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Kim H, Park MK, Park SN, Cho HH, Choi JY, Lee CK, Lee IW, Moon IJ, Jung JY, Jung J, Lee KY, Oh JH, Park HJ, Seo JH, Song JJ, Ha J, Jang JH, Choung YH. Efficacy of the Bonebridge BCI602 for Adult Patients with Single-sided Deafness: A Prospective Multicenter Study. Otolaryngol Head Neck Surg 2024; 170:490-504. [PMID: 37811702 DOI: 10.1002/ohn.520] [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: 04/05/2023] [Revised: 07/09/2023] [Accepted: 08/12/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE To investigate the safety and efficacy of a novel active transcutaneous bone conduction implant (BCI) device for patients with single-sided deafness (SSD). STUDY DESIGN Prospective cohort study. SETTING Tertiary referral hospitals. METHODS This prospective multicenter study was conducted at 15 institutions nationwide. Thirty adult (aged ≥19 years) SSD patients were recruited. They underwent implantation of an active transcutaneous BCI device (Bonebridge BCI602). Objective outcomes included aided pure-tone thresholds, aided speech discrimination scores (SDSs), and the Hearing in Noise Test (HINT) and sound localization test results. The Bern Benefit in Single-Sided Deafness (BBSS) questionnaire, the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, and the Tinnitus Handicap Inventory (THI) were used to measure subjective benefits. RESULTS The mean aided pure-tone threshold was 34.2 (11.3), mean (SD), dB HL at 500 to 4000 Hz. The mean total BBSS score was 27.5 (13.8). All APHAB questionnaire domain scores showed significant improvements: ease of communication, 33.6 (23.2) versus 22.6 (21.3), P = .025; reverberation, 44.8 (16.6) versus 32.8 (15.9), P = .002; background noise, 55.5 (23.6) versus 35.2 (18.1), P < .001; and aversiveness, 36.7 (22.8) versus 25.8 (21.4), P = .028. Moreover, the THI scores were significantly reduced [47.4 (30.1) versus 31.1 (27.0), P = .003]. Congenital SSD was a significant factor of subjective benefit (-11.643; 95% confidence interval: -21.946 to -1.340). CONCLUSION The BCI602 active transcutaneous BCI device can provide functional hearing gain without any adverse effects and is a feasible option for acquired SSD patients with long-term deafness.
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Affiliation(s)
- Hantai Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon, Korea
| | - Moo Kyun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Shi Nae Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyong-Ho Cho
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, Korea
| | - Jae Young Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Chi Kyou Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, Korea
| | - Il-Woo Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University College of Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Il Joon Moon
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Yun Jung
- Department of Otolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Korea
| | - Jinsei Jung
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Kyu-Yup Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jeong-Hoon Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Hong Ju Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae-Hyun Seo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jungho Ha
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
| | - Jeong Hun Jang
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
| | - Yun-Hoon Choung
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
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Portelli D, Ciodaro F, Loteta S, Alberti G, Bruno R. Audiological assessment with Matrix sentence test of percutaneous vs transcutaneous bone-anchored hearing aids: a pilot study. Eur Arch Otorhinolaryngol 2023; 280:4065-4072. [PMID: 36933021 DOI: 10.1007/s00405-023-07918-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] [Received: 01/15/2023] [Accepted: 03/06/2023] [Indexed: 03/19/2023]
Abstract
PURPOSE The study evaluated if there were differences between two types of bone-anchored hearing aids (BAHA), percutaneous vs transcutaneous implants in terms of audiological and psychosocial outcomes. METHODS Eleven patients were enrolled. Inclusion criteria were: patients with conductive or mixed hearing loss in the implanted ear with a bone conduction pure-tone average (BC PTA) of the hearing threshold at 500, 1000, 2000, and 3000 Hz ≤ 55 dB HL, aged > 5 years. Patients were assigned to two groups: percutaneous implant (BAHA Connect) and transcutaneous implant (BAHA Attract). Pure-tone audiometry, speech audiometry, free-field pure-tone and speech audiometry with the hearing aid, and Matrix sentence test were performed. The Satisfaction with Amplification in Daily Life (SADL) questionnaire, the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, and the Glasgow Benefit Inventory (GBI) were used to assess the psychosocial and audiological benefits provided by the implant, and the variation in the quality of life after the surgery. RESULTS No differences were found comparing the data of Matrix SRT. APHAB and GBI questionnaires did not show a statistically significant difference comparing each subscale and the global score. The comparison of scores obtained from the SADL questionnaire demonstrated a difference in the "Personal Image" subscale with a better score for the transcutaneous implant. Furthermore, the Global Score of the SADL questionnaire was statistically different between groups. Other subscales did not show any significant difference. A Spearman's ρ correlation test was used to evaluate if the age could influence the SRT results; no correlation was found between age and SRT. Furthermore, the same test was used to confirm a negative correlation between SRT and the global benefit of the APHAB questionnaire. CONCLUSION The current research confirms the absence of statistically significant differences comparing percutaneous and transcutaneous implants. The Matrix sentence test has shown the comparability of the two implants in the speech-in-noise intelligibility. Actually, the choice of the implant type can be done according to the patient's personal needs, the surgeon's experience, and the patient anatomy.
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Affiliation(s)
- Daniele Portelli
- Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology "Gaetano Barresi", Policlinico "G. Martino", University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy.
| | - Francesco Ciodaro
- Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology "Gaetano Barresi", Policlinico "G. Martino", University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
| | - Sabrina Loteta
- Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology "Gaetano Barresi", Policlinico "G. Martino", University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
| | - Giuseppe Alberti
- Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology "Gaetano Barresi", Policlinico "G. Martino", University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
| | - Rocco Bruno
- Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology "Gaetano Barresi", Policlinico "G. Martino", University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
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Shoman NM, Khan U, Hong P. Comparison of passive versus active transcutaneous bone anchored hearing devices in the pediatric population. JOURNAL OF OTOLARYNGOLOGY - HEAD & NECK SURGERY 2022; 51:44. [DOI: 10.1186/s40463-022-00595-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 09/05/2022] [Indexed: 11/15/2022]
Abstract
Abstract
Objective
Transcutaneous bone anchored hearing devices (BAHDs) were introduced in an effort to avoid potential complications associated with the abutment of percutaneous BAHDs. Transcutaneous BAHDs can be active or passive. While studies have demonstrated good outcomes with both, a direct comparison of audiological and clinical outcomes of these devices in the pediatric population has not yet been studied.
Study design
Retrospective, multicenter study.
Setting
Two tertiary academic centers.
Methods
Between 2015 and 2019, all patients who received an active transcutaneous BAHD (Bonebridge, BB) at one center, and patients that received a passive transcutaneous BAHD (Attract, AT) at another center, were included in this study. Exclusion criteria included age > 18 years, and mixed hearing loss or single-sided deafness. Study outcomes included patient demographics, indications, complications and preoperative and one-year postoperative audiometric data.
Results
Eighteen BB and eight AT patients met the inclusion criteria. The age range was 5–16 years. There were no significant differences in complication outcomes. Both devices demonstrated similar mean improvements in hearing thresholds at frequencies of 250 Hz (38 dB Active vs. 38 dB Passive), 500 Hz (34 dB vs. 42 dB), 1000 Hz (34 dB vs. 40 dB) and 2000 Hz (31 dB vs. 22 dB). The BB was significantly more effective at frequencies of 4000 Hz (28 dB vs. 7 dB) and 8000 Hz (29 dB vs. 6 dB) (p < 0.05).
Conclusion
This is the first study comparing audiological outcomes between an active and a passive transcutaneous BAHD in the pediatric population. While both devices improved audiometric outcomes in the low and mid frequencies, the active BAHD demonstrated significantly better outcomes in the higher frequencies.
Graphical Abstract
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Gordon KA, Papsin BC, Feness M, Negandhi J, Cushing SL. First Generation Osseointegrated Steady State Implant Benefits in Children With Hearing Loss. Otol Neurotol 2022; 43:337-344. [PMID: 34935762 PMCID: PMC8843378 DOI: 10.1097/mao.0000000000003447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess outcomes of a new Osseointegrated Steady State Implant (OSSI) for bone conduction in adolescents. METHOD In an initial trial, 14 adolescents (14.5 years of age, SD = 2.22) were provided with an OSSI; unilateral OSSI (n = 13), bilateral OSSI in sequential surgeries (n = 1). Outcomes measured were surgical duration, complications, hearing thresholds, speech perception and self-reported hearing benefits using the Speech and Spatial Quality of Hearing Questionnaire. RESULTS The surgical times were mean 93.6 minutes (SD = 33.3). Surgery was slightly longer in three adolescents who required skin flap reduction (n = 1) or significant bone polishing (n = 2) (121.33 minutes, SD = 8.14). Adverse events occurred in two adolescents post-implant poor external device retention in one child requiring revision flap reduction and inflammation at the incision site due to magnet overuse in another. The "Digital Link Calibration" measure was a good proxy predictor of the strength of magnet required for external device adherence (p = 0.002). The OSSI increased audibility in the implanted ear by mean 31.48 dB HL (SE = 1.58). Aided thresholds were best at 1 kHz (mean 25.33 dB HL, SD = 22.60) and only slightly poorer at 3000 and 4000 Hz (estimate decrease = 8.33 dB HL, SE = 3.54), reflecting good auditory sensitivity even at high frequencies. Speech perception when using the new device alone was good (89.67%, SD = 7.84%) and self-reported hearing by participants and parents improved in all domains assessed by the Speech and Spatial Quality of Hearing Questionnaire (estimate = 1.90 points, SE = 0.25, p < 0.0001). CONCLUSION The OSSI provides hearing benefits with surgical safety in a carefully selected cohort of adolescents.
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Affiliation(s)
- Karen A. Gordon
- Department of Otolaryngology, Head and Neck Surgery, University of Toronto
- Department of Communication Disorders, Hospital for Sick Children
- Archie's Cochlear Implant Laboratory, Hospital for Sick Children
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Blake C. Papsin
- Department of Otolaryngology, Head and Neck Surgery, University of Toronto
- Department of Communication Disorders, Hospital for Sick Children
- Archie's Cochlear Implant Laboratory, Hospital for Sick Children
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - MaryLynn Feness
- Archie's Cochlear Implant Laboratory, Hospital for Sick Children
| | - Jaina Negandhi
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Sharon L. Cushing
- Department of Otolaryngology, Head and Neck Surgery, University of Toronto
- Department of Communication Disorders, Hospital for Sick Children
- Archie's Cochlear Implant Laboratory, Hospital for Sick Children
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
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Transcutaneous Osseo-integrated Auditory Devices: Analysis of Two Different Implants in Adults With Different Audiological Inclusion Criteria. Otol Neurotol 2021; 42:e1308-e1312. [PMID: 34528925 DOI: 10.1097/mao.0000000000003286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine and compare audiological and speech/language discrimination results in patients with osteo-integrated auditory devices, by comparing two different systems including different audiological indications in adult population. STUDY DESIGN Descriptive and analytic, cross-sectional, cohort, and retrospective case review. SETTING Tertiary referral center. MATERIALS AND METHODS Fifty patients >14 years old, with conductive, mixed, or unilateral sensorineural hearing loss were compared. The variables studied were the following: pure tone audiometry results, air-bone gap, and the percentage of speech/language discrimination using Disyllabic Word Test. The patients were tested preoperative and 12 months after surgical procedure. Subsequently, a comparative analysis of the both systems was carried out. RESULTS With both implants, pure tone audiometry results and the difference in auditory thresholds and between the air-bone gap improved significantly. Speech discrimination increased significantly after implantation too. A significant difference was observed after implantation of both devices. Patients implanted with one of the implants showed better audiological results, but no significant differences were found with the other device. So, it was shown that the type of device and the type of hearing loss have no influence on the audiological results or complications. CONCLUSION Both implants represent a good choice for audiological rehabilitation in patients with transmissive hearing loss, mixed hearing loss, or unilateral sensorineural hearing loss with a high success and low complication rates.
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Active Versus Passive Transcutaneous Bone Conduction Hearing Devices: A Systematic Review and Meta-Analysis. Ear Hear 2021; 43:32-40. [PMID: 34191755 DOI: 10.1097/aud.0000000000001088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Active and passive transcutaneous devices (tBCHDs) have been introduced in an effort to address complication concerns with percutaneous devices. Direct comparison of active and passive devices through evidence synthesis practices is incomplete. This systematic review and meta-analysis sought to synthesize and compare available evidence on audiological, quality of life, and complication-related outcomes of active and passive tBCHDs. DESIGN MEDLINE, EMBASE, CINAHL, and Cochrane CENTRAL were searched from inception to September 23, 2019. Observational and experimental studies investigating active or passive tBCHDs in adults were eligible. Studies were screened independently in duplicate. This study is reported in accordance with the PRISMA guidelines. Risk of bias and quality assessments were completed using the Newcastle-Ottawa Scale and the Quality Appraisal Tool for Case Series. Meta-analysis was performed with random-effects models. Audiological outcomes included changes in pure-tone average, functional hearing, and high-frequency hearing. Quality of life outcomes included patient-reported results. Complications included minor, major, and total complications experienced. RESULTS One thousand five hundred forty-two nonduplicate articles were screened. Twenty-eight studies were included. Quality of included studies was low overall. The pooled complication rate for active devices was 14.8% (95% confidence interval: 0.09-0.21, I2: 0%). The pooled improvement in functional hearing for active devices among those with mixed or conductive hearing loss was 31.8 dB (95% confidence interval: 27.7-35.9, I2: 44.6). Improvement in functional hearing ranged from 25.2 to 44.3 dB for passive devices. Active devices provided improved high-frequency hearing compared to passive devices: the weighted average hearing gains at 2, 3, 4, and 6 kHz were 26.5, 25.7, 31.8, and 34.3 dB for active devices and 26.2, 21.1, 16.8, and 6.4 dB for passive devices, respectively. Both device types demonstrated improvement in ease of communication, reverberation, and understandability in background noise. CONCLUSIONS Both active and passive tBCHDs demonstrate acceptable safety profiles and QoL improvements. Active devices may provide better hearing outcomes, especially in high frequencies, but high-quality comparative studies are lacking. Future work is needed in this regard.
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Ellsperman SE, Nairn EM, Stucken EZ. Review of Bone Conduction Hearing Devices. Audiol Res 2021; 11:207-219. [PMID: 34069846 PMCID: PMC8161441 DOI: 10.3390/audiolres11020019] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/30/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022] Open
Abstract
Bone conduction is an efficient pathway of sound transmission which can be harnessed to provide hearing amplification. Bone conduction hearing devices may be indicated when ear canal pathology precludes the use of a conventional hearing aid, as well as in cases of single-sided deafness. Several different technologies exist which transmit sound via bone conduction. Here, we will review the physiology of bone conduction, the indications for bone conduction amplification, and the specifics of currently available devices.
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Abstract
Objective: A new active transcutaneous bone conduction hearing implant system that uses piezoelectric technology has been developed: an active osseointegrated steady-state implant system (OSI). This was the first clinical investigation undertaken to demonstrate clinical performance, safety, and benefit of the new implant system. Study Design and Setting: A multicenter prospective within-subject clinical investigation was conducted. Patients: Fifty-one adult subjects with mixed and conductive hearing loss (MHL/CHL, n = 37) and single-sided sensorineural deafness (SSD, n = 14) were included. Main Outcome Measure: Audiological evaluations included audiometric thresholds, speech recognition in noise, and quiet. Hearing and health-related patient-reported outcomes (PROs; health utilities index [HUI], abbreviated profile of hearing aid benefit [APHAB], and speech, spatial of qualities of hearing scale [SSQ]), daily use, surgical and safety parameters were collected. Results: Intra- and postoperative complications were few. One implant was removed before activation due to post-surgical infection. Compared with the preoperative softband tests, a significant improvement in speech recognition-in-noise was observed in the MHL/CHL group (–7.3 dB, p ≤ 0.0001) and the SSD group (–8.1 dB, p = 0.0008). In quiet, word recognition improved in the MHL/CHL group, most markedly at lower intensity input of 50 dB SPL (26.7%, p ≤ 0.0001). The results of all PROs showed a significant improvement with the new device compared with preoperative softband in the MHL/CHL group. In the SSD group significant improvements were observed in the APHAB and SSQ questionnaires. Discussion: The results confirmed the clinical safety, performance, and benefit of this new treatment modality for subjects with CHL, MHL, and SSD.
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Strijbos RM, Straatman LV, Calon TGA, Johansson ML, de Bruijn AJG, van den Berge H, Wagenaar M, Eichhorn E, Janssen M, Jonhede S, van Tongeren J, Holmberg M, Stokroos R. Long-Term Outcomes of the Minimally Invasive Ponto Surgery vs. Linear Incision Technique With Soft Tissue Preservation for Installation of Percutaneous Bone Conduction Devices. Front Neurol 2021; 12:632987. [PMID: 33716934 PMCID: PMC7945693 DOI: 10.3389/fneur.2021.632987] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/19/2021] [Indexed: 12/19/2022] Open
Abstract
Objective: Comparing the surgical outcomes of the Minimally Invasive Ponto Surgery (MIPS) technique with the linear incision technique with soft tissue preservation (LITT-P) for bone conduction devices after a follow-up of 22 months. Methods: In this multicenter randomized controlled trial, there was the inclusion of 64 adult patients eligible for unilateral surgery. There was 1:1 randomization to the MIPS (test) or the LITT-P (control) group. The primary outcome was an (adverse) soft tissue reaction. Secondary outcomes were pain, loss of sensibility, soft tissue height/overgrowth, skin sagging, implant loss, Implant Stability Quotient measurements, cosmetic scores, and quality of life questionnaires. Results: Sixty-three subjects were analyzed in the intention-to-treat population. No differences were found in the presence of (adverse) soft tissue reactions during complete follow-up. Also, there were no differences in pain, wound dehiscence, skin level, soft tissue overgrowth, and overall quality of life. Loss of sensibility (until 3-month post-surgery), cosmetic scores, and skin sagging outcomes were better in the MIPS group. The Implant Stability Quotient was higher after the LITT-P for different abutment lengths at various points of follow-up. Implant extrusion was nonsignificantly higher after the MIPS (15.2%) compared with LITT-P (3.3%). Conclusion: The long-term results show favorable outcomes for both techniques. The MIPS is a promising technique with some benefits over the LITT-P. Concerns regarding nonsignificantly higher implant loss may be overcome with future developments and research. Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT02438618.
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Affiliation(s)
- Ruben M Strijbos
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Centre Utrecht, Utrecht, Netherlands.,University Medical Centre Utrecht Brain Centre, University of Utrecht, Utrecht, Netherlands
| | - Louise V Straatman
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Centre Utrecht, Utrecht, Netherlands.,University Medical Centre Utrecht Brain Centre, University of Utrecht, Utrecht, Netherlands
| | - Tim G A Calon
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Centre Utrecht, Utrecht, Netherlands.,University Medical Centre Utrecht Brain Centre, University of Utrecht, Utrecht, Netherlands
| | - Martin L Johansson
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Oticon Medical AB, Askim, Sweden
| | | | - Herbert van den Berge
- Department of Otorhinolaryngology, Medisch Centrum Leeuwarden, Leeuwarden, Netherlands
| | - Mariette Wagenaar
- Department of Otorhinolaryngology, Medisch Centrum Leeuwarden, Leeuwarden, Netherlands
| | - Edwin Eichhorn
- Department of Otorhinolaryngology, Medisch Centrum Leeuwarden, Leeuwarden, Netherlands
| | - Miranda Janssen
- Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands.,Department of Methodology and Statistics, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | | | - Joost van Tongeren
- Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | | | - Robert Stokroos
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Centre Utrecht, Utrecht, Netherlands.,University Medical Centre Utrecht Brain Centre, University of Utrecht, Utrecht, Netherlands
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Lagerkvist H, Carvalho K, Holmberg M, Petersson U, Cremers C, Hultcrantz M. Ten years of experience with the Ponto bone-anchored hearing system-A systematic literature review. Clin Otolaryngol 2020; 45:667-680. [PMID: 32386454 PMCID: PMC7496709 DOI: 10.1111/coa.13556] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 04/18/2020] [Indexed: 12/17/2022]
Abstract
Background Bone‐anchored hearing systems (BAHSs) are widely used for hearing rehabilitation and are indicated in cases of conductive and mixed hearing loss and in single‐sided deafness. The Ponto system, that is one available option, has been on the market since 2009. Objective of review The aim of this study is to systematically review the literature reporting on the Ponto system, with regard to audiological and surgical outcomes and patient's quality‐of‐life scores. Type of review A systematic literature search was performed in the PubMed database 2009‐July 2019. Search strategy Search term: ((osseointegrated hearing aid) OR (bone conduction implant) OR (bone anchored hearing) OR BAHA OR BAHS OR BAHI). Pre‐defined inclusion and exclusion criteria were applied. Evaluation method English‐language articles reporting original clinical data (audiological, surgical or quality‐of‐life outcomes) on the Ponto system were included. Articles reporting on Ponto and another BAHS system where the results on Ponto constituted less than 50% of the patient population or including only results on testband or softband devices were excluded. Results Audiological outcomes were discussed in 20 publications. Improvement against the unaided thresholds was demonstrated. The functional improvement was on average 33.9 dB. The effective gain or remaining air‐bone gap was on average 6.7 dB. All evaluated data showed aided speech reception thresholds significantly below normal speech level. Twenty‐seven publications reported surgical and follow‐up data for the Ponto system. Implant survival was 97.7%, adverse skin reactions (Holgers ≥ 2) were 5% across visits and 15% across patients. No complications were life‐threatening, causing permanent disability/damage or requiring a hospitalisation. Five studies reported quality of life using the Glasgow benefit inventory, 98% reported an improvement when analysing the score on an individual level. Conclusions The outcomes of this systematic review confirm that percutaneous systems provide consistent audiological benefits and improved quality of life for patients. Further, the review demonstrates that the percutaneous systems are safe, with relatively low complication rates. Skin‐related complications are the most common complication type and are experienced by approximately one patient out of seven, or in less than one of 20 follow‐up visits.
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Affiliation(s)
| | | | | | | | - Cor Cremers
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
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Han JJ, Park HR, Song JJ, Koo JW, Choi BY. A comparison study of audiological outcome and compliance of bone conduction implantable hearing implants. Eur Arch Otorhinolaryngol 2020; 277:3003-3012. [PMID: 32405813 DOI: 10.1007/s00405-020-06025-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 04/27/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE The present study aimed to evaluate and compare the outcome of different bone conduction hearing implants (BCHIs) in subjects with mixed hearing loss (MHL) and single-sided deafness (SSD) in terms of audiometric results and compliance. METHODS Twenty-one subjects with MHL and 18 subjects with SSD undergoing implantation of Baha connect, Baha attract, or Bonebridge were enrolled. Functional gain, effective gain, and usage rate of BCHIs were retrospectively reviewed. RESULTS As for MHL, the functional gain of three devices was not significantly different (p = 0.477), while the effective gain of Bonebridge was higher (- 8.8 [- 15.0, - 3.5] dB) than that of Baha connect (- 20.0 [- 26.3, - 11.3] dB, p = 0.037), especially at 0.5 kHz (p = 0.010) and 1 kHz (p = 0.014). In SSD subjects, the effective gain of Bonebridge was significantly higher than that of Baha attract (- 11.3 [- 15.0, - 7.5] vs - 21.3 [- 21.3, - 16.3] dB, p = 0.012), while the functional gain of Bonebridge and Baha attract was not different. The constant usage rate of BCHIs tends to be higher in MHL subjects [17/21 (82%)] than that in SSD subjects [10/18 (56%)]. In SSD subjects, the constant user group showed higher functional gain than the non-constant user group, with a significant difference at 3 kHz (35.0 [33.8, 45.0] vs 17.5 [10.0, 27.5] dB, p = 0.006). CONCLUSION Bonebridge shows a higher effective gain than Baha connect in the MHL group and Baha attract in the SSD group. The usage rate of BCHIs is lower in SSD than that in MHL. In SSD subjects, the constant user group tended to show higher functional gain than the non-constant user group. Irrespective of the device type, the tendency of higher functional gain of BCHIs, especially at mid frequencies, may potentially lead to yield good compliance in SSD, mandating a meticulous fitting strategy ensuring a sufficient mid-frequency functional gain in SSD.
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Affiliation(s)
- Jae Joon Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, Korea
| | - Hye-Rim Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, 166 Gumi-Ro, Bundang-Gu, Seongnam-si, Gyeonggi-Do, Republic of Korea
| | - Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, 166 Gumi-Ro, Bundang-Gu, Seongnam-si, Gyeonggi-Do, Republic of Korea
| | - Ja-Won Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, 166 Gumi-Ro, Bundang-Gu, Seongnam-si, Gyeonggi-Do, Republic of Korea
| | - Byung Yoon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, 166 Gumi-Ro, Bundang-Gu, Seongnam-si, Gyeonggi-Do, Republic of Korea.
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Minimal invasive pocket technique for magnet bone implant hearing aid without fixation. Eur Arch Otorhinolaryngol 2019; 277:715-725. [PMID: 31811384 PMCID: PMC7031225 DOI: 10.1007/s00405-019-05746-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 11/27/2019] [Indexed: 11/11/2022]
Abstract
Introduction The BAHA (bone-anchored hearing aid) Attract is a magnetic transcutaneous bone conduction device anchored into the temporal bone. The standard surgical technique for BAHA Attract is a multi-tools time-consuming process, which requires a large cutaneous incision. The objective of this study is to describe and test the feasibility of a minimally invasive pocket (MIP) technique for Magnet Bone Implant Hearing Aid (MBIHA) with a modified magnet of BAHA Attract without fixation and without any tissue reduction. We use a 3-cm vertical skin incision and a subperiosteal pocket. Method A study of 10 patients with conductive or mixed hearing loss who benefited from a MBIHA using the MIP technique is presented. The pure tone average (PTA) (dB) for air-conduction thresholds and the speech recognition threshold (SRT) (dB) in speech audiometry in quiet are calculated. The Entific Medical Systems (EMS) questionnaire and the postoperative clinical outcomes are realized. Results We found a significant improvement of 33.8 dB on average for the PTA and 44.8 dB for the SRT with MBIHA at 3 months, compared with unaided situation. No implant was removed or displaced after 2 years of follow-up. The skin condition remains intact in all the cases. Conclusion The minimally subperiosteal pocket surgical technique MIP without fixation and with tissue preservation for the MBIHA is safe, rapid and effective for patients with conductive or mixed hearing loss. It opens new perspectives of development and modify conventional concept in magnetic coupling of bone-conducted device. Electronic supplementary material The online version of this article (10.1007/s00405-019-05746-5) contains supplementary material, which is available to authorized users.
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Speech Perception Outcomes in Transcutaneous Versus Percutaneous Bone Conduction Stimulation in Individuals With Single-sided Deafness. Otol Neurotol 2019; 40:1068-1075. [DOI: 10.1097/mao.0000000000002362] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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