verified by absence of head pressure and improvement of patient’s quality of life.


2019 ◽  
Vol 19 (08) ◽  
pp. 1940051
Author(s):  
JAE SUNG PARK ◽  
SUNG DAE NA ◽  
KI WOONG SEONG ◽  
JUNG HYUN LEE ◽  
SEONG TAK WOO ◽  
...  

Recently, the elderly population and excessive use of multimedia devices are increasing, which contribute to the growing number of patients with hearing loss. Hearing aids are used as a hearing rehabilitation method for patients with hearing loss and can be classified as air conduction and bone conduction according to the sound transmission pathway. Bone conduction is advantageous over sound transmission as it does not affect the eardrum. Bone conduction systems are divided into BAHA, Bone Bridge and B81 according to the vibration transmission method. BAHA has disadvantages as it can result in skin diseases and has inconveniences, and patients are reluctant to accept Bone Bridge because it has to be implanted into the temporal bone. Due to its location on the skin, B81 can solve these problems; however, this method may reduce transmission efficiency. In this paper, we have proposed a resonance frequency analysis model of a curved beam diaphragm to solve these problems. The proposed method involved a natural frequency equation with derived parameters. An improved efficiency (vibration transmission) was confirmed using the fabricated diaphragm. In the future, the proposed method may be used in various fields.


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