Outcomes after Application of Active Bone Conducting Implants

2019 ◽  
Vol 24 (4) ◽  
pp. 197-205 ◽  
Author(s):  
Eleonor Koro ◽  
Mimmi Werner

Background: A bone conducting implant is a treatment option for individuals with conductive or mixed hearing loss (CHL, MHL) who do not tolerate regular hearing aids, and for individuals with single-sided deafness (SSD). An active bone conducting implant (ABCI) was introduced in 2012 with indication in CHL, MHL, and SSD, and it is still the only ABCI available. With complete implantation of the active transducer and consequent intact skin, a decrease in infections, skin overgrowth, and implant losses, all common disadvantages with earlier passive bone conducting implants, could be expected. Our Ear, Nose and Throat Department, a secondary care center for otosurgery that covers a population of approximately 365,000 inhabitants, was approved to implant ABCIs in 2012. Objectives: Our aim was to conduct an evaluation of audiological and subjective outcomes after ABCIs. Method: A cohort study with retrospective and prospective data collection was performed.The first 20 consecutive patients operated with an ABCI were asked for informed consent. The main outcome measures werepure tone and speech audiometry and the Glasgow Benefit Inventory (GBI). Results: Seventeen patients accepted to participate and 15 were able to complete all parts. Six patients had CHL or MHL. In this group the pure tone audiometry tests are comparable with an average functional hearing gain of 29.8 dB HL. With bilateral hearing, the mean Word Recognition Score (WRS) in noise was 35.7% unaided and 62.7% aided. Ten patients had the indication SSD. With the hearing ear blocked, the pure tone average was >101 dB HL, compared to 29.3 dB HL in sound field aided. With bilateral hearing, the mean WRS in noise was 59.7% unaided and 72.8% aided. The mean of the total GBI score was 42.1 in the group with CHL or MHL and 20.6 in the group with SSD. Conclusions: The patients benefit from their implants in terms of quality of life, and there is a substantial hearing gain from the implant for patients with conductive or MHL. Patients with SSD benefit less from the implant than other diagnoses but the positive outcomes are comparable to other options for this group.

Author(s):  
Л. Е. Голованова ◽  
Е. А. Огородникова ◽  
Н. С. Белокурова ◽  
Е. С. Лаптева ◽  
М. Ю. Бобошко

Целью исследования был сравнительный анализ жалоб и аудиологических показателей у пациентов сурдологического центра в зависимости от возраста. Представлены результаты обследования 300 первичных пациентов (случайная выборка), обратившихся к сурдологу-оториноларингологу в течение 1 мес. В группу молодых пациентов (19-44 года) вошли 40 человек; в группу среднего возраста (45- 59 лет) - 62 человека; в группу пожилых (60-74 года) - 100 человек; в группу старческого возраста (75-90 лет) - 98 человек. Обследование включало сбор жалоб и анамнеза, ЛОР-осмотр, тональную пороговую аудиометрию, импедансометрию, речевую аудиометрию в наушниках для выявления признаков центральных слуховых расстройств или в свободном звуковом поле для оценки эффективности слухопротезирования. Установлено, что для ранней диагностики тугоухости и профилактики возрастных сенсорнокогнитивных дисфункций целесообразно использовать не только результаты тональной пороговой аудиометрии, но и данные речевой аудиометрии, а также анализ субъективных жалоб. Результаты работы свидетельствуют о необходимости организации скрининга состояния слуха в рамках диспансеризации населения старше 60 лет. The aim of the study was a comparative analysis of complaints and audiological findings in patients of the audiological center depending on their age. The results of the examination of 300 fi rstly consulted patients (random sample) are presented. The group of young patients (19-44 years) included 40 people; middle age (45-59 years) - 62 people; elderly (60-74 years) - 100 people; senile age (75-90 years) - 98 people. The survey included the collection of complaints and anamnesis, ENT checkup, pure tone audiometry, impedancemetry, speech audiometry in headphones to detect the signs of Central Auditory Processing Disorder or in the free sound field to assess the effectiveness of hearing aids. It was found that for early diagnosis of hearing loss and prevention of age-related sensory-cognitive dysfunction, it is advisable to use not only the results of pure tone audiometry, but also the data of speech audiometry, as well as the analysis of subjective complaints. The results of the work indicate the need for hearing screening in the population over 60 years old.


2020 ◽  
Vol 163 (3) ◽  
pp. 582-587
Author(s):  
John T. McElveen ◽  
J. Douglas Green ◽  
Moises A. Arriaga ◽  
William H. Slattery

Objectives To demonstrate the feasibility and efficacy for next-day loading of a percutaneous bone-anchored hearing device. Study Design Multicenter prospective cohort study. Setting Tertiary neurotologic referral centers. Subject and Methods In this multicenter prospective study, a 4.5-mm laser-etched bone-anchored hearing device was implanted in adult subjects who had conductive/mixed hearing loss or single-sided deafness. One day following implantation, the surgical site was assessed for soft tissue reaction per the Holgers Scale, and implant stability was evaluated by manual palpation and resonance frequency analysis. On the same day, subjects were fitted with the processor. Follow-up evaluations were at 1 week, 4 weeks, 3 months, 6 months, and 12 months. The Glasgow Benefit Inventory and Abbreviated Profile of Hearing Aid Benefit questionnaires were completed postoperatively. Results Fourteen devices were implanted in 12 subjects. Two subjects underwent bilateral implantation. Implant stability was rated as firm at every interval for all ears, and the Implant Stability Quotient values at 3 months were stable or increased as compared with day 1 measurements. Skin irritation was limited to Holgers grade 0 and 1, with the majority having no skin irritation. The mean Glasgow Benefit Inventory global score was +43.8, and the mean Abbreviated Profile of Hearing Aid Benefit global benefit score was 60.2%. All 14 implants have remained firmly anchored. Conclusions Next-day loading of this 4.5-mm-diameter percutaneous bone-anchored hearing device appears to be a feasible alternative to the original 3-month delayed loading. Although this is a preliminary study, the results support continued investigation of a next-day loading strategy.


2018 ◽  
Vol 132 (5) ◽  
pp. 457-460 ◽  
Author(s):  
H R F Powell ◽  
I Pai ◽  
H Ghulam ◽  
D Jiang

AbstractObjective:To report a novel management strategy for mixed hearing loss in advanced otosclerosis.Methods:A 50-year-old male was referred to St Thomas’ Hearing Implant Centre with otosclerosis; he was no longer able to wear conventional hearing aids because of recurrent otitis externa. The patient underwent short process incus vibroplasty (using the Med-El Vibrant Soundbridge device), followed at a suitable interval (six weeks) by stapes surgery. The main outcome measures were: pure tone audiometry, functional gain and monosyllabic word recognition scores.Results:Post-operative pure tone audiometry showed a reduction of the mean air–bone gap from 55 dB HL to 20 dB HL. The residual mixed hearing loss was rehabilitated with the Vibrant Soundbridge, with an average device gain of 32 dB. The monosyllabic word recognition scores in quiet at 65 dB improved from 37 to 100 per cent when using the Vibrant Soundbridge at six months after switch-on of the device.Conclusion:Stapedotomy in conjunction with incus short process vibroplasty (i.e. inner-ear vibroplasty) is a safe and promising procedure for managing advanced otosclerosis with mixed hearing loss in selected patients.


2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P57-P57
Author(s):  
Drew M Horlbeck ◽  
Herman A Jenkins ◽  
Ben J Balough ◽  
Michael E Hoffer

Objective The efficacy of the Otologics Fully Implantable Hearing Device (MET) was assessed in adult patients with bilateral moderate to severe sensorineural hearing loss. Methods Surgical insertion of this totally implanted system was identical to the Phase I study. A repeated-measures within-subjects design assessed aided sound field thresholds and speech performances with the subject's own, appropriately fit, walk-in hearing aid(s) and the Otologics Fully Implantable Hearing Device. Results Six- and 12-month Phase II data will be presented. Ten patients were implanted and activated as part Phase II clinical trial. Three patients were lost to long term follow-up due to two coil failures and one ossicular abnormality preventing proper device placement. No significant differences between preoperative (AC = 59 dB, BC = 55 dB) and postoperative (AC = 61 dB, BC = 54 dB) unaided pure tone averages were noted (p < 0.05). Pure tone average implant aided thresholds (41 dB) were equivalent to that of walk-in-aided (37 dB) condition with no significant difference (p < 0.05) between patients’ walk-in-aided individual frequency thresholds and implant-aided thresholds. Word recognition scores and hearing in noise scores were similar between the walk-in-aided and for the implant-aided condition. Patient benefit scales will be presented at all end points. Conclusions Results of the Otologics MET Fully Implantable Hearing Device Phase II trial provide evidence that this fully implantable device is a viable alternative to currently available hearing aids in patients with sensorineural hearing loss.


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.


2015 ◽  
Vol 20 (4) ◽  
pp. 251-260 ◽  
Author(s):  
Gaëlle Leterme ◽  
Daniele Bernardeschi ◽  
Anissa Bensemman ◽  
Cyrille Coudert ◽  
Jean-Jacques Portal ◽  
...  

The aim of this study was to compare a contralateral routing of signal (CROS) hearing aid to a transcutaneous bone-anchored device in the same conditions. This prospective crossover study included 18 adult patients with a single-sided deafness (SSD). After a trial period of 60 days with CROS and 7 days with a transcutaneous bone-anchored device (Alpha 1®, Sophono, Boulder, Colo., USA) on a headband, 13 (72%) patients opted for Alpha 1, 2 patients for CROS, and 3 rejected both rehabilitation methods. Clinical tolerance, satisfaction, hearing performances (pure-tone audiometry, speech test in quiet and in noise, stereo audiometry, sound localization, and Hearing in Noise Test), and quality of life (Glasgow Benefit Inventory, Abbreviated Profile of Hearing Aid Benefit and Glasgow Hearing Aid Benefit questionnaires) were measured at 3 and 12 months after the implantation. Both devices improved equally the hearing in noise and the quality of life. Transcutaneous devices represent an effective option in SSD.


2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Birgul Gumus ◽  
Armagan Incesulu ◽  
Mehmet Ozgur Pinarbasli

Background.Keratitis-ichthyosis-deafness (KID) syndrome is a syndrome which presents with hearing loss and visual and keratinization disorders. In such patients, hearing aids cannot be effectively used in the rehabilitation of hearing loss because of the frequent blockage of the external ear canal with epithelial debris and due to dry and tense skin of the external ear canal. Moreover, severe or profound hearing loss also limits the benefits gained from the conventional hearing aids. On the other hand, cochlear implantation is a method that has been used in limited cases in the literature.Case Report.This study presents the results of cochlear implantation applied in our clinic to two children who had been diagnosed with KID. Audiological assessments before and after the cochlear implant operation were performed using pure-tone audiometry, immittance audiometry, and auditory brainstem response (ABR), and the postoperative follow-up was conducted using pure-tone audiometry.Conclusion.Skin problems, visual disturbances, and other additional problems complicate the short-term and long-term rehabilitation after implantation in individuals with KID syndrome. Close monitoring should be exercised due to possible skin complications that may develop during the postoperative period. The families and rehabilitation teams should be warned about the possible visual disturbances and skin complications.


Author(s):  
Digant Patni ◽  
Alok Tyagi ◽  
Vishal R. Munjal

<p class="abstract"><strong>Background:</strong> This was a prospective, descriptive study performed by collecting and analyzing the results of vestibular exams, evoked myogenic potential tests, pure tone audiometry test and impedence test performed in the Otorhinolaryngology Department of Sri Aurobindo Institute of Medical Sciences, Indore.</p><p class="abstract"><strong>Methods:</strong> This was a prospective, descriptive study performed by collecting and analyzing the results of vestibular exams, evoked myogenic potential tests, pure tone audiometry test and impedence test performed in the Otorhinolaryngology Department of Sri Aurobindo Institute of Medical Sciences, Indore.  </p><p class="abstract"><strong>Results:</strong> In age group of 20 to 60, maximum number of patients were in group of 31-40 (16), followed by 51-60 (15), followed by 20-30 (24.) Maximum positive seen in Romberg (07), followed by nystagmus (06), followed by Dix-Hallpike (06). The patients in our study (30 out of 50) were suffering from hypertension. Two patients were of Meniere’s disease and rest 16 were of SNHL, 08 were of SNHL and BPPV combined. The rest of the cases were of mixed hearing loss and other central hearing loss causes will have be ruled out.</p><p class="abstract"><strong>Conclusions:</strong> The main aim of study is to study clinicopathological aspects in patients with vertigo. We also studied incidence of SNHL in our study. It has been established by this study that hypertension is one the major causes of vertigo in patients whereas VEMP has not proven to be very beneficial in our study to see peripheral vertigo patients. Most of the patients with BPPV also had a normal cVEMP which showed that it was not a very reliable instrument in BPPV.</p>


2012 ◽  
Vol 19 (Number 2) ◽  
pp. 7-11
Author(s):  
Md. M Rahman ◽  
Md. Daulatuzzaman ◽  
N Khan

A cross sectional study was done in the department of otolaryngology of Central Police Hospital. Rajarbagh, Dhaka., during the period of January 2005 to December 2007 to find out noise induced hearing loss of traffic polices and to raise awareness for early diagnosis and treatment and also preventive measures of noise induced hearing loss. 'Thirty patients who were diagnosed as a case of hearing impairment by detailed history, clinical examination and related investigations were included in the study who were exposed to noise 0-20 years. Common chief complaints of the patients were impairment of hearing (100%), Minims (50%), dizziness (20%), aural discharge (6.66)%. Medical history of 11w patients were diabetes (6.66%) and hypertension (26.66 %). 40 % patients were smoker and 60 % patients were non smoker. A ssoc jar ed other disease like chronic supporative otitis media (CSOM) t vas present in 13.33 %. Pure tone audiometry revealed normal hearing 3.3 %, conductive hearing loss 10 %, sensorineural hearing loss 73.33 %, mixed hearing loss 13.33 % and normal hearing 6.66 %, mild hearing loss 50 To, moderate type of hearing loss 36.66 % and moderately severe 3.33 %, severe hearing loss were 3.33 %. Treatment of the patients were given by vitamin 13,, Lli, B6, cochlear vasodilators such as vinpocetine and hearing aids. Patients were advised to Hume to other department of police service. those traffic police persons are vulnerable of noise induced hearing loss determined by patients complain, clinical examination and investigations like PTA, were advised to be changed to other department of police service.


2020 ◽  
Vol 14 (2) ◽  
pp. 106-114
Author(s):  
Abdullahi Musa Kirfi ◽  
◽  
Mohammed Bello Fufore ◽  
Garba Mohammed Mainasara ◽  
Abdulrazak Ajiya ◽  
...  

Background: Prisoners, due to confinement are isolated from contact with the society and access to many of the facilities, including medical care. This study aimed to evaluate the hearing threshold of inmates of Kaduna convict prison. Method: It was a cross-sectional study of prison inmates at the Kaduna convict prison between April 2017 and February 2019. Ethical approvals were obtained from relevant bodies and all consented inmates aged 18 – 55years in the Kaduna convict prison were enrolled. Equal number of control matched for age and gender were enrolled from the communities in Kaduna North Local Government Area. Data were collated using a structured questionnaire. A diagnostic Pure Tone Audiometry was performed to assess their hearing threshold. Statistical Package for Social Sciences (SPSS) version 20.0 was used for analysis. Results: Four hundred and thirty inmates and equal number of control group were enrolled. The mean age for the inmates and controls were 30.2±7.5 and 30.4±8.02 years respectively. There were 383 males and 47 females in both groups. Among the 860 ears of the inmates, 238(27.7%) ears had hearing loss while in the control group, 95/ (11.1%) ears had impaired hearing. Conductive hearing loss was the commonest among the inmates 111(46.6%) while sensorineural was commoner among the controls 57(60.0%). The mean pure tone average among the inmates was 25.6±11.3dBHL and 26.1±11.2dBHL on the right and left ears respectively while in the control group, it was 18.4±7.8dBHL on the right and 17.9±7.9dBHL on the left. Conclusion: This study revealed that hearing loss was more prevalent among prison inmates than the general population. In majority of the inmates, the hearing loss was mild, conductive and mostly affecting all the frequencies.


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