Clinical experience of an adhesive bone conduction hearing system in children with congenital single-sided deafness

OBJECTIVES

This study aimed to investigate the effects of an adhesive bone conduction device (aBCD) in children with congenital single-sided deafness (SSD). Specifically, we examined whether the aBCD elicits improvement in the speech perception ability of children with congenital SSD and whether using this device would adversely affect the horizontal localisation abilities of these children.

METHODS

Thirteen school-aged children with SSD and seven children with Normal Hearing (NH) were included in this study. Speech perception in noise was measured using the Mandarin Speech Test Materials and sound localisation performance was evaluated using broadband noise stimuli (0.5-20 kHz), randomly played from seven loudspeakers at different stimulus levels (65-, 70-, and 75-dB SPL).

RESULTS

All children with SSD showed inferior speech perception and sound localisation performance compared with children with NH. The aBCD use remarkably improved the speech perception abilities of these children under quiet and noise conditions; however, their sound localisation abilities neither improved nor deteriorated.

CONCLUSION

This study reveals the effectiveness and safety of a non-surgical aBCD in paediatric patients with SSD. Our results provide a theoretical basis for early hearing intervention with an aBCD in children with congenital SSD who are temporarily unable to undergo ear surgery.

LEVEL OF EVIDENCE

Level 3.

Effects of SoundBite Bone Conduction Hearing Aids on Speech Recognition and Quality of Life in Patients with Single-Sided Deafness

Objectives

To analyze the clinical application of SoundBite bone conduction hearing aids by assessing the improvement of speech recognition and the scores of the benefit scale questionnaire for patients with single-sided deafness (SSD).

Design

Nine patients aged 24 to 61 years with SSD for more than 3 months were enrolled in this study. The patients could understand and repeat Mandarin and have good compliance with the study. The measurements were evaluated before and after one month of wearing hearing aids using the pure tone audiometry threshold, speech recognition in quiet and in noise, and the Glasgow Benefit Inventory (GBI) benefit scale score.

Results

Pure tone audiometry results showed that the average hearing threshold of good ears and bad ears was 11.4 ± 2.6 dB HL and 89.9 ± 6.4 dB HL, respectively. The average hearing threshold of bad ears after wearing hearing aids was 23.5 ± 9.0 dB HL. Statistical analysis showed that the hearing improvement for the bad ears after wearing hearing aids was significant. The speech audiometry results showed that the disyllable word recognition score of the bad ears in quiet increased significantly at 50 dB SPL by 40 ± 12 percentage points and at 65 dB SPL by 71 ± 15 percentage points. As for the speech recognition in noise, when the signal sound came from the bad ear side and the noise from the good ear side (S_SSDN_AH), the speech recognition score (SRS) significantly increased by 17 ± 6 and 9 ± 4 at a signal-to-noise ratio (SNR) of -2 dB and -5 dB, respectively, after wearing the hearing aids. When the signal sound came from the front of the patient and the noise from the bad ear side (S₀N_SSD), the SRS scores were reduced by 5 ± 5 and 7 ± 5 percentage points at SNR equal to -2 dB and -5 dB, which was significantly different from that before wearing the hearing aids. When the signal and noise both came from the front of the patients (S₀N₀), the SRS was not significantly increased by 5 ± 4 percentage points at SNR equal to -2 dB compared to before wearing hearing aids. However, the SRS was significantly increased by 5 ± 2 percentage points at SNR equal to -5 dB compared to before wearing hearing aids. The average total GBI score was 31 ± 12 for the nine patients, with an average score of 32 ± 10, 31 ± 8, and 30 ± 7 for general conditions, social support, and physical health, respectively. The results of the questionnaires showed that patients' quality of life was improved after wearing SoundBite bone conduction hearing aids.

Conclusions

SoundBite bone conduction hearing aids are a good choice for patients with SSD, as it could improve the speech recognition ability of patients both in a quiet and noisy environment and improves the quality of life after wearing hearing aids.

Transcutaneous bone conductive implants in patients with conductive/mixed hearing loss: audiological outcomes in noise condition

BACKGROUND

Recently, the use of transcutaneous bone conduction implants (BCIs) has been increased. However, scarce data about BCI hearing recovery in noise conditions have been reported.

OBJECTIVES

To investigate the audiological benefits obtained with transcutaneous BCI-Sophono Alpha System in noise conditions. To evaluate post-implantation clinical outcomes and patient satisfaction levels.

MATERIALS AND METHODS

Fourteen patients suffering from conductive or mixed hearing loss implanted with the Sophono Alpha System were evaluated. Patients underwent physical examination, free-field pure-tone and speech audiometry both in unaided and aided conditions. The matrix sentence test was employed with fixed noise at 65 dB, and with a fluctuating primary signal, in three different conditions of noise presentations (S0/N0, S0/Ncontra, S0/Nipsi).

RESULTS

Hearing gain, expressed as the difference between pre-implant AC and post-implant SAS free field, was on average 26.7 dB. The unaided speech recognition score in quiet conditions had a mean value of 64.6%, and improved after SAS implantation, achieving mean values of 98.2%. SRT₅₀ with the matrix sentence test improved in all three conditions of noise presentation.

CONCLUSIONS

Sophono Alpha System devices represent a valid treatment option for hearing rehabilitation of patients with conductive or mixed hearing loss. The audiological results regarding hearing gain in noise conditions were good.

Fluctuating Hearing Loss in the Only Hearing Ear: Cochlear Implantation in the Contralateral Deaf Side

Objective To investigate the hearing performance of adult patients presenting unilateral deafness with contralateral fluctuating hearing loss who received a cochlear implant on the deaf side. Study Design Case series with chart review. Setting University tertiary referral center. Subjects and Methods Preoperatively and at 6 and 12 months postoperatively, 23 patients underwent pure tone audiometry and speech audiometry with disyllabic and monosyllabic words in a quiet environment and sentences in quiet and noisy (signal-to-noise ratio +10 dB SPL) environments under best-aided conditions. The Abbreviated Profile of Hearing Aid Benefit (APHAB) inventory was evaluated preoperatively and at 6 and 12 months postoperatively. Results No difference was found between pre- and postoperative tests for disyllabic and monosyllabic words. For sentences in quiet and noisy environments, a difference between pre- and postoperative performance was present at 1 year ( P = .002 and P = .02, respectively). In a noisy environment, a difference was present at 6 and 12 months postoperatively as compared with the preoperative value (mean ± SD: 6 months: 42% ± 7.1% vs 61% ± 6.5%, P = .016). A significant improvement in the APHAB score was found at 6 and 12 months postimplantation (Friedman's 2-way analysis of variance by ranks, P < .001). The number of years of hearing deprivation of the deaf ear was not correlated with performance. Conclusion When incapacitating fluctuating hearing loss occurs in patients presenting a contralateral deaf ear, a cochlear implant is indicated in the latter ear, significantly improving performance in noisy conditions and allowing a better quality of communication to be achieved.

Preliminary audiologic and peri-operative outcomes of the Sophono™ transcutaneous bone conduction device: A systematic review

OBJECTIVE

To delineate the auditory functional improvement and peri-operative outcomes of the Sophono™ transcutaneous bone conduction device.

METHODS

Eligible articles presenting patients implanted with the Sophono™ were identified through a comprehensive search of PubMed and Embase electronic databases. All relevant articles were reviewed to justify inclusion independently by 2 authors. Studies that successfully passed critical appraisal for directness of evidence and risk of bias were included.

RESULTS

From a total of 125 articles, 8 studies encompassing 86 patients using 99 implants were selected. Most patients (79.1%) were children. Ear atresia (67.5%) was the most frequently reported indication for Sophono™ implantation. Overall pure tone average auditory improvement was 31.10 (±8.29) decibel. During a mean follow-up time of 12.48 months, 25 patients (29%) presented with post-operative complications from which 3 were deemed as serious implant-related adverse events (3.5%).

CONCLUSIONS

The Sophono™ transcutaneous bone conduction device shows promising functional improvement, no intra-operative complications and minor post-operative skin related complications. If suitable, the device could be a proposed solution for the rehabilitation of hearing in children meeting eligibility criteria. A wearing schedule must be implemented in order to reduce magnet-related skin complications.