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Yakawa S, Sugiuchi T, Myojin R, Sato K, Murakami T, Miyoshi Y, Sugio Y. Management of Cartilage Conduction Hearing Aids in Pediatric Patients. Audiol Res 2023; 13:871-888. [PMID: 37987334 PMCID: PMC10660859 DOI: 10.3390/audiolres13060076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/22/2023] Open
Abstract
Forty-nine children who started wearing cartilage conduction hearing aids (CC-HAs) before completing elementary school (17 with bilateral hearing loss and 32 with unilateral hearing loss) were followed-up and examined. The wearing and utilization status of the CC-HA and its progress to date were evaluated. In addition, 33 participants who purchased the CC-HAs were interviewed to assess the wearing effect. Eleven of seventeen children with bilateral hearing loss and 25 of 32 children with unilateral hearing loss continued to use the CC-HAs. In terms of wearing effect, a good wearing effect was reported, even by those with unilateral hearing loss. In cases where it was difficult to wear CC-HAs stably with pasting or ear tips, it was possible to fix them stably using commercially available hair bands and eyeglass vines. In two cases, the CC-HAs were worn from infancy. With ingenuity and appropriate educational and medical support, it is possible to wear CC-HAs from infancy.
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Affiliation(s)
- Satomi Yakawa
- Department of Otolaryngology, Sugiuchi Clinic, 2-7-4 Jiyugaoka, Meguro-ku, Tokyo 152-0035, Japan (R.M.)
- Kotoba no Mori—Child Development Support and After-School Daycare Facility, 2-7-4-2F Jiyugaoka, Meguro-ku, Tokyo 152-0035, Japan
| | - Tomoko Sugiuchi
- Department of Otolaryngology, Sugiuchi Clinic, 2-7-4 Jiyugaoka, Meguro-ku, Tokyo 152-0035, Japan (R.M.)
- Kotoba no Mori—Child Development Support and After-School Daycare Facility, 2-7-4-2F Jiyugaoka, Meguro-ku, Tokyo 152-0035, Japan
- Department of Otolaryngology, Kanto Rosai Hospital, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki-shi 211-8510, Kanagawa, Japan
| | - Rika Myojin
- Department of Otolaryngology, Sugiuchi Clinic, 2-7-4 Jiyugaoka, Meguro-ku, Tokyo 152-0035, Japan (R.M.)
- Kotoba no Mori—Child Development Support and After-School Daycare Facility, 2-7-4-2F Jiyugaoka, Meguro-ku, Tokyo 152-0035, Japan
| | - Kiyoko Sato
- Kotoba no Mori—Child Development Support and After-School Daycare Facility, 2-7-4-2F Jiyugaoka, Meguro-ku, Tokyo 152-0035, Japan
- Department of Communication Sciences and Disorders, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara-shi 723-0053, Hiroshima, Japan
| | - Takako Murakami
- Kawasaki City Central Rehabilitation Centre, 3-16-1 Ida, Nakahara-ku, Kawasaki-shi 211-0035, Kanagawa, Japan
| | - Yuki Miyoshi
- Department of Otolaryngology, Kanto Rosai Hospital, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki-shi 211-8510, Kanagawa, Japan
| | - Yuichiro Sugio
- Department of Otolaryngology, Kanto Rosai Hospital, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki-shi 211-8510, Kanagawa, Japan
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Abstract
Congenital anomalies of the external auditory canal (EAC) are classically divided into congenital aural atresia (CAA) and congenital aural stenosis (CAS). CAA can present as an isolated anomaly, unilateral or bilateral, or in the setting of a craniofacial syndrome. Hearing testing (ABR with air and bone conduction thresholds for both ears) early in the perinatal period is important to document hearing thresholds. Hearing status thus informs parent counseling on options for hearing habilitation: Bone conducting technology is a must for children with bilateral CAA to support normal speech and language development. Bone conducting technology should be considered for children with unilateral CAA; benefits are unclear. In select candidates, atresia repair can provide improved hearing with a clean, dry, epithelialized ear canal. First branchial cleft cyst or sinus is rare; high index of suspicion is needed to diagnose along with high-resolution CT. Congenital aural stenosis (CAS) is a rare condition, and hearing testing should be similar to that in children with CAA. Early (age 4-5) CT imaging is recommended in the setting of a canal <2 mm or pinpoint canal to evaluate for trapped skin/ear canal cholesteatoma.
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Affiliation(s)
- Daniel Morrison
- Department of Otolaryngology-Head and Neck Surgery, University of Virginia School of Medicine, University of Virginia Department of Otolaryngology, Box 800713, Charlottesville, VA, USA
| | - Bradley Kesser
- Department of Otolaryngology-Head and Neck Surgery, University of Virginia School of Medicine, University of Virginia Department of Otolaryngology, Box 800713, Charlottesville, VA, USA.
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Li B, Lee S, Cao Z, Koike T, Joseph R, Brown TH, Zhao F. A Systematic Review of the Audiological Efficacy of Cartilage Conduction Hearing Aids and the Factors Influencing Their Clinical Application. Audiol Res 2023; 13:636-650. [PMID: 37622931 PMCID: PMC10451753 DOI: 10.3390/audiolres13040055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
This systematic review evaluates the efficacy and benefit of cartilage conduction hearing aids (CC-HAs) and that factors that influence purchasing decisions. The hearing thresholds and functional gain following CC-HA wear were synthesised. A one-way analysis of variance compared the differences in the hearing thresholds and functional gain at individual frequencies and in patients with a variety of pathological changes. The synchronised aided hearing threshold and functional gain at 2.0 kHz were significantly better than at 0.5, 1.0, and 4.0 kHz. There was no significant difference in the synchronised unaided hearing thresholds across individual frequencies between 0.5 and 4.0 kHz. The synchronised functional gain in patients with atresia was significantly greater than in patients with aural atresia or stenosis and middle ear pathologies with normal ear canals. The acceptability of CC-HAs in terms of purchase decision is influenced by the condition of the external auditory meatus and severity of hearing loss, with the highest purchase rate seen in patients with aural atresia or stenosis. CC-HAs' fitting procedure advantages and cosmetic considerations make these devices a viable and preferred choice for individuals with microtia and aural atresia. Additional research to evaluate the benefits towards emotional well-being is crucial to gain insights into the psychological impact of CC-HA use.
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Affiliation(s)
- Bei Li
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF5 2YB, UK;
- Department of Otolaryngology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
| | - Sinyoung Lee
- Department of Mechanical Engineering, Faculty of Engineering, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, Yamanashi 400-8511, Japan;
| | - Zuwei Cao
- Centre for Rehabilitative Auditory Research, Guizhou Provincial People’s Hospital, Guiyang 550002, China;
| | - Takuji Koike
- Department of Mechanical and Intelligent Systems Engineering, Graduate School of Informatics and Engineering, The University of Electro-Communications, Chofu 182-8585, Japan;
| | - Robin Joseph
- King Edward VII Hospital, Berkshire NHS Foundation Trust, Winsor SL4 3DP, UK;
| | | | - Fei Zhao
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF5 2YB, UK;
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Nishimura T, Hosoi H, Shimokura R, Kitahara T. Cartilage Conduction Hearing Aids in Clinical Practice. Audiol Res 2023; 13:506-515. [PMID: 37489381 PMCID: PMC10366921 DOI: 10.3390/audiolres13040045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/07/2023] [Accepted: 07/11/2023] [Indexed: 07/26/2023] Open
Abstract
A relatively loud sound is audible when a vibrator is attached to the aural cartilage. This form of conduction is referred to as cartilage conduction (CC). In Japan, a new type of hearing aid has been developed using CC and has been available in clinical practice since 2017. A clinical study conducted prior to its launch demonstrated its benefits, particularly in patients with aural atresia who were unable to use air conduction hearing aids. Several studies have been published on the benefits of CC hearing aids since their introduction into clinical practice. Most of the patients included in these studies had canal stenosis or aural atresia, and the purchase rates of CC hearing aids in these patients were relatively high. However, the number of patients with canal-open ears was small, with overall poor results in the trials, with the exception of patients with continuous otorrhea. CC hearing aids are considered a good option for compensating for hearing loss in ears with canal stenosis or atresia in both bilateral and unilateral cases. However, CC hearing aids are not currently considered the first choice for patients with a canal-open ear.
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Affiliation(s)
- Tadashi Nishimura
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan
| | - Hiroshi Hosoi
- MBT (Medicine-Based Town) Institute, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan
| | - Ryota Shimokura
- Graduate School of Engineering Science, Osaka University, D436, 1-3 Machikaneyama, Toyonaka 560-8531, Osaka, Japan
| | - Tadashi Kitahara
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Nara, Japan
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Kakuki T, Miyata R, Yoshida Y, Kaizaki A, Kimura A, Kurashima K, Kuwata R, Takano K. The Effects of Utilizing Cartilage Conduction Hearing Aids among Patients with Conductive Hearing Loss. Audiol Res 2023; 13:408-417. [PMID: 37366682 DOI: 10.3390/audiolres13030036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
The cartilage-conduction hearing aid (CC-HA) is a new hearing device that is suitable for use in patients with conductive hearing loss. It has been 5 years since the introduction of the CC-HA. Although the number of users has increased, the CC-HA is not yet widely known. This study examines the effects of CC-HA on patients with conductive hearing loss and investigates factors that affect the willingness to use the device by comparing purchasers and non-purchasers of CC-HA in patients with unilateral conductive hearing loss. Eight patients had bilateral conductive hearing loss, and 35 had unilateral conductive hearing loss. Each patient underwent sound field tests and speech audiometry, and the effects of the CC-HA were compared with those of conventional bone conduction hearing aids (BC-HA). In patients with bilateral conductive hearing loss, the CC-HA was non-inferior to BC-HA. The CC-HA improved the hearing thresholds and speech recognition in patients with unilateral conductive hearing loss. Moreover, in patients with unilateral conductive hearing loss, experiencing the effect of wearing the CC-HA under conditions such as putting noise in the better ear could affect patients' willingness to use the CC-HA.
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Affiliation(s)
- Takuya Kakuki
- Department of Otolaryngology-Head and Neck Surgery, Sapporo Medical University School of Medicine, Sapporo 060-8556, Hokkaido, Japan
| | - Ryo Miyata
- Ebetsu City Hospital, Ebetsu 067-8585, Hokkaido, Japan
| | - Yurie Yoshida
- Department of Otolaryngology-Head and Neck Surgery, Sapporo Medical University School of Medicine, Sapporo 060-8556, Hokkaido, Japan
| | - Aya Kaizaki
- Department of Otolaryngology-Head and Neck Surgery, Sapporo Medical University School of Medicine, Sapporo 060-8556, Hokkaido, Japan
| | - Ayami Kimura
- Department of Otolaryngology-Head and Neck Surgery, Sapporo Medical University School of Medicine, Sapporo 060-8556, Hokkaido, Japan
| | - Kaede Kurashima
- Department of Otolaryngology-Head and Neck Surgery, Sapporo Medical University School of Medicine, Sapporo 060-8556, Hokkaido, Japan
| | - Rui Kuwata
- Department of Otolaryngology-Head and Neck Surgery, Sapporo Medical University School of Medicine, Sapporo 060-8556, Hokkaido, Japan
| | - Kenichi Takano
- Department of Otolaryngology-Head and Neck Surgery, Sapporo Medical University School of Medicine, Sapporo 060-8556, Hokkaido, Japan
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Nishimura T. Bone and Cartilage Conduction. Audiol Res 2022; 12:77-78. [PMID: 35200257 PMCID: PMC8869453 DOI: 10.3390/audiolres12010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 01/27/2023] Open
Affiliation(s)
- Tadashi Nishimura
- Department of Otolaryngology-Head & Neck Surgery, Nara Medical University, Nara 634-8521, Japan
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Nishimura T, Hosoi H, Saito O, Shimokura R, Morimoto C, Okayasu T, Kitahara T. Effect of transducer placements on thresholds in ears with an abnormal ear canal and severe conductive hearing loss. Laryngoscope Investig Otolaryngol 2021; 6:1429-1435. [PMID: 34938884 PMCID: PMC8665469 DOI: 10.1002/lio2.697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/30/2021] [Accepted: 11/02/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Providing hearing compensation to patients with aural atresia is considerably challenging. Hearing aid transducers vibrating the aural cartilage (cartilage conduction; CC) have been devised, and hearing aids utilizing them (CC hearing aids) have quickly become a beneficial option for aural atresia in clinical applications. However, it remains unclear which placement (on the aural cartilage or mastoid) is beneficial to signal transmission. METHODS This study included 35 patients (53 ears with an abnormal ear canal and severe conductive hearing loss) who were using CC hearing aids. Thresholds were compared between the transducers on the aural cartilage and on the mastoid. RESULTS In ears with bony aural atresia, thresholds were significantly improved when the transducer was placed on the aural cartilage compared to when it was placed on the mastoid for frequencies ≤ 500 Hz (P < .05). In aural atresia ears with a fibrotic tissue pathway, the aural cartilage stimulation improved the thresholds by approximately 20 dB for frequencies ≤ 1000 Hz (P < .05). In non-atretic ears, the aural cartilage locations significantly worsened the threshold at 4000 Hz (P < .05). CONCLUSION Our findings demonstrated that placing the transducer at the aural cartilage improved the mid-to-low frequency thresholds compared to mastoid transduction in aural atretic ears. In contrast, no clear improvement to the signal transmission due to the transducer's placement on the aural cartilage was recognized in non-atretic ears. LEVEL OF EVIDENCE 2.
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Affiliation(s)
- Tadashi Nishimura
- Department of Otolaryngology‐Head and Neck SurgeryNara Medical UniversityNaraJapan
| | - Hiroshi Hosoi
- MBT (Medicine‐Based Town) InstituteNara Medical UniversityNaraJapan
| | - Osamu Saito
- Department of Otolaryngology‐Head and Neck SurgeryNara Medical UniversityNaraJapan
| | - Ryota Shimokura
- Graduate School of Engineering ScienceOsaka UniversityOsakaJapan
| | - Chihiro Morimoto
- Department of Otolaryngology‐Head and Neck SurgeryNara Medical UniversityNaraJapan
| | - Tadao Okayasu
- Department of Otolaryngology‐Head and Neck SurgeryNara Medical UniversityNaraJapan
| | - Tadashi Kitahara
- Department of Otolaryngology‐Head and Neck SurgeryNara Medical UniversityNaraJapan
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Suwento R, Widodo DW, Airlangga TJ, Alviandi W, Watanuki K, Nakanowatari N, Hosoi H, Nishimura T. Clinical Trial for Cartilage Conduction Hearing Aid in Indonesia. Audiol Res 2021; 11:410-417. [PMID: 34449547 PMCID: PMC8395500 DOI: 10.3390/audiolres11030038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/06/2021] [Accepted: 08/10/2021] [Indexed: 11/27/2022] Open
Abstract
Hearing improvement represents one of the may valuable outcomes in microtia and aural atresia reconstruction surgery. Most patients with poor development in their hearing function have had a severe microtia. Conventional methods to improve hearing function are bone conduction and bone anchored hearing aids. Cartilage conduction hearing aids (CCHA) represents a new amplification method. This study assessed the outcomes and evaluated the impact and its safety in the patients with microtia and aural atresia whose hearing dysfunction did not improve after surgery for ear reconstruction in our hospital. Hearing functions were evaluated with pure tone audiometry or sound field testing by behavioral audiometry and speech audiometry before and after CCHA fitting. As a result, there was a significant difference between unaided and aided thresholds (p < 0.001). Speech recognition threshold and speech discrimination level also significantly improved with CCHA. The average functional gains of 14 ears were 26.9 ± 2.3 dB. Almost all parents of the patients reported satisfaction with the performance of CCHA, and daily communication in children with hearing loss also became better than usual.
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Affiliation(s)
- Ronny Suwento
- Department of Otorhinolaryngology Head and Neck Surgery, Cipto Mangunkusumo Hospital—Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (T.J.A.); (W.A.)
- Correspondence: (R.S.); (D.W.W.)
| | - Dini Widiarni Widodo
- Department of Otorhinolaryngology Head and Neck Surgery, Cipto Mangunkusumo Hospital—Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (T.J.A.); (W.A.)
- Correspondence: (R.S.); (D.W.W.)
| | - Tri Juda Airlangga
- Department of Otorhinolaryngology Head and Neck Surgery, Cipto Mangunkusumo Hospital—Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (T.J.A.); (W.A.)
| | - Widayat Alviandi
- Department of Otorhinolaryngology Head and Neck Surgery, Cipto Mangunkusumo Hospital—Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (T.J.A.); (W.A.)
| | | | | | - Hiroshi Hosoi
- Nara Medical University, Kashihara 634-8522, Nara, Japan; (H.H.); (T.N.)
| | - Tadashi Nishimura
- Nara Medical University, Kashihara 634-8522, Nara, Japan; (H.H.); (T.N.)
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