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Gutierrez JA, Shannon CM, Nguyen SA, Meyer TA, Lambert PR. Comparison of Quality of Life Outcomes for Percutaneous Versus Transcutaneous Implantable Hearing Devices: A Systematic Review and Meta-analysis. Otol Neurotol 2024; 45:e129-e136. [PMID: 38270194 DOI: 10.1097/mao.0000000000004111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
OBJECTIVE To compare quality of life (QOL) outcomes of percutaneous and transcutaneous bone conduction devices (pBCD and tBCD, respectively). DATABASES REVIEWED Pubmed, Scopus, CINAHL. METHODS A systematic review was performed searching for English language articles from inception to March 15, 2023. Studies reporting QOL outcomes measured using a validated tool following implantation of either pBCDs or tBCDs were considered for inclusion. QOL outcomes included scores for Glasgow Benefit Inventory, Glasgow Children's Benefit Inventory, Abbreviated Profile of Hearing Aid Benefit, and the Speech, Spatial, and Qualities of Hearing Scale. A meta-analysis of continuous measures was performed. RESULTS A total of 52 articles with 1,469 patients were included. Six hundred eighty-nine patients were implanted with pBCDs, and the remaining 780 were implanted with tBCDs. Average Glasgow Benefit Inventory scores for the tBCD group (33.0, 95% confidence interval [22.7-43.3]) were significantly higher than the pBCD group (30.9 [25.2-36.6]) (Δ2.1 [1.4-2.8], p < 0.0001). Mean Glasgow Children's Benefit Inventory scores (Δ3.9 [2.0-5.8], p = 0.0001) and mean gain in Abbreviated Profile of Hearing Aid Benefit scores (Δ5.6 [4.8-6.4], p < 0.0001) were significantly higher among patients implanted with tBCDs than those implanted with pBCDs. Patients implanted with tBCDs also had significantly higher gains on the Speech (Δ1.1 [0.9-1.3], p < 0.0001), Spatial (Δ0.8 [0.7-0.9], p < 0.0001), and Qualities of Hearing (Δ1.2 [1.1-1.3], p < 0.0001) portions of the Speech, Spatial, and Qualities of Hearing Scale than those implanted with pBCDs. CONCLUSIONS Patients implanted with transcutaneous devices had better QOL outcomes than those implanted with percutaneous devices.
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Affiliation(s)
- Jorge A Gutierrez
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
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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: 3] [Impact Index Per Article: 3.0] [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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Bruschini L, Canzi P, Canale A, Covelli E, Laborai A, Monteforte M, Cinquini M, Barbara M, Beltrame MA, Bovo R, Castigliano B, De Filippis C, Della Volpe A, Dispenza F, Marsella P, Mainardi A, Orzan E, Piccirillo E, Ricci G, Quaranta N, Cuda D. Implantable hearing devices in clinical practice. Systematic review and consensus statements. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2024; 44:52-67. [PMID: 38165206 PMCID: PMC10914359 DOI: 10.14639/0392-100x-n2651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/21/2023] [Indexed: 01/03/2024]
Abstract
Objective Implantable hearing devices represent a modern and innovative solution for hearing restoration. Over the years, these high-tech devices have increasingly evolved but their use in clinical practice is not universally agreed in the scientific literature. Congresses, meetings, conferences, and consensus statements to achieve international agreement have been made. This work follows this line and aims to answer unsolved questions regarding examinations, selection criteria and surgery for implantable hearing devices. Materials and methods A Consensus Working Group was established by the Italian Society of Otorhinolaryngology. A method group performed a systematic review for each single question to identify the current best evidence on the topic and to guide a multidisciplinary panel in developing the statements. Results Twenty-nine consensus statements were approved by the Italian Society of Otorhinolaryngology. These were associated with 4 key area subtopics regarding pre-operative tests, otological, audiological and surgical indications. Conclusions This consensus can be considered a further step forward to establish realistic guidelines on the debated topic of implantable hearing devices.
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Affiliation(s)
- Luca Bruschini
- Otolaryngology, ENT Audiology and Phoniatrics Unit, University Hospital of Pisa, Pisa, Italy
| | - Pietro Canzi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Canale
- Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Edoardo Covelli
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Andrea Laborai
- Department of Otolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Marta Monteforte
- Laboratory of systematic review methodology and guidelines production, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Michela Cinquini
- Laboratory of systematic review methodology and guidelines production, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Maurizio Barbara
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Millo Achille Beltrame
- Department of Otorhinolaryngology, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Roberto Bovo
- Department of Neuroscience DNS, Otolaryngology Section, Padua University, Padua, Italy
| | - Bruno Castigliano
- Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Cosimo De Filippis
- Department of Neuroscience, Audiology Section, University of Padua, Treviso, Italy
| | - Antonio Della Volpe
- Otology and Cochlear Implant Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - Francesco Dispenza
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, Azienda Ospedaliera Universitaria Policlinico ‘’Paolo Giaccone’’, University of Palermo, Palermo, Italy
| | - Pasquale Marsella
- Audiology and Otosurgery Department, “Bambino Gesù” Children’s Hospital, Rome, Italy
| | - Anna Mainardi
- Department of Otolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Eva Orzan
- ENT and Audiology Unit, Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, Trieste, Italy
| | | | - Giampietro Ricci
- Department of Surgical and Biomedical Sciences, Section of Otorhinolaryngology, University of Perugia, Perugia, Italy
| | - Nicola Quaranta
- Translational Biomedicine and Neurosciences Department, University of Bari, Bari, Italy
| | - Domenico Cuda
- Department of Otolaryngology, Guglielmo da Saliceto Hospital, Piacenza, Italy
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Koro E, Lundgren E, Smeds H, Werner M. Long-Term Follow-Up in Active Transcutaneous Bone Conduction Implants. Otol Neurotol 2024; 45:58-64. [PMID: 38085764 DOI: 10.1097/mao.0000000000004057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
OBJECTIVE To evaluate long-term outcomes of active transcutaneous bone conduction implants (atBCIs) regarding safety, hearing, and quality of life. STUDY DESIGN A clinical study with retrospective medical record analysis combined with prospective audiometry and quality of life questionnaires. SETTING Three secondary to tertiary care hospitals. PATIENTS All subjects operated with an atBCI in three regions in Sweden were asked for informed consent. Indications for atBCI were single-sided deafness (SSD) and conductive or mixed hearing loss (CMHL). INTERVENTION Evaluation of atBCI. MAIN OUTCOME MEASURES Pure tone and speech audiometry and Glasgow Benefit Inventory (GBI). RESULT Thirty-three subjects were included and 29 completed all parts. The total follow-up time was 124.1 subject-years. Nineteen subjects had CMHL and in this group, pure tone averages (PTA4) were 56.6 dB HL unaided and 29.6 dB HL aided, comparable with a functional gain of 26.0 dB. Effective gain (EG) was -12.7 dB. With bilateral hearing, Word Recognition Scores (WRS) in noise were 36.5% unaided and 59.1% aided. Fourteen subjects had SSD or asymmetric hearing loss (AHL) and in this group, PTA4 were >100 dB HL unaided and 32.1 dB HL aided with the contralateral ear blocked. EG was -9.1 dB. With bilateral hearing, WRSs were 53.2% unaided and 67.9% aided. The means of the total GBI scores were 31.7 for CMHL and 23.6 for SSD/AHL. CONCLUSION Few complications occurred during the study. The atBCI is concluded to provide a safe and effective long-term hearing rehabilitation.
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Affiliation(s)
- Eleonor Koro
- Department of Clinical Sciences, Otorhinolaryngology, University of Umeå, Umeå, Sweden
| | - Elenor Lundgren
- Department of Clinical Sciences, Otorhinolaryngology, University of Umeå, Umeå, Sweden
| | - Henrik Smeds
- Department of Clinical Science, Intervention and Technology, Division of ENT Diseases, Karolinska Institute, Stockholm, Sweden
| | - Mimmi Werner
- Department of Clinical Sciences, Otorhinolaryngology, University of Umeå, Umeå, Sweden
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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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王 琴, 郭 玉, 徐 百. [Clinical research progress of bonebridge implantation]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:726-730. [PMID: 36036078 PMCID: PMC10127618 DOI: 10.13201/j.issn.2096-7993.2022.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Indexed: 06/15/2023]
Abstract
Implantable bonebridge(BB) is suitable for patients over 5 years with conductive/mixed hearing loss and unilateral deafness, and the surgical approach depends on the anatomical structure of the patient's ear. Recent studies have shown that compared with other implantable hearing devices, implantable BB have more efficient hearing gain and lower incidence of complications. However, the postoperative effect of implantable BB on unilateral deafness patients and the poor compensation of low-frequency hearing threshold need to be further studied. This article reviews the clinical research on implantable BB, so as to provide some reference for clinicians to select hearing devices for patients individually.
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Affiliation(s)
- 琴 王
- 兰州大学第二医院耳鼻咽喉头颈外科(兰州,730030)Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Lanzhou University, Lanzhou, 730030, China
| | - 玉芬 郭
- 兰州大学第二医院耳鼻咽喉头颈外科(兰州,730030)Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Lanzhou University, Lanzhou, 730030, China
| | - 百成 徐
- 兰州大学第二医院耳鼻咽喉头颈外科(兰州,730030)Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Lanzhou University, Lanzhou, 730030, China
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Cywka KB, Skarzynski PH, Krol B, Hatzopoulos S, Skarzynski H. Evaluation of the Bonebridge BCI 602 active bone conductive implant in adults: efficacy and stability of audiological, surgical, and functional outcomes. Eur Arch Otorhinolaryngol 2022; 279:3525-3534. [PMID: 35182185 PMCID: PMC9130189 DOI: 10.1007/s00405-022-07265-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/10/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE (1) To assess the effectiveness and safety of a bone-conduction implant, the Bonebridge BCI 602, in adults with conductive or mixed hearing loss. (2) To investigate whether the Bonebridge BCI 602 is at least as effective as the Bonebridge BCI 601 in such patients. METHODS The study group included 42 adults who had either conductive or mixed hearing loss. All patients underwent Bonebridge BCI 602 implant surgery. Before and after implantation, pure-tone audiometry, speech recognition tests (in quiet and noise), and free-field audiometry were performed. Word recognition scores were evaluated using the Polish Monosyllabic Word Test. Speech reception thresholds in noise were assessed using the Polish Sentence Matrix Test. Subjective assessment of benefits was done using the APHAB (Abbreviated Profile of Hearing Aid Benefit) questionnaire. RESULTS The APHAB questionnaire showed that difficulties in hearing decreased after BCI 602 implantation. Both word recognition in quiet and speech reception threshold in noise were significantly better after BCI 602 implantation and remained stable for at least 12 months. A significant advantage of the device is a reduced time for surgery while maintaining safety. In this study, the mean time for BCI 602 implantation was 28.3 min ± 9.4. CONCLUSIONS The second-generation Bonebridge BCI 602 implant is an effective hearing rehabilitation device for patients with conductive or mixed hearing loss. Patient satisfaction and audiological results confirm its efficacy and safety. Its new shape and dimensions allow it to be used in patients previously excluded due to insufficient or difficult anatomical conditions. The new BCI 602 implant is as effective as its predecessor, the BCI 601.
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Affiliation(s)
- Katarzyna B Cywka
- Otorhinolaryngosurgery Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Piotr H Skarzynski
- Teleaudiology and Screening Department, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mokra 17 Street, Nadarzyn, 05-830, Warsaw/Kajetany, Poland.
- Heart Failure and Cardiac Rehabilitation Department, Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.
- Institute of Sensory Organs, Kajetany/Warsaw, Poland.
| | - Bartlomiej Krol
- Otorhinolaryngosurgery Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | | | - Henryk Skarzynski
- Otorhinolaryngosurgery Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
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Auinger AB, Liepins R, Brkic FF, Vyskocil E, Arnoldner C. The Functional Hearing Gain with an Active Transcutaneous Bone Conduction Implant Does Not Correlate with the Subjective Hearing Performance. J Pers Med 2022; 12:jpm12071064. [PMID: 35887561 PMCID: PMC9321828 DOI: 10.3390/jpm12071064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/21/2022] [Accepted: 06/25/2022] [Indexed: 11/24/2022] Open
Abstract
The functional hearing outcome with hearing implants does not always properly reflect the subjective benefit in everyday listening situations. In this study, the functional hearing gain and the impact on the subjective hearing ability and quality of life were assessed in patients with a Bonebridge. A chart review was performed on 45 patients with a Bonebridge who were provided with questionnaires regarding the hearing quality and health-related quality of life during their last clinical visit. The questionnaires consisted of the Speech, Spatial and Qualities (SSQ) and the Health Utility Index Mark 3 (HUI3). Eleven patients had to be excluded due to missing data. A total of 34 patients (37 ears) were included in the study. Aided hearing thresholds were significantly lower compared with the unaided condition, with a mean functional gain of 26.87 dB for patients with mixed/conductive hearing loss (MHL/CHL). Although patients with single-sided deafness (SSD) scored slightly lower on the SSQ compared with patients with MHL/CHL, all included patients reported improved subjective hearing quality with the BB compared with the hearing situation before implantation. No correlation was found between the functional hearing gain and the subdomains of the SSQ. SSD patients scored the HUI3 subdomain “hearing” slightly lower compared with MHL/CHL patients. Although not significant, a relationship was found between the functional gain and the “hearing” subdomain. No correlation was found for the other subdomains of the HUI3. Audiological measurements showed significantly improved hearing thresholds with the Bonebridge. Most importantly, the subjective benefit achieved in everyday listening situations was superior compared with the previous hearing condition. The lack of correlation between subjective questionnaire results and the functional hearing gain shows the importance of assessing both audiological and subjective hearing quality parameters in clinical routine.
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AlFarraj A, AlIbrahim M, AlHajjaj H, Khater F, AlGhamdi A, Fayad J. Transcutaneous Bone Conduction Implants in Patients With Single-Sided Deafness: Objective and Subjective Evaluation. EAR, NOSE & THROAT JOURNAL 2022:1455613221099996. [PMID: 35499947 DOI: 10.1177/01455613221099996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the audiological outcomes and subjective benefits of transcutaneous bone conduction implants (BCIs) in patients with single-sided deafness (SSD). METHODS This retrospective study was conducted on 11 patients with SSD implantations between 2015 and 2018 at a tertiary center. Pure-tone audiometry, speech reception threshold (SRT), and speech-in-noise (SPIN) tests were performed. Preoperative and postoperative performances were compared. Subjective satisfaction level was assessed using validated questionnaires. A PubMed search was conducted to identify the relevant studies published to date. RESULTS All patients demonstrated significant audiological improvements compared with their preoperative condition. The mean SRT improved significantly (p = 0.001) from 109 dB to 23 dB after implantation. The mean SPIN score improved significantly after implantation. The questionnaires showed an overall positive benefit of transcutaneous bone conduction devices (BCDs). A literature search revealed 21 articles, of which 14 reported the use of BCIs in patients with SSD. Our results agree with the published evidence showing the overall benefit of BCI in patients with SSD. CONCLUSIONS Transcutaneous BCDs could be considered as an alternative treatment option for patients with SSD, it could show good audiological outcomes and high satisfaction levels. Further studies should be conducted on patients with SSD to determine the most appropriate hearing solutions.
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Affiliation(s)
- Ali AlFarraj
- ENT Unit, 432601Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Manal AlIbrahim
- ENT Unit, 432601Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Haifa AlHajjaj
- ENT Unit, 432601Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Fatima Khater
- ENT Unit, 432601Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Ali AlGhamdi
- ENT Unit, 432601Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Jose Fayad
- ENT Unit, 432601Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
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Canzi P, Avato I, Beltrame M, Bianchin G, Perotti M, Tribi L, Gioia B, Aprile F, Malpede S, Scribante A, Manfrin M, Benazzo M. Retrosigmoidal placement of an active transcutaneous bone conduction implant: surgical and audiological perspectives in a multicentre study. ACTA ACUST UNITED AC 2021; 41:91-99. [PMID: 33746228 PMCID: PMC7982754 DOI: 10.14639/0392-100x-n0609] [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: 01/15/2020] [Accepted: 04/10/2020] [Indexed: 11/25/2022]
Abstract
Introduction The retrosigmoidal (RS) placement of the Bonebridge system (BB) has been advocated for cases of unfavourable anatomical or clinical conditions which contraindicate transmastoid-presigmoidal positioning. However, these disadvantageous conditions, combined with the considerable dimensions of the implant, may represent a challenge, especially for surgeons with no skull base experience. Moreover, the literature reports only limited experience concerning RS implantation of the BB system. Methods A multicentre, retrospective study was conducted to analyse the surgical and functional outcomes of a wide population of patients undergoing RS placement of the BB system by means of a surgical technique specifically developed to overcome the intraoperative issues related to this surgery. Twenty patients with conductive or mixed hearing loss and single sided deafness were submitted to RS implantation of the BB system. Results Audiological assessment concerning the measurement of the functional and effective gain by pure-tone audiometry (28 dB HL and -12.25 dB HL, respectively) and speech audiometry (24.7 dB HL and -21 dB HL, respectively) was conducted. A high overall subjective improvement of quality of life was recorded with the Glasgow Benefit Inventory questionnaire. No major complications, such as device extrusions or other conditions requiring revision surgery, were reported during the follow-up period (median: 42 months). Conclusions In our study, which has one of the largest cohort of patients reported in the literature, RS placement of the BB system was safe and effective. Our functional results showed comparable hearing outcomes with presigmoidal placement. The effective gain, rarely investigated in this field, may be the object of further research to improve our understanding of bone conduction mechanisms exploited by bone conduction hearing implants.
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Affiliation(s)
- Pietro Canzi
- Department of Otorhinolaryngology, University of Pavia, Foundation IRCCS Policlinico "San Matteo", Pavia, Italy
| | - Irene Avato
- Department of Otorhinolaryngology, University of Pavia, Foundation IRCCS Policlinico "San Matteo", Pavia, Italy.,PhD in Experimental Medicine, University of Pavia, Italy
| | - Millo Beltrame
- Department of Otorhinolaryngology, University of Pavia, Foundation IRCCS Policlinico "San Matteo", Pavia, Italy
| | - Giovanni Bianchin
- Department of Otolaryngology and Audiology, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Marco Perotti
- Otorhinolaryngology Unit, Ospedale Civile "SS Antonio Biagio and C. Arrigo", Alessandria, Italy
| | - Lorenzo Tribi
- Department of Otolaryngology and Audiology, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Barbara Gioia
- Otorhinolaryngology Unit, Ospedale Civile "SS Antonio Biagio and C. Arrigo", Alessandria, Italy
| | - Federico Aprile
- Department of Otorhinolaryngology, University of Pavia, Foundation IRCCS Policlinico "San Matteo", Pavia, Italy
| | - Stefano Malpede
- Department of Otorhinolaryngology, University of Pavia, Foundation IRCCS Policlinico "San Matteo", Pavia, Italy
| | - Andrea Scribante
- Unit of Orthodontics and Paediatric Dentistry-Section of Dentistry-Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Marco Manfrin
- Department of Otorhinolaryngology, University of Pavia, Foundation IRCCS Policlinico "San Matteo", Pavia, Italy
| | - Marco Benazzo
- Department of Otorhinolaryngology, University of Pavia, Foundation IRCCS Policlinico "San Matteo", Pavia, Italy
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Hundertpfund J, Meyer JE, Óvári A. Patient-reported long-term benefit with an active transcutaneous bone-conduction device. PLoS One 2020; 15:e0241247. [PMID: 33137128 PMCID: PMC7605656 DOI: 10.1371/journal.pone.0241247] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 10/11/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose To evaluate the long-term benefits in hearing-related quality of life, patient satisfaction and wearing time of patients rehabilitated with an active transcutaneous bone-conduction device. Adverse events and audiological outcomes are reported as secondary outcomes. Methods This retrospective, mono-centric cohort analysis involves 16 adults with conductive or mixed hearing loss with a mean device experience of 51.25 months. Patient-reported outcome measures were assessed using the short version of the Speech, Spatial and Qualities of Hearing Scale (SSQ12-B) and the German version of the Audio Processor Satisfaction Questionnaire (APSQ). Audiological outcomes as well as incidence of adverse events were obtained from patients´ charts. Results The hearing-related quality of life improved significantly within all subscales of the SSQ12-B scoring a mean overall of 2.95 points. Patient satisfaction measured with the APSQ scored 8.8 points on average. Wearing times differed considerably and patients with lower levels of education seemed to use their device longer compared to patients with academic education. Eight minor adverse events were documented, all of which resolved during follow-up. The mean gain in word recognition score at the last follow-up measured at 65 dB was 75.9%, while speech reception threshold was lowered by 35.1 dB. Conclusion Even after several years, patients report significant benefits in hearing-related quality of life and device satisfaction. In combination with a low rate of minor adverse events and significantly improved audiological outcomes, the device is considered as a comfortable and effective option in hearing rehabilitation.
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Affiliation(s)
| | - Jens Eduard Meyer
- Asklepios Medical School, Semmelweis University, Hamburg, Germany
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Plastic Surgery, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Attila Óvári
- Asklepios Medical School, Semmelweis University, Hamburg, Germany
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Plastic Surgery, Asklepios Klinik St. Georg, Hamburg, Germany
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery “Otto Koerner”, University Medical Center, Rostock, Germany
- * E-mail:
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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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13
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Rohani SA, Bartling ML, Ladak HM, Agrawal SK. The BONEBRIDGE active transcutaneous bone conduction implant: effects of location, lifts and screws on sound transmission. J Otolaryngol Head Neck Surg 2020; 49:58. [PMID: 32778163 PMCID: PMC7418375 DOI: 10.1186/s40463-020-00454-1] [Citation(s) in RCA: 16] [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: 04/27/2020] [Accepted: 07/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The BONEBRIDGE (MED-EL, Innsbruck, Austria) is a bone-conduction implant used in the treatment of conductive and mixed hearing loss. The BONEBRIDGE consists of an external audio processor and a bone-conduction floating mass transducer that is surgically implanted into the skull in either the transmastoid, retrosigmoid or middle fossa regions. The manufacturer includes self-tapping screws to secure the transducer; however, self-drilling screws have also been used with success. In cases where the skull is not thick enough to house the transducer, lifts are available in a variety of sizes to elevate the transducer away from the skull. The objective of the present study was to investigate the effects of screw type, lift thickness, and implant location on the sound transmission of the BONEBRIDGE. METHOD Six cadaveric temporal bones were embalmed and dried for use in this study. In each sample, a hole was drilled in each of the three implant locations to house the implant transducer. At the middle fossa, six pairs of screw holes were pre-drilled; four pairs to be used with self-tapping screws and lifts (1, 2, 3, and 4 mm thick lifts, respectively), one pair with self-tapping screws and no lifts, and one pair with self-drilling screws and no lifts. At the transmastoid and retrosigmoid locations, one pair of screw holes were pre-drilled in each for the use of the self-tapping screws. The vibration of transmitted sound to the cochlea was measured using a laser Doppler vibrometry technique. The measurements were performed on the cochlear promontory at eight discrete frequencies (0.5, 0.75, 1, 1.5, 2, 3, 4 and 6 kHz). Vibration velocity of the cochlear wall was measured in all samples. Measurements were analyzed using a single-factor ANOVA to investigate the effect of each modification. RESULTS No significant differences were found related to either screw type, lift thickness, or implant location. CONCLUSIONS This is the first known study to evaluate the effect of screw type, lift thickness, and implant location on the sound transmission produced by the BONEBRIDGE bone-conduction implant. Further studies may benefit from analysis using fresh cadaveric samples or in-vivo measurements.
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Affiliation(s)
- Seyed Alireza Rohani
- Department of Otolaryngology - Head and Neck Surgery, Western University, London, Canada
| | | | - Hanif M Ladak
- Department of Otolaryngology - Head and Neck Surgery, Western University, London, Canada
- Department of Medical Biophysics, Western University, London, Canada
- Department of Electrical and Computer Engineering, Western University, London, Canada
- National Centre for Audiology, Western University, London, Canada
| | - Sumit K Agrawal
- Department of Otolaryngology - Head and Neck Surgery, Western University, London, Canada.
- National Centre for Audiology, Western University, London, Canada.
- Cochlear Implant Program, London Health Sciences Centre, London, Canada.
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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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Lau K, Scotta G, Wright K, Proctor V, Greenwood L, Dawoud M, Ray J. First United Kingdom experience of the novel Osia active transcutaneous piezoelectric bone conduction implant. Eur Arch Otorhinolaryngol 2020; 277:2995-3002. [PMID: 32405815 DOI: 10.1007/s00405-020-06022-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/27/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Bone conduction hearing devices are widely used and indicated in cases of conductive, mixed or single-sided deafness where the conventional hearing aids are not indicated or tolerated. This prospective study aims to investigate the surgical and hearing outcomes of a novel active piezoelectric transcutaneous bone conduction device (t-BCD). METHODS Prospective data were collected from the first 10 patients who underwent implantation with the t-BCD Osia (Cochlear, Australia) (between Dec 2018 and March 2019) in a tertiary referral centre. The main outcome measures include: surgical outcome, free field speech testing with speech recognition thresholds, audiological gain and patient-reported outcomes including the 'Glasgow Benefit Inventory' (GBI) and the 'Client Oriented Scale of Improvement (COSI). RESULTS The mean length of surgery was 70.6 min (range 50-87, SD = 9.5). Mean skin thickness measured was 5.6 mm (range 4-8, SD = 1.1). There were two post-operative wound infections which settled conservatively. One required revision surgery to thin skin. The average gain in hearing with the implant was + 39.4 dB. Pre-implantation mean unaided SRT was 38.1 dB (SD = 7.8) and the post-implantation mean-aided SRT was 22.7 dB (SD = 4.6) (p = 0.000078). There was improvement in COSI domains. The mean Glasgow disability score dropped from 52% pre-implantation to 20% post-implantation (p = 0.001). CONCLUSIONS This new active t-BCHD provides excellent audiological gain and improvement in speech recognition. Patient-reported outcomes have also been very positive. The surgery was straightforward with no major surgical complications reported. Further studies will be required to examine long-term outcomes in larger number of patients.
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Affiliation(s)
- Kimberley Lau
- Otolaryngology Department, Sheffield Teaching Hospitals, Sheffield, UK. .,ENT Department, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK.
| | - Gianluca Scotta
- Otolaryngology Department, Sheffield Teaching Hospitals, Sheffield, UK.,ENT Department, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK
| | - Kay Wright
- Hearing Services, Sheffield Teaching Hospitals, Sheffield, UK
| | - Vicki Proctor
- Hearing Services, Sheffield Teaching Hospitals, Sheffield, UK
| | | | - Moustafa Dawoud
- Otolaryngology Department, Sheffield Teaching Hospitals, Sheffield, UK.,ENT Department, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK
| | - Jaydip Ray
- Otolaryngology Department, Sheffield Teaching Hospitals, Sheffield, UK.,ENT Department, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK
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Magele A, Schoerg P, Stanek B, Gradl B, Sprinzl GM. Active transcutaneous bone conduction hearing implants: Systematic review and meta-analysis. PLoS One 2019; 14:e0221484. [PMID: 31525208 PMCID: PMC6746395 DOI: 10.1371/journal.pone.0221484] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 08/07/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In July 2018 the active transcutaneous bone conduction hearing implant received FDA approval in the US (for patients 12 years and older with conductive and/or mixed hearing loss or single-sided deafness), reflecting the current trend of moving away from percutaneous hearing solutions towards intact skin systems. OBJECTIVES To critically assess the current literature on safety, efficacy and subjective benefit after implantation with an active transcutaneous bone conduction hearing device. DATA SOURCES Literature investigation was performed by electronic database search including PubMed and Cochrane Central Register of Controlled Trials, and manual search of relevant journals and reference lists of included studies. STUDY ELIGIBILITY CRITERIA Randomized controlled trials, clinical controlled trials and cohort studies, case series and case reports investigating subjective and objective outcomes. STUDY APPRAISAL AND SYNTHESIS METHODS Retrieved literature was screened and extracted by two reviewers independently. Subgroup analysis of indications (conductive and/or mixed hearing loss, single-sided deafness) and participant ages (pediatric vs. adults) was conducted on patients with active transcutaneous bone conduction devices. Sensitivity analysis was performed to test the stability of the results in meta-analysis. RESULTS 39 citations reporting on pre- and postoperative audiological results, speech performance in quiet and in noise, localization testing as well as subjective outcomes were included in this systematic review. Functional gain as well as word recognition score outcomes could be further investigated via meta-analysis. All outcomes reported and summarized here reflect beneficial audiological performance and high patient satisfaction, accompanied with a low complications rate (minor event incidence rate: 9.9 person-years; major incidence rate: 148.9 person-years) for the indications of conductive and mixed hearing loss as well as in individuals suffering from single-sided deafness for all age groups of subjects who underwent active transcutaneous bone conduction hearing device implantation. LIMITATIONS A limiting factor of this systematic review was the Level of Evidence of the reviewed literature, comprising 2a/3a studies (cohort studies and case-control studies). Furthermore, the reporting standards, especially in outcomes such as word recognition scores in quiet and in noise, vary across study cites from various countries, which impedes comparisons. Last but not least, no other comparable other device was retrieved as the active transcutaneous bone conduction hearing device is the only available at the moment. CONCLUSION The device's transcutaneous technology results in a minor event incidence rate of one in 9.9 person-years and a major incidence rate of one in 148.9 person-years. Based on the audiological outcomes, high patient satisfaction as well as the low complication rate, the authors recommend the active transcutaneous bone conduction hearing device as a safe and effective treatment for patients suffering from hearing loss within the device's indication criteria (conductive and/or mixed hearing loss or single-sided deafness).
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Affiliation(s)
- Astrid Magele
- University Clinic St. Poelten, Department of Otorhinolaryngology, Head & Neck Surgery, St. Poelten, Austria
- Karl Landsteiner Institute of Implantable Hearing Devices, St. Poelten, Austria
| | - Philipp Schoerg
- University Clinic St. Poelten, Department of Otorhinolaryngology, Head & Neck Surgery, St. Poelten, Austria
- Karl Landsteiner Institute of Implantable Hearing Devices, St. Poelten, Austria
| | - Barbara Stanek
- University Clinic St. Poelten, Department of Otorhinolaryngology, Head & Neck Surgery, St. Poelten, Austria
| | - Bernhard Gradl
- University Clinic St. Poelten, Department of Otorhinolaryngology, Head & Neck Surgery, St. Poelten, Austria
| | - Georg Mathias Sprinzl
- University Clinic St. Poelten, Department of Otorhinolaryngology, Head & Neck Surgery, St. Poelten, Austria
- Karl Landsteiner Institute of Implantable Hearing Devices, St. Poelten, Austria
- * E-mail:
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17
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Alzhrani F. Objective and subjective results of the Bonebridge transcutaneous active direct-drive bone conduction hearing implant. Saudi Med J 2019; 40:797-801. [PMID: 31423516 PMCID: PMC6718859 DOI: 10.15537/smj.2019.8.24383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: To investigate the effectiveness of a bone-anchored hearing implant system (Bonebridge implant technology) as a rehabilitation treatment for individuals with conductive or mixed hearing losses. Methods: This is a retrospective cohort study. Twelve implanted ears with conductive or mixed hearing losses were implanted with this device at a tertiary university hospital between 2012 and 2016. Audiological tests included pure tone air conduction (AC) and bone conduction (BC) measurements and unaided and aided sound-field thresholds. To evaluate the speech intelligibility in a quiet environment, the speech discrimination score (SDS) was tested using Arabic monosyllabic words, and the speech reception threshold (SRT) was measured using Arabic disyllabic words spoken in front of them. The subjective sound quality was assessed with the Hearing Implant Sound Quality Index (HISQUI). Results: In comparison with the unaided condition, there was a significant improvement in the aided thresholds, SDS, and SRT. Comparing the aided and unaided thresholds, the average AC threshold improved with an average functional gain of 40±6.3dB. The unaided SRT improved from 72.5 dB hearing levels (HL)(median) to 27.5 dB HL (median) when aided, and patients performed 71% better, on average, based on the SDS with the help of the device. The HISQUI questionnaire revealed high satisfaction with the device sound quality. Conclusion: Patients with conductive and mixed hearing loss substantially benefit from the Bonebridge active transcutaneous BC hearing implant.
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Affiliation(s)
- Farid Alzhrani
- King Abdullah Ear Specialist Center, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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18
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Svrakic M, Vambutas A. Medical and Audiological Indications for Implantable Auditory Devices. Otolaryngol Clin North Am 2019; 52:195-210. [DOI: 10.1016/j.otc.2018.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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19
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Ratuszniak A, Skarzynski PH, Gos E, Skarzynski H. The Bonebridge implant in older children and adolescents with mixed or conductive hearing loss: Audiological outcomes. Int J Pediatr Otorhinolaryngol 2019; 118:97-102. [PMID: 30599287 DOI: 10.1016/j.ijporl.2018.12.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/17/2018] [Accepted: 12/19/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION For children with conductive or mixed hearing loss, in whom use of conventional hearing aids is impossible or limited, use of bone conduction devices is recommended. The choice between the available types of devices depends mostly on the degree of hearing loss, age, and anatomical conditions. One device application in children older than 5 years is the Bonebridge implant. The aim of this study is to assess the benefits and safety of this device in children. METHODS The material was a group of 11 older children and adolescents aged 10-17 years (mean = 14.7, SD = 2.45) with single-sided or bilateral conductive or mixed hearing loss, implanted unilaterally with the Bonebridge system at the World Hearing Center in Kajetany near Warsaw between 2014 and 2016. Benefits of the Bonebridge were assessed with warble tone audiometry and word audiometry in free field, as well as an APHAB (Abbreviated Profile of Hearing Aid Benefit) questionnaire before and after implantation. RESULTS Hearing tests showed a statistically significant improvement in hearing sensitivity and speech discrimination. Results of the questionnaire confirm the benefits of Bonebridge implantation to the older children in terms of their auditory performance under various acoustic conditions. CONCLUSIONS At a one-year follow up the Bonebridge system was found to be a safe, efficient, and effective tool for compensating for conductive or mixed hearing loss in older children and adolescents. For good anatomical conditions the Bonebridge implant provides a safe alternative to other popular bone conduction systems.
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Affiliation(s)
- Anna Ratuszniak
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Otorhinolaryngology Surgery Clinic, Mokra 17 Str., 05-830, Kajetany, Poland.
| | - Piotr Henryk Skarzynski
- Institute of Sensory Organs, Kajetany, Mokra 1 Str., 05-830, Kajetany, Poland; Heart Failure and Cardiac Rehabilitation Department, Second Faculty, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland; Institute of Physiology and Pathology of Hearing, World Hearing Center, Teleaudiology Department, Mokra 17 Str., 05-830, Kajetany, Poland
| | - Elzbieta Gos
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Teleaudiology Department, Mokra 17 Str., 05-830, Kajetany, Poland
| | - Henryk Skarzynski
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Otorhinolaryngology Surgery Clinic, Mokra 17 Str., 05-830, Kajetany, Poland
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Abstract
Bonebridge is an active bone conduction device that consists of a bone conduction-floating mass transducer (BC-FMT) and magnet internally and an audio processor externally. Surgery for implantation can be performed under local anesthesia but requires surgical planning for adequate bone depth for the BC-FMT well. Bonebridge does not require osseointegration to function, so the device can be activated early. One disadvantage of Bonebridge is the sizable artifact on MRI created by the internal magnet. Studies of Bonebridge implantation demonstrate few complications, and hearing outcomes are audiologically equivalent to other bone conduction devices.
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Affiliation(s)
- Mia E Miller
- House Clinic, 2100 West 3rd Street, Suite 111, Los Angeles, CA 90057, USA.
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21
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Positioning a Novel Transcutaneous Bone Conduction Hearing Implant: a Systematic Anatomical and Radiological Study to Standardize the Retrosigmoid Approach, Correlating Navigation-guided, and Landmark-based Surgery. Otol Neurotol 2018; 39:458-466. [DOI: 10.1097/mao.0000000000001734] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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Zanetti D, Di Berardino F. A Bone Conduction Implantable Device as a Functional Treatment Option in Unilateral Microtia with Bilateral Stapes Ankylosis: A Report of Two Cases. AMERICAN JOURNAL OF CASE REPORTS 2018; 19:82-89. [PMID: 29358571 PMCID: PMC5789751 DOI: 10.12659/ajcr.904907] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Implantable devices have been proposed as an alternative to hearing aids and auditory canal reconstruction in patients with microtia (congenital aural atresia), which includes a malformation of the external and middle ear. This report is of two rare cases of microtia associated with congenital stapes ankylosis treated with an implantable device and describes the treatment outcomes. CASE REPORT Two siblings from Ecuador, a 29-year-old woman, and her 35-year-old brother, were born with unilateral type II microtia with bilateral external auditory canal atresia and conductive hearing loss. Pre-operatively, high-resolution computed tomography (HRCT) imaging was performed using FastView software to allow placement of a bone conduction-floating mass transducer (BC-FMT) to couple a Bonebridge bone conduction implant (BCI) system in both patients. Pure-tone audiometry (PTA) testing and speech audiology were performed. The Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Speech, Spatial and Qualities (SSQ) of hearing scale questionnaires and scoring systems were used. Following activation of the implantable device, both patients achieved improved bilateral conductive hearing with sound-field (field-free) thresholds >25 dB, and speech recognition scores >90%. In both cases, hearing improvement remained at three years following surgery. CONCLUSIONS To our knowledge, these are the first reported cases of microtia with congenital stapes ankylosis successfully treated with a bone conduction implantable device. Patients with microtia and stapes ankylosis who are reluctant to undergo surgery may benefit from unilateral or bilateral, short-term or long-term use of a Bonebridge bone conduction implantable device.
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Affiliation(s)
- Diego Zanetti
- Audiology Unit, Department of Clinical Science and Community Health, University of Milano, IRCCS Fondazione Cà Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Federica Di Berardino
- Audiology Unit, Department of Clinical Science and Community Health, University of Milano, IRCCS Fondazione Cà Granda, Ospedale Maggiore Policlinico, Milano, Italy
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Monini S, Bianchi A, Talamonti R, Atturo F, Filippi C, Barbara M. Patient satisfaction after auditory implant surgery: ten-year experience from a single implanting unit center. Acta Otolaryngol 2017; 137:389-397. [PMID: 27918233 DOI: 10.1080/00016489.2016.1258733] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
CONCLUSIONS The satisfaction rate of the subjects with an auditory implant appears strictly related to the resulting auditory improvement, and the surgical variables would play a prevailing role in respect to the esthetic factors. OBJECTIVES To assess the rate of satisfaction in subjects who underwent the surgical application of an auditory device at a single Implanting Center Unit. METHOD A series of validated questionnaires has been administered to subjects who underwent the surgical application of different auditory devices. The Glasgow Benefit Inventory (GBI), the Visual Analog Scale (VAS), and the Abbreviated Profile of Hearing Aid Benefit (APHAB) have been used to compare the implanted situation with the hearing-aided one; a percutaneous bone conductive implant (pBCI) with an active middle ear implant (AMEI) on the round window in mixed hearing loss; and an invisible, fully-implantable device with a frankly and bulky semi-implantable device. RESULTS The mean GBI scores were higher in Vibrant Soundbridge (VSB)® and Bonebridge® subjects, without significant differences among the various devices. The mean VAS score increased for all the devices in comparison with the conventional hearing aid. The mean APHAB score was similarly better in the implanted condition as total and partial scores.
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Affiliation(s)
- Simonetta Monini
- NESMOS Department, ENT Clinic, Medicine and Psychology, Sapienza University, Rome, Italy
| | - Alessandra Bianchi
- NESMOS Department, ENT Clinic, Medicine and Psychology, Sapienza University, Rome, Italy
| | - Rita Talamonti
- NESMOS Department, ENT Clinic, Medicine and Psychology, Sapienza University, Rome, Italy
| | - Francesca Atturo
- NESMOS Department, ENT Clinic, Medicine and Psychology, Sapienza University, Rome, Italy
| | - Chiara Filippi
- NESMOS Department, ENT Clinic, Medicine and Psychology, Sapienza University, Rome, Italy
| | - Maurizio Barbara
- NESMOS Department, ENT Clinic, Medicine and Psychology, Sapienza University, Rome, Italy
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Mandavia R, Carter A, Haram N, Mossialos E, Schilder A. An evaluation of the quality of evidence available to inform current bone conducting hearing device national policy. Clin Otolaryngol 2017; 42:1000-1024. [DOI: 10.1111/coa.12831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2017] [Indexed: 11/28/2022]
Affiliation(s)
- R. Mandavia
- evidENT; Ear Institute; University College London; London UK
| | - A.W. Carter
- Centre for Health Policy; Imperial College London; London UK
| | - N. Haram
- Wound Healing Research Group; Royal Free Hospital; London UK
| | - E. Mossialos
- Centre for Health Policy; Imperial College London; London UK
| | - A.G.M. Schilder
- evidENT; Ear Institute; University College London; London UK
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Ihler F, Blum J, Berger MU, Weiss BG, Welz C, Canis M. The Prediction of Speech Recognition in Noise With a Semi-Implantable Bone Conduction Hearing System by External Bone Conduction Stimulation With Headband: A Prospective Study. Trends Hear 2016; 20:2331216516669330. [PMID: 27698259 PMCID: PMC5051673 DOI: 10.1177/2331216516669330] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 08/24/2016] [Accepted: 08/24/2016] [Indexed: 02/05/2023] Open
Abstract
Semi-implantable transcutaneous bone conduction devices are treatment options for conductive and mixed hearing loss (CHL/MHL). For counseling of patients, realistic simulation of the functional result is desirable. This study compared speech recognition in noise with a semi-implantable transcutaneous bone conduction device to external stimulation with a bone conduction device fixed by a headband. Eight German-language adult patients were enrolled after a semi-implantable transcutaneous bone conduction device (Bonebridge, Med-El) was implanted and fitted. Patients received a bone conduction device for external stimulation (Baha BP110, Cochlear) fixed by a headband for comparison. The main outcome measure was speech recognition in noise (Oldenburg Sentence Test). Pure-tone audiometry was performed and subjective benefit was assessed using the Glasgow Benefit Inventory and Abbreviated Profile of Hearing Aid Benefit questionnaires. Unaided, patients showed a mean signal-to-noise ratio threshold of 4.6 ± 4.2 dB S/N for speech recognition. The aided results were -3.3 ± 7.2 dB S/N by external bone conduction stimulation and -1.2 ± 4.0 dB S/N by the semi-implantable bone conduction device. The difference between the two devices was not statistically significant, while the difference was significant between unaided and aided situation for both devices. Both questionnaires for subjective benefit favored the semi-implantable device over external stimulation. We conclude that it is possible to simulate the result of speech recognition in noise with a semi-implantable transcutaneous bone conduction device by external stimulation. This should be part of preoperative counseling of patients with CHL/MHL before implantation of a bone conduction device.
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Affiliation(s)
- Friedrich Ihler
- Department of Otorhinolaryngology, University Medical Center Göttingen, Georg-August-University Göttingen, Germany
| | - Jenny Blum
- Department of Otorhinolaryngology, University Medical Center Göttingen, Georg-August-University Göttingen, Germany
| | - Max-Ulrich Berger
- Department of Otorhinolaryngology, University Medical Center Göttingen, Georg-August-University Göttingen, Germany Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Hamburg-Eppendorf (UKE), University of Hamburg, Germany
| | - Bernhard G Weiss
- Department of Otorhinolaryngology, University Medical Center Göttingen, Georg-August-University Göttingen, Germany
| | - Christian Welz
- Department of Otorhinolaryngology, University Medical Center Göttingen, Georg-August-University Göttingen, Germany
| | - Martin Canis
- Department of Otorhinolaryngology, University Medical Center Göttingen, Georg-August-University Göttingen, Germany
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Safety and effectiveness of the Bonebridge transcutaneous active direct-drive bone-conduction hearing implant at 1-year device use. Eur Arch Otorhinolaryngol 2016; 274:1835-1851. [DOI: 10.1007/s00405-016-4228-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 07/23/2016] [Indexed: 10/21/2022]
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Postoperative pain in patients undergoing a transcutaneous active bone conduction implant (Bonebridge). Eur Arch Otorhinolaryngol 2016; 273:4103-4110. [DOI: 10.1007/s00405-016-3972-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 03/05/2016] [Indexed: 10/22/2022]
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