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Koitschev A, Neudert M, Lenarz T. [Transcutaneous bone conduction implant with self-drilling screws : A new method for fixation of an active transcutaneous bone conduction implant. German version]. HNO 2024; 72:554-560. [PMID: 37106143 DOI: 10.1007/s00106-023-01294-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND The active transcutaneous bone conduction implant (tBCI; BONEBRIDGE™ BCI 601; MED-EL, Innsbruck, Austria) is fixed to the skull with two self-tapping screws in predrilled screw channels. The aim of this prospective study was to evaluate the safety and effectiveness of fixation with self-drilling screws instead of the self-tapping screws, in order to simplify the surgical procedure. MATERIALS AND METHODS Nine patients (mean age 37 ± 16 years, range 14-57 years) were examined pre- and 12 months postoperatively for word recognition scores (WRS) at 65 dB SPL, sound-field (SF) thresholds, bone conduction thresholds (BC), health-related quality of life (Assessment of Quality of Life, AQOL-8D questionnaire), and adverse events (AE). RESULTS Due to avoidance of one surgical step, the surgical technique was simplified. Mean WRS in SF was 11.1 ± 22.2% (range 0-55%) pre- and 77.2 ± 19.9% (range 30-95%) postoperatively; mean SF threshold (pure tone audiometry, PTA4) improved from 61.2 ± 14.3 dB HL (range 37.0-75.3 dB HL) to 31.9 ± 7.2 dB HL (range 22.8-45.0 dB HL); mean BC thresholds were constant at 16.7 ± 6.8 dB HL (range 6.3-27.5 dB HL) pre- and 14.2 ± 6.2 dB HL (range 5.8-23.8 dB HL) postoperatively. AQOL-8D mean utility score increased from 0.65 ± 0.18 preoperatively to 0.82 ± 0.17 postoperatively. No device-related adverse events occurred. CONCLUSION Implant fixation by means of self-drilling screws was safe and effective in all nine patients. There was significant audiological benefit 12 months after implantation.
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Affiliation(s)
- Assen Koitschev
- Klinik für Hals‑, Nasen‑, Ohrenkrankheiten , Plastische Operationen, Klinikum Stuttgart - Olgahospital, Kriegsbergstr. 62, 70174, Stuttgart, Deutschland.
| | - Marcus Neudert
- Klinik und Poliklinik für HNO, Universitätsklinikum Carl Gustav Carus an der TU Dresden, Dresden, Deutschland
| | - Thomas Lenarz
- Klinik für Hals-Nasen-Ohrenheilkunde, Medizinische Hochschule Hannover, Hannover, Deutschland
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Lorente-Piera J, Manrique-Huarte R, Patricio de Lima J, Huarte-Irujo A, Manrique M. Bone Conduction Implants: Comparative of Audiometric Results and Quality-of-Life Bonebridge® versus Osia®. Audiol Neurootol 2024; 29:341-350. [PMID: 38377970 DOI: 10.1159/000537868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 02/07/2024] [Indexed: 02/22/2024] Open
Abstract
INTRODUCTION Bone conduction implants have been indicated for patients with conductive hearing loss, mixed hearing loss, and even profound unilateral sensorineural hearing loss. With the introduction of Bonebridge®, new transcutaneous implant options emerged. The latest is Osia®, a direct-drive variant or active systems, where the implant directly generates and applies vibration to the bone. MATERIALS AND METHODS Retrospective study of two cohorts of patients treated with active bone conduction implants at a single center, one with the Bonebridge® device and the other with Osia®. OUTCOMES Fourteen patients were included, seven in each group (n = 14). The Bonebridge® group showed an average hearing gain in tonal intelligibility thresholds of 32.43 ± 21.39 dB and a gain in the average intelligibility threshold (with 50% discrimination) of 26.29 ± 19.10 dB. In the Osia® group, there was a gain in average tonal thresholds of 41.49 ± 14.16 dB and 23.72 ± 6.98 dB in average intelligibility thresholds. Both devices contributed to improvements in patients' quality of life, as assessed with APHAB in all the variables studied in the test. Both devices offer rehabilitation for hearing loss as an alternative to hearing aids. The Osia® system shows statistically significant (p < 0.05) improvements in mid and high frequencies, but Bonebridge® slightly outperforms in speech understanding at 50%. Differences in average tonal thresholds and quality of life are not statistically significant. CONCLUSIONS While auditory improvement is observed postimplantation, other aspects, such as intelligibility thresholds and quality of life, lack statistical significance. Given the limited experience with Osia® and the small sample size, the choice of the device should be personalized. Although the literature is inconsistent due to small sample sizes and variable approaches, some studies suggest potential advantages of the Osia® system, especially in speech comprehension in different environments and greater hearing gain compared to Bonebridge®.
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Affiliation(s)
- Joan Lorente-Piera
- Otorhinolaryngology Department, University of Navarra Clinic, Pamplona, Spain
| | | | - Janaina Patricio de Lima
- Unit of Audiology of the Otorhinolaryngology Department, University of Navarra Clinic, Pamplona, Spain
| | - Alicia Huarte-Irujo
- Unit of Audiology of the Otorhinolaryngology Department, University of Navarra Clinic, Pamplona, Spain
| | - Manuel Manrique
- Otorhinolaryngology Department, University of Navarra Clinic, Pamplona, Spain
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Koitschev A, Neudert M, Lenarz T. A bone conduction implant using self-drilling screws : Self-drilling screws as a new fixation method of an active transcutaneous bone conduction hearing implant. HNO 2023; 71:61-66. [PMID: 37322168 DOI: 10.1007/s00106-023-01295-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND The active transcutaneous bone conduction implant (tBCI; BONEBRIDGE™ BCI 601; MED-EL, Innsbruck, Austria) is fixed to the skull with two self-tapping screws in predrilled screw channels. The aim of this prospective study was to evaluate the safety and effectiveness of fixation with self-drilling screws instead of the self-tapping screws, in order to simplify the surgical procedure. MATERIALS AND METHODS Nine patients (mean age 37 ± 16 years, range 14-57 years) were examined pre- and 12 months postoperatively for word recognition scores (WRS) at 65 dB SPL, sound-field (SF) thresholds, bone conduction thresholds (BC), health-related quality of life (Assessment of Quality of Life, AQOL-8D questionnaire), and adverse events (AE). RESULTS Due to avoidance of one surgical step, the surgical technique was simplified. Mean WRS in SF was 11.1 ± 22.2% (range 0-55%) pre- and 77.2 ± 19.9% (range 30-95%) postoperatively; mean SF threshold (pure tone audiometry, PTA4) improved from 61.2 ± 14.3 dB HL (range 37.0-75.3 dB HL) to 31.9 ± 7.2 dB HL (range 22.8-45.0 dB HL); mean BC thresholds were constant at 16.7 ± 6.8 dB HL (range 6.3-27.5 dB HL) pre- and 14.2 ± 6.2 dB HL (range 5.8-23.8 dB HL) postoperatively. AQOL-8D mean utility score increased from 0.65 ± 0.18 preoperatively to 0.82 ± 0.17 postoperatively. No device-related adverse events occurred. CONCLUSION Implant fixation by means of self-drilling screws was safe and effective in all nine patients. There was significant audiological benefit 12 months after implantation.
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Affiliation(s)
- Assen Koitschev
- Klinik für Hals‑, Nasen‑, Ohrenkrankheiten, Plastische Operationen, Klinikum Stuttgart-Olgahospital, Kriegsbergstraße 62, 70174, Stuttgart, Germany.
| | - Marcus Neudert
- Klinik für Hals‑, Nasen‑, Ohrenkrankheiten, Plastische Operationen, Universitätsklinikum Carl Gustav Carus an der TU Dresden, Dresden, Germany
| | - Thomas Lenarz
- Klinik für Hals‑, Nasen‑, Ohrenkrankheiten, Plastische Operationen, Medizinische Hochschule Hannover, Hannover, Germany
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Carnevale C, Morales-Olavarría C, Til-Pérez G, Sarría-Echegaray P. Bonebridge ® bone conduction implant. Hearing outcomes and quality of life in patients with conductive/mixed hearing loss. Eur Arch Otorhinolaryngol 2023; 280:1611-1619. [PMID: 36063211 DOI: 10.1007/s00405-022-07631-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 08/25/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to analyze the hearing outcomes and quality of life in a series of 52 patients affected by conductive or mixed hearing loss and treated with Bonebridge®. METHODS 52 of 71 patients implanted with Bonebridge® between October 2012 and January 2022, were included in the study. We compared the air conduction thresholds at the frequencies 500, 1000, 2000, 3000, 4000 Hz, the SRT50% and the World Recognition Score at an intensity of 50 dB with and without the implant. The Abbreviated Profile of Hearing Aid Benefit (APHAB) was employed to assess the quality of life of patients. RESULTS The liminal tone audiometry (free field) pure tone average for air conduction after 6 months with the implant was 35.12 dB, obtaining a mean gain of 31.83 dB. With Bonebridge®, the mean SRT was 34.17 dB, whereas before the surgery no patient achieved 50% of correct answers at a sound intensity of 50 dB. The world recognition score at 50 dB changed from 11% without the implant to 85% with it. We observed one case of implant failure and one case of implant exposure. The APHAB questionnaire showed an improvement after implantation in practically all the subscales. CONCLUSIONS The hearing outcomes and the subjective benefits reported by patients obtained in our study are similar to those published in the literature. Bonebridge® represents an excellent method for the rehabilitation of patients with conductive and mixed hearing loss, showing a low rate of complications.
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Affiliation(s)
- Claudio Carnevale
- Department of Otorhinolaryngology Head and Neck Surgery, Son Espases University Hospital, Carretera Valldemossa 79, 07210, Palma, Spain.
| | - C Morales-Olavarría
- Department of Otorhinolaryngology Head and Neck Surgery, Son Espases University Hospital, Carretera Valldemossa 79, 07210, Palma, Spain
| | - G Til-Pérez
- Department of Otorhinolaryngology Head and Neck Surgery, Son Espases University Hospital, Carretera Valldemossa 79, 07210, Palma, Spain
| | - P Sarría-Echegaray
- Department of Otorhinolaryngology Head and Neck Surgery, Son Espases University Hospital, Carretera Valldemossa 79, 07210, Palma, Spain
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Šikolová S, Urík M, Hošnová D, Kruntorád V, Bartoš M, Motyka O, Jabandžiev P. Two Bonebridge bone conduction hearing implant generations: audiological benefit and quality of hearing in children. Eur Arch Otorhinolaryngol 2022; 279:3387-3398. [PMID: 34495351 PMCID: PMC9130159 DOI: 10.1007/s00405-021-07068-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 08/31/2021] [Indexed: 12/05/2022]
Abstract
PURPOSE The study aimed to evaluate audiological benefits, quality of hearing and safety of two Bonebridge generation: BCI601 and BCI602 (MED-EL, Innsbruck, Austria) in children. METHODS Twelve children were implanted: five BCI601 and seven BCI602 comprising of ten conductive hearing loss, and two single sided deaf SSD subjects. Audiological outcomes tested were sound field audiometry, functional gain, speech recognition threshold (SRT50), speech recognition in noise (SPRINT) and localisation abilities. Subjective measures were Speech, Spatial and Qualities of Hearing Scale (SSQ12). RESULTS The mean FG with the BCI601 was 25.0 dB and with the BCI602 28.0 dB. The benefit in SRT50 was 23.2 dB and 33.8 dB, respectively. The mean benefit in SPRINT was 15% and 6.7% and the localisation ability improved from 33.3° to 16° and from 26.2° to 17.6°, respectively. The two SSD subjects reported a FG of 17 dB, a benefit in SRT50 of 22.5 and a benefit in SPRINT of 20%. Subjective outcomes improved significantly and even exceeded the values of their age-and sex matched normal hearing peers. One revision was reported: a retroauricular emphysema above the implant occurred 12 months post-OP, it was resolved operatively with the implant still being functional. CONCLUSION The pediatric cohort reports significant audiological benefit, even exceeding that of the age- and sex matched control. The combination of the high safety and audiological benefit makes the Bonebridge a comfortable and effective option in hearing rehabilitation in children.
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Affiliation(s)
- Soňa Šikolová
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300, Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500, Brno, Czech Republic
| | - Milan Urík
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300, Brno, Czech Republic.
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500, Brno, Czech Republic.
| | - Dagmar Hošnová
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300, Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500, Brno, Czech Republic
| | - Vít Kruntorád
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300, Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500, Brno, Czech Republic
| | - Michal Bartoš
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300, Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500, Brno, Czech Republic
| | - Oldřich Motyka
- Nanotechnology Centre, CEET, VSB-Technical University of Ostrava, 708 00, Ostrava-Poruba, Czech Republic
- Centre ENET, CEET, VSB-Technical University of Ostrava, 708 00, Ostrava-Poruba, Czech Republic
| | - Petr Jabandžiev
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500, Brno, Czech Republic
- Department of Pediatrics, University Hospital Brno, 61300, Brno, Czech Republic
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Cywka KB, Skarżyński H, Król B, Skarżyński PH. The Bonebridge BCI 602 Active Transcutaneous Bone Conduction Implant in Children: Objective and Subjective Benefits. J Clin Med 2021; 10:jcm10245916. [PMID: 34945210 PMCID: PMC8707547 DOI: 10.3390/jcm10245916] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/08/2021] [Accepted: 12/10/2021] [Indexed: 11/24/2022] Open
Abstract
Background: the Bonebridge hearing implant is an active transcutaneous bone conduction implant suitable for various types of hearing loss. It was first launched in 2012 as the BCI 601, with a newer internal part (BCI 602) released in 2019. With the new size and shape, the BCI 602 can be used in patients previously excluded due to insufficient anatomical conditions, especially in patients with congenital defects of the outer and middle ear. Objectives: the purpose of this study is to evaluate the objective and subjective benefits of the new Bonebridge BCI 602 in children who have hearing impairment due to conductive or mixed hearing loss. Safety and effectiveness of the device was assessed. Methods: the study group included 22 children aged 8–18 years (mean age 14.7 years) who had either conductive or mixed hearing loss. All patients were implanted unilaterally with the new Bonebridge BCI 602 implant. Pure tone audiometry, speech recognition tests (in quiet and noise), and free-field audiometry were performed before and after implantation. Word recognition scores were evaluated using the Demenko and Pruszewicz Polish Monosyllabic Word Test, and speech reception thresholds in noise were assessed using the Polish Sentence Matrix Test. The subjective assessment of benefits was carried outusing the APHAB (Abbreviated Profile of Hearing Aid Benefit) questionnaire. Results: after implantation of the Bonebridge BCI 602 all patients showed a statistically significant improvement in hearing and speech understanding. The mean word recognition score (WRS) changed from 12.1% before implantation to 87.3% after 6 months. Mean speech reception threshold (SRT) before implantation was +4.79 dB SNR and improved to −1.29 dB SNR after 6 months. All patients showed stable postoperative results. The APHAB questionnaire showed that difficulties in hearing decreased after implantation, with a statistically significant improvement in global score. Pre-operative scores (M = 35.7) were significantly worse than post-operative scores at 6 months (M = 25.7). Conclusions: the present study confirms that the Bonebridge BCI 602 is an innovative and effective solution, especially for patients with conductive and mixed hearing loss due to anatomical ear defects. The Bonebridge BCI 602 system provides valuable and stable audiological and surgical benefits. Subjective assessment also confirms the effectiveness of the BCI 602. The BCI 602 offers the same amplification as the BCI601, but with a smaller size. The smaller dimensions make it an effective treatment option for a wider group of patients, especially children with congenital defects of the outer and middle ear.
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Affiliation(s)
- Katarzyna B. Cywka
- Otorhinolaryngosurgery Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, 02-042 Warsaw, Poland; (K.B.C.); (B.K.)
| | | | - Bartłomiej Król
- Otorhinolaryngosurgery Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, 02-042 Warsaw, Poland; (K.B.C.); (B.K.)
| | - Piotr H. Skarżyński
- Institute of Sensory Organs, 05-830 Warsaw, Poland;
- World Hearing Center, Department of Teleaudiology and Screening, Institute of Physiology and Pathology of Hearing, 02-042 Warsaw, Poland
- Heart Failure and Cardiac Rehabilitation Department, Second Faculty of the Medical University of Warsaw, 02-091 Warsaw, Poland
- Correspondence: ; Tel.: +48-223-560-366
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Seiwerth I, Fröhlich L, Schilde S, Götze G, Plontke SK, Rahne T. Clinical and functional results after implantation of the bonebridge, a semi-implantable, active transcutaneous bone conduction device, in children and adults. Eur Arch Otorhinolaryngol 2021; 279:101-113. [PMID: 33674927 PMCID: PMC8738362 DOI: 10.1007/s00405-021-06626-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 01/15/2021] [Indexed: 11/28/2022]
Abstract
Purpose Aim of the study was to evaluate the surgical, clinical and audiological outcome of 32 implantations of the Bonebridge, a semi-implantable transcutaneous active bone conduction implant. Methods In a retrospective cohort study, we analyzed data for 32 implantations in 31 patients (one bilateral case; seven age < 16 years) with conductive or mixed hearing loss, malformations, after multiple ear surgery, or with single-sided deafness as contralateral routing of signal (CROS). Results Four implantations were done as CROS. Five cases were simultaneously planned with ear prosthesis anchors, and 23 implantations (72%) were planned through three-dimensional (3D) “virtual surgery.” In all 3D-planned cases, the implant could be placed as expected. For implant-related complications, rates were 12.5% for minor and 3.1% for major complications. Implantation significantly improved mean sound field thresholds from a preoperative 60 dB HL (SD 12) to 33 dB HL (SD 6) at 3 postoperative months and 34 dB HL (SD 6) at > 11 postoperative months (p < 0.0001). Word recognition score in quiet at 65 dB SPL improved from 11% (SD 20) preoperatively to 74% (SD 19) at 3 months and 83% (SD 15) at > 11 months (p < 0.0001). The speech reception threshold in noise improved from − 1.01 dB unaided to − 2.69 dB best-aided (p = 0.0018). Conclusion We found a clinically relevant audiological benefit with Bonebridge. To overcome anatomical challenges, we recommend preoperative 3D planning in small and hypoplastic mastoids, children, ear malformation, and simultaneous implantation of ear prosthesis anchors and after multiple ear surgery.
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Affiliation(s)
- Ingmar Seiwerth
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle, Germany.
| | - Laura Fröhlich
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle, Germany
| | - Sebastian Schilde
- Department of Orthopedics, Trauma and Reconstructive Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle (Saale), Halle, Germany
| | - Gerrit Götze
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle, Germany
| | - Stefan K Plontke
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle, Germany
| | - Torsten Rahne
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle, Germany
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Cervicofacial surgery and implantable hearing device extrusion: management of challenging cases. The Journal of Laryngology & Otology 2021; 135:212-216. [PMID: 33641688 DOI: 10.1017/s0022215121000505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To describe our management of implantable hearing device extrusion in cases of previous cervicofacial surgery. METHODS A review was conducted of a retrospectively acquired database of surgical procedures for implantable hearing devices performed at our department between January 2011 and December 2019. Cases of device extrusion and previous cervicofacial surgery are included. Medical and surgical management is discussed. RESULTS Four cases of implant extrusion following cervicofacial surgery were identified: one involving a Bonebridge system and three involving cochlear implants. In all cases, antibiotic treatment was administered and surgical debridement performed. The same Bonebridge system was implanted in the middle fossa. The three cochlear implants were removed, and new devices were implanted in a more posterior region. CONCLUSION Previous cervicofacial surgery is a risk factor for hearing implant extrusion. The middle fossa approach is the best option for the Bonebridge system. Regarding the cochlear implant, it is always suitable to place it in a more posterior area. An inferiorly based fascio-muscular flap may be a good option to reduce the risk of extrusion.
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Jones S, Spielmann P. Device profile of the Bonebridge bone conduction implant system in hearing loss: an overview of its safety and efficacy. Expert Rev Med Devices 2020; 17:983-992. [PMID: 33050771 DOI: 10.1080/17434440.2020.1834845] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The Bonebridge is an active transcutaneous semi-implantable bone conduction hearing device suitable for several types of hearing loss. It has unique benefits over some more established technologies. It consists of an internal active implant and an external sound processor. It was first launched in 2012, with a newer model released in late 2019. AREAS COVERED The structure and features of the device are described. Indications, audiological criteria, and contraindications to implantation are discussed. The planning and procedure of implantation surgery are also described. Research outlining the outcomes of implant use and risk of adverse events is highlighted. EXPERT OPINION The evidence included in this article demonstrates the successful audiological outcomes and patient satisfaction with Bonebridge implantation. The rate of adverse events following surgery is low and compares well with other devices which may be considered for Bonebridge candidates. The device should be considered as an option for suitable candidates and in many cases may be the better option available, given the low incidence of skin complications and the absence of a skin penetrating abutment. Future advances are likely to affect sound processor technology, connectivity, and possibly further reduction in implant size and gain.
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Affiliation(s)
- Stephen Jones
- Department of Otolaryngology, Ninewells Hospital & Medical School , Dundee, UK
| | - Patrick Spielmann
- Department of Otolaryngology, Ninewells Hospital & Medical School , Dundee, UK
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Active Transcutaneous Bone Conduction Implant: Audiometric Outcomes Following a Novel Middle Fossa Approach With Self-Drilling Screws. Otol Neurotol 2020; 41:605-613. [PMID: 32080031 DOI: 10.1097/mao.0000000000002597] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To present surgical and audiometric outcomes of patients implanted with an active transcutaneous bone conduction implant following the novel middle fossa surgical approach with self-drilling screws. STUDY DESIGN Retrospective review. SETTING Tertiary care center. PATIENTS Thirty-seven adults with either conductive or mixed hearing loss that met indications for an active transcutaneous bone conduction implant were consecutively implanted from April, 2013 to May, 2018. INTERVENTION Unilateral middle fossa implantation of an active transcutaneous bone conduction implant. MAIN OUTCOME MEASURES Patient charts were reviewed for surgical outcomes and complications over the 6-year period. Preoperative air conduction, preoperative bone conduction, and 3-month postoperative aided thresholds were recorded. Speech perception was assessed using CNC words and AzBio sentences. Pure-tone averages (PTAs; measured at 0.5, 1.0, 2.0 and 3.0 kHz), air-bone gap, and functional gain were calculated. RESULTS Mean air conduction and bone conduction PTAs (±standard deviation) of the implanted ear were 66.8 dB (±14.9 dB) and 21.9 dB (±14.0 dB), respectively. Mean aided PTA was 26.5 dB (± 8.5 dB). The average functional gain was 40.3 dB (±19.0 dB). Favorable speech perception outcomes were observed. No complications or instances of revision surgery were reported, with a mean follow-up time of 32 months (range, 9-71 mo). CONCLUSIONS This is the first paper to describe outcomes of patients implanted with an active transcutaneous bone conduction implant via the middle fossa with self-drilling screws. Favorable surgical outcomes were observed with a follow-up of up to 6 years.
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Carnevale C, Tomás-Barberán M, Til-Pérez G, Enchev E, Sarría-Echegaray P. Commentary on "the middle fossa approach with self-drilling screws: a novel technique for BONEBRIDGE implantation". J Otolaryngol Head Neck Surg 2019; 48:56. [PMID: 31690342 PMCID: PMC6833236 DOI: 10.1186/s40463-019-0377-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 09/21/2019] [Indexed: 11/23/2022] Open
Affiliation(s)
- C Carnevale
- Otolaryngology Head and Neck Surgery Department, Son Espases University Hospital, Carretera Valldemosa, 79. 07210 Servicio ORL, Palma de Mallorca, Islas Balears, Spain.
| | - M Tomás-Barberán
- Otolaryngology Head and Neck Surgery Department, Son Espases University Hospital, Carretera Valldemosa, 79. 07210 Servicio ORL, Palma de Mallorca, Islas Balears, Spain
| | - G Til-Pérez
- Otolaryngology Head and Neck Surgery Department, Son Espases University Hospital, Carretera Valldemosa, 79. 07210 Servicio ORL, Palma de Mallorca, Islas Balears, Spain
| | - E Enchev
- Otolaryngology Head and Neck Surgery Department, Son Espases University Hospital, Carretera Valldemosa, 79. 07210 Servicio ORL, Palma de Mallorca, Islas Balears, Spain
| | - P Sarría-Echegaray
- Otolaryngology Head and Neck Surgery Department, Son Espases University Hospital, Carretera Valldemosa, 79. 07210 Servicio ORL, Palma de Mallorca, Islas Balears, Spain
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Brkic FF, Riss D, Scheuba K, Arnoldner C, Gstöttner W, Baumgartner WD, Vyskocil E. Medical, Technical and Audiological Outcomes of Hearing Rehabilitation with the Bonebridge Transcutaneous Bone-Conduction Implant: A Single-Center Experience. J Clin Med 2019; 8:jcm8101614. [PMID: 31623414 PMCID: PMC6832994 DOI: 10.3390/jcm8101614] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 09/25/2019] [Accepted: 09/29/2019] [Indexed: 12/05/2022] Open
Abstract
Bone-conduction implants are a standard therapeutic option for patients with conductive, unilateral, or mixed hearing loss who either do not tolerate conventional hearing aids or can benefit from surgery. The aim of this study was to evaluate long-term medical and technical outcomes, and audiological results with the Bonebridge transcutaneous bone-conduction implant. This retrospective study included all patients implanted with a bone-conduction hearing implant at a tertiary medical referral center between March 2012 and October 2018. Medical and technical outcomes included the mean length of implant usage, medical and technical complications (skin and wound infection, lack of benefit, technical failure), explantations and revisions, coupling approaches, implant failure rate, implant survival and the implant loss for added follow-up years. Auditory results were measured by functional hearing gain and the Freiburger monosyllabic test at 65 dB sound pressure level. Sixty-four patients were included in the study; five of these were implanted bilaterally (69 devices). Five unilaterally implanted patients were lost to follow-up. The mean follow-up was 27.1 months (range: 0.2 months–6.3 years). The mean implant usage was 25.9 months (range: 0.2 months–6.3 years). Fifty-seven implants (89.1%) were in use at the end of the follow-up period. Complications occurred in six ears (9.4%). Five implants (7.8%) were explanted without reimplantation. Device failure occurred in one implant (1.6%), which was possibly caused by recurrent head trauma. The rate of implant loss due to technical device failure (damage to device) was 1 per 72 follow-up years. The mean improvement on the Freiburger monosyllabic test (52.1%, p = 0.0001), and in functional hearing gain across frequencies (26.5 dB, p = 0.0001) was significant. This single-center follow-up reveals the medical and technical reliability of a transcutaneous bone-conduction implant for hearing rehabilitation because complication and revision rates were low. The majority of patients still used the device at the end of the observation period. Implantation resulted in favorable hearing outcomes in comparison to that of unaided conditions. Cautious patient selection mainly regarding co-morbidities, the history of chronic otologic diseases and proper surgical technique seems to be crucial in reducing complications.
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Affiliation(s)
- Faris F Brkic
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Dominik Riss
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Katharina Scheuba
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Christoph Arnoldner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Wolfgang Gstöttner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Wolf-Dieter Baumgartner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Erich Vyskocil
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
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Audiological effectiveness of Bonebridge implantation for bilateral congenital malformation of the external and middle ear. Eur Arch Otorhinolaryngol 2019; 276:2755-2762. [DOI: 10.1007/s00405-019-05533-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 06/25/2019] [Indexed: 10/26/2022]
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