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INTRODUCTION: The mechanism of non-osseous bone conduction pathways, involving the intracranial contents (ICC) of the skull, is still not well understood. This study aimed to investigate the influence of the ICC on the skull bone wave propagation, including dependence on stimulation location and coupling. METHODS: Three Thiel-embalmed whole-head cadaver specimens were studied before and after the removal of the ICC. Stimulation was via the electromagnetic actuators from commercial bone conduction hearing aids. Osseous pathways were sequentially activated by mastoid, forehead, and bone-anchored hearing aid location stimulation via a 5-Newton steel headband or percutaneously implanted screw. Non-osseous pathways were activated by stimulation on the eye and dura via a 5-Newton steel headband and a custom-made pneumatic holder, respectively. Under each test condition, the 3D motion of the superior skull bone was monitored at ∼200 points. RESULTS: The averaged response of the skull surface showed limited differences due to the removal of the ICC. In some isolated cases, the modal pattern on the skull surface showed a trend for an upshift (∼1/2 octave) in the observed natural frequencies for drained heads. This was also consistent with an observed trend for an upshift in the transition frequency in the estimated deformation across the lateral surfaces of the temporal bones. Such changes were consistent with the expected reduction in mass and damping due to the absence of the ICC. CONCLUSION: Overall, the ICC affect to a limited extent the motion of the skull bone, with a limited trend for a reduction of its natural frequencies.

Asunto(s)

Conducción Ósea , Cadáver , Audífonos , Cráneo , Humanos , Conducción Ósea/fisiología , Cráneo/fisiología , Movimientos de la Cabeza/fisiología

RESUMEN

OBJECTIVE: To detail a modified surgical technique for implantation of the Osia 2 Bone Conduction Hearing Aid (BCHA) system and to assess intra- and postoperative outcomes of this technique. METHODS: A retrospective review was performed for cases undergoing implantation of an Osia 2 BCHA at a tertiary academic medical center. Modifications were made to the surgical procedure including: horizontal or curvilinear incisions, placement of the osseointegrated screw slightly superior to the plane of the external auditory canal, and double layer wound closure. Data regarding outcomes including demographics, incision type, surgical time, drilling requirements, and complications were collected using the electronic medical record. RESULTS: A total of twenty-eight cases were evaluated with 57.1% and 42.9% utilizing horizontal and curved incisions, respectively. The median age for recipients was 43.1 years with six pediatric cases included in the study. Median operative time was 58 min (43-126 min). The majority of cases required minimal (60.7%) or no drilling (28.6%) with a significant increase in operative time for those requiring moderate drilling versus minimal to no drilling (F = 8.02, p = 0.002). There were no intraoperative complications. One (3.6%) postoperative seroma occurred which resolved with conservative management. CONCLUSION: The proposed modified surgical technique is a safe and effective method for implantation of the transcutaneous BCHA system with a low complication rate. Keys include incision design, implant placement, and two-layered closure to minimize wound tension. These modifications can improve ease of the procedure and reduce operative time. These techniques also appear to be applicable to the pediatric population. LEVEL OF EVIDENCE: 3 Laryngoscope, 134:2401-2404, 2024.

Asunto(s)

Conducción Ósea , Audífonos , Humanos , Niño , Adulto , Implantación de Prótesis/métodos , Conducto Auditivo Externo/cirugía , Estudios Retrospectivos , Resultado del Tratamiento , Pérdida Auditiva Conductiva/cirugía , Pérdida Auditiva Conductiva/rehabilitación

RESUMEN

BACKGROUND: Under bone conduction (BC) stimulation, the otic capsule, and surrounding temporal bone, undergoes a complex 3-dimentional (3D) motion that depends on the frequency, location and coupling of the stimulation. The correlation between the resultant intracochlear pressure difference across the cochlear partition and the 3D motion of the otic capsule is not yet known and is to be investigated. METHODS: Experiments were conducted in 3 fresh frozen cadaver heads, individually on each temporal bone, resulting in a total of 6 samples. The skull bone was stimulated, via the actuator of a BC hearing aid (BCHA), in the frequency range of 0.1-20 kHz. Stimulation was applied at the ipsilateral mastoid and the classical BAHA location via a conventional transcutaneous (5-N steel headband) and percutaneous coupling, sequentially. Three-dimensional motions were measured across the lateral and medial (intracranial) surfaces of the skull, the ipsilateral temporal bone, the skull base, as well as the promontory and stapes. Each measurement consisted of 130-200 measurement points (∼5-10 mm pitch) across the measured skull surface. Additionally, intracochlear pressure in the scala tympani and scala vestibuli was measured via a custom-made intracochlear acoustic receiver. RESULTS: While there were limited differences in the magnitude of the motion across the skull base, there were major differences in the deformation of different sections of the skull. Specifically, the bone near the otic capsule remained primarily rigid across all test frequency (above 10 kHz), in contrast to the skull base, which deformed above 1-2 kHz. Above 1 kHz, the ratio, between the differential intracochlear pressure and the promontory motion, was relatively independent of coupling and stimulation location. Similarly, the stimulation direction appears to have no influence on the cochlear response, above 1 kHz. CONCLUSIONS: The area around the otic capsule appears rigid up to significantly higher frequencies than the rest of the skull surface, resulting in primarily inertial loading of the cochlear fluid. Further work should be focused at the investigation of the solid-fluid interaction between the bony walls of the otic capsule and the cochlear contents.

Asunto(s)

Conducción Ósea , Sonido , Humanos , Conducción Ósea/fisiología , Estimulación Acústica/métodos , Hueso Temporal/fisiología , Cóclea/fisiología , Movimiento (Física) , Vibración , Cadáver

RESUMEN

Objectives: The young population requires early rehabilitation of their hearing loss for normal cognitive, auditive hence social development. All of which, in turn, may have an impact on quality of life (QoL). This study aims to evaluate QoL between two different bone conduction (BC) hearing devices: a noninvasive adhesive hearing aid (Adhear [ADH]) vs. an active transcutaneous implant (Bonebridge [BB]). Methods: This study composed of 12 BB and 15 ADH users. Pure tone as well as speech in noise and quiet measurements were evaluated and compared to the Assessment in QoL questionnaire (AQoL-6d). Results: Freefield results showed significant improvements for both devices compared to the unaided condition (p < .0001). Emphasis needs to be drawn on the different unaided level of conductive hearing loss as well as the indication range for both evaluated device groups: the ADH subjects exhibited a mean BC value of 9.50 ± 7.96 dB HL (the indication range up to 25 dB) and the BB subjects a mean of 23.33 ± 25.66 dB HL (the indication range up to 45 dB). Speech perception in quiet and in noise was significantly improved (p < .05; p < .001, respectively). QoL was significantly improved for both treatments (p < .05) but was not different among the devices, and the values were similar to their normal hearing, age, and sex-matched control group. High correlations were found between QoL utility scores and improved PTA4 in the aided condition (r 2 = .8839 and .7810 for BB and ADH, respectively). Conclusion: Our results show that both devices offer significant beneficial audiological rehabilitations with significantly increased QoL. However, the underlying condition and the unaided degree of hearing loss, hence the required higher stimulation must be the deciding factor when opting for a hearing device, and this should be independent of age. Level of evidence: 2c.

RESUMEN

INTRODUCTION: A nonsurgical bone conduction hearing aid (BCHA) is a well-established treatment for children with congenital unilateral microtia and atresia (UMA). To date, limited studies have evaluated the audiological characteristics of the different wearing modes in the same nonsurgical BCHA. METHODS: Eighteen patients with UMA aged 5-24 years were included. Warble tones at frequencies of 0.5, 1, 2, and 4 kHz were presented to determine functional hearing gain (FHG) of hearing thresholds (in dB HL) in the sound field. The speech perception abilities were assessed by the speech discrimination score (SDS, in %) of monosyllables, disyllables, and sentences in quiet and noise using the Chinese Mandarin speech test materials. Hearing outcomes were evaluated with the ADHEAR™ worn on a softband and with an adhesive adapter. A correlational analysis was conducted to analyze the correlations between variables (e.g., age, height, weight, body mass index [BMI], bone conduction pure-tone threshold, and air conduction pure-tone threshold) and the differences in the two wearing modes. RESULTS: The mean FHG (standard deviation, SD) at 0.5-4 kHz was 20.63 (3.94) dB HL with the adhesive adapter and 26.39 (3.15) dB HL with the softband. When aided with the BCHA, significant improvements in SDS were revealed in all Mandarin speech test material lists either in quiet or noise for both wearing modes. Compared with the adapter mode, the softband provided higher aided SDS values. Correctional analyses revealed that higher BMI values were positively associated with larger delta outcomes between the two coupling methods of the softband and adhesive adapter in patients with UMA. Furthermore, a larger delta average FHG of 0.5-4 kHz was consistently associated with larger delta monosyllabic SDS in quiet, disyllabic SDS in quiet, and disyllabic SDS in noise. DISCUSSION: To the best of our knowledge, this is the first study to compare the hearing benefits of coupling methods using novel adhesive adapters and conventional softbands with the same audio processor (ADHEAR™). Under uniform internal settings, softband integration provided more hearing benefits than adhesive adapter integration, and the differences were more obvious in patients with higher BMI values. Besides, a brief measurement of FHG can be utilized to predict individualized speech perception levels.

Asunto(s)

Microtia Congénita , Audífonos , Percepción del Habla , Humanos , Niño , Microtia Congénita/cirugía , Adhesivos , Pérdida Auditiva Conductiva/cirugía , Audición , Pruebas Auditivas , Conducción Ósea

RESUMEN

BACKGROUND: Retrosigmoid sinus (RS) approach was not the dominant choice for BONEBRIDGE implantation. OBJECTIVE: To investigate the efficacy and safety of auricular reconstruction concomitant with BONEBRIDGE implantation using retrosigmoid approach for aural atresia patients. MATERIALS AND METHODS: A retrospective analysis was conducted of 15 children (28 ears) who underwent auricular reconstruction using a completely expanded postauricular flap with a skin expander concomitant with retrosigmoid BONEBRIDGE implantation from July 2019 to September 2020. RESULTS: All 15 patients healed well and had no bone conduction shift. Average SFT improvement was 27.1 dB HL (p < .001). Comparison between aided and unaided speech recognition rate in quiet and in noise showed significant improvements, respectively (p < .001). After a follow-up of 21-35 months, the hearing results were stable and the aesthetic outcomes were satisfying. CONCLUSIONS AND SIGNIFICANCE: For patients who undergo auricle reconstruction using expanded postauricular flap, retrosigmoid approach can avoid interfering the flap of reconstructed auricular without increasing the surgical risk or impact the clinical efficacy, and without significantly prolonging the total anesthesia time. The integrated surgical approach is a safe, and convenient option for patients who require simultaneous auricular reconstruction with BONEBRIDGE implantation.

Asunto(s)

Audífonos , Conducción Ósea , Niño , Oído Externo , Pérdida Auditiva Conductiva/cirugía , Pruebas Auditivas , Humanos , Estudios Retrospectivos , Resultado del Tratamiento

RESUMEN

Abstract Introduction Modern medicine offers a wide spectrum of different hearing devices, and bone conduction implants can be found among them. Objective The presentation of the outcomes of the implantation of a new active bone conduction hearing implant - the Osia®, and its comparison with the well-known passive transcutaneous system - the Baha® Attract. Methods Eight adult patients with bilateral mixed hearing loss were randomly divided into two groups. Group 1 was implanted with the Osia®, and group 2 was implanted with the Baha® Attract. The details of the surgery were analyzed, along with the functional and audiological results. Results In all the cases, the surgery was successful, and the healing uneventful. In both groups, it was observed that pure tone audiometry and speech audiometry in free field improved significantly after the implantation (mean gain in pure tone audiometry for the Osia group 42.8 dB SPL and for the Baha group 38.8 dB SPL). In the Osia group, the results after the surgery were much better than with the Baha® 5 Power processor on the Softband. The patients implanted with the Osia® evaluated the quality of their hearing as being superior to those implanted with the Baha® Attract. There was an evident improvement in the abbreviated profile of hearing aid benefit questionnaire and in the speech, spatial and qualities of hearing scale for both systems. In the abbreviated profile of hearing aid benefit, changes were more evident in the Osia group (in global score 49% vs. 37.2%). Conclusion Implantation of the Osia® is an effective treatment option for the patients with bilateral mixed hearing loss. The surgery is safe but more complex and time-consuming than the Baha® Attract implantation. The preliminary audiological results as well as the overall quality of life indicate that the Osia® is a better solution than the Baha® Attract. However, future studies should be carried out to make further observations in a larger group of patients, and with longer follow-up.

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Resumo Introdução A medicina moderna oferece um amplo espectro de diferentes aparelhos auditivos, e implantes de condução óssea estão entre eles. Objetivo Apresentação dos resultados do uso de um novo implante auditivo de condução óssea ativa - o Osia® e sua comparação com o conhecido sistema transcutâneo passivo - o sistema Baha® Attract. Método Oito pacientes adultos com perda auditiva mista bilateral foram divididos aleatoriamente em dois grupos. O grupo 1 foi implantado com o Osia® e o grupo 2 foi implantado com o sistema Baha® Attract. Os detalhes da cirurgia foram analisados, juntamente com os resultados funcionais e audiológicos. Resultados Em todos os casos, a cirurgia foi bem-sucedida e a cicatrização ocorreu sem intercorrências. Nos dois grupos, observou-se que a audiometria de tons puros e a audiometria de fala em campo livre melhoraram significativamente após o implante (ganho médio na audiometria para tons puros para o grupo Osia® de 42,8 dB NPS e para o grupo Baha®, 38,8 dB NPS). No grupo Osia®, os resultados após a cirurgia foram muito melhores do que com o processador Baha® 5 Power no sistema SoftBand. Os pacientes implantados com o Osia® avaliaram melhor a qualidade de sua audição do que os implantados com o sistema Baha® Attract. Houve uma melhoria evidente no questionário abbreviated profile of hearing aid benefit e na escala speech, spatial and qualities of hearing, para ambos os sistemas. No questionario abbreviated profile of hearing aid benefit, as mudanças foram mais evidentes no grupo Osia® (escore global 49% vs. 37,2%). Conclusão O sistema Osia® é uma opção de tratamento eficaz para pacientes com perda auditiva mista bilateral. A cirurgia é segura, mas mais complexa e demorada que a implantação do sistema Baha® Attract. Os resultados audiológicos preliminares, bem como aqueles avaliando a qualidade de vida, indicam que o Osia® é uma alternativa melhor que o Baha® Attract. Entretanto, mais observações são necessárias em grupos maiores de pacientes e com tempo de seguimento mais longo.

RESUMEN

BACKGROUND: The frequency dependent contributions of the various bone conduction pathways are poorly understood, especially the fluid pathway. The aim of this work is to measure and investigate sound pressure propagation from the intracranial space to the cochlear fluid. METHODS: Stimulation was provided sequentially to the bone (BC) or directly to the intracranial contents (hydrodynamic conduction, or HC) in four cadaver heads, where each ear was tested individually, for a total of 8 samples. Intracranial pressure was generated and monitored via commercial hydrophones, while the intracochlear sound pressure (ICSP) levels were monitored via custom-made intracochlear acoustic receivers (ICAR). In parallel, measurements of the 3D motion of the cochlear promontory and stapes were made via 3D Laser Doppler Vibrometer (3D LDV). RESULTS: Reliability of the intracochlear sound pressure measurements depends on the immobilization of the ICAR relative to the otic capsule. Regardless of the significant differences in absolute stapes and promontory motion, the ratios between the otic capsule velocity, the stapes volume velocity (relative to the cochlea), and the intracochlear pressure were very similar under BC and HC stimulus. Under HC, the cochlear fluid appears be activated by an osseous pathway, rather than a direct non-osseous pathway from the cerebrospinal fluid (CSF), however, the osseous pathway itself is activated by the CSF pressure. CONCLUSIONS: Data suggests that the skull bone surrounding the brain and CSF could play a role in the interaction between the two CSF and the cochlea, under both stimulation conditions, at high frequencies, while inertia is dominant factor at low frequencies. Further work should be focused on the investigation of the solid-fluid interaction between the skull bone walls and the intracranial content.

Asunto(s)

Conducción Ósea , Complejo Hierro-Dextran , Estimulación Acústica , Conducción Ósea/fisiología , Cadáver , Cóclea/fisiología , Humanos , Reproducibilidad de los Resultados , Vibración

RESUMEN

INTRODUCTION: Modern medicine offers a wide spectrum of different hearing devices, and bone conduction implants can be found among them. OBJECTIVE: The presentation of the outcomes of the implantation of a new active bone conduction hearing implant - the Osia®, and its comparison with the well-known passive transcutaneous system - the Baha® Attract. METHODS: Eight adult patients with bilateral mixed hearing loss were randomly divided into two groups. Group 1 was implanted with the Osia®, and group 2 was implanted with the Baha® Attract. The details of the surgery were analyzed, along with the functional and audiological results. RESULTS: In all the cases, the surgery was successful, and the healing uneventful. In both groups, it was observed that pure tone audiometry and speech audiometry in free field improved significantly after the implantation (mean gain in pure tone audiometry for the Osia group 42.8 dB SPL and for the Baha group 38.8 dB SPL). In the Osia group, the results after the surgery were much better than with the Baha® 5 Power processor on the Softband. The patients implanted with the Osia® evaluated the quality of their hearing as being superior to those implanted with the Baha® Attract. There was an evident improvement in the abbreviated profile of hearing aid benefit questionnaire and in the speech, spatial and qualities of hearing scale for both systems. In the abbreviated profile of hearing aid benefit, changes were more evident in the Osia group (in global score 49% vs. 37.2%). CONCLUSION: Implantation of the Osia® is an effective treatment option for the patients with bilateral mixed hearing loss. The surgery is safe but more complex and time-consuming than the Baha® Attract implantation. The preliminary audiological results as well as the overall quality of life indicate that the Osia® is a better solution than the Baha® Attract. However, future studies should be carried out to make further observations in a larger group of patients, and with longer follow-up.

Asunto(s)

Audífonos , Perdida Auditiva Conductiva-Sensorineural Mixta , Adulto , Audiometría de Tonos Puros , Conducción Ósea , Pérdida Auditiva Conductiva/cirugía , Perdida Auditiva Conductiva-Sensorineural Mixta/cirugía , Humanos , Calidad de Vida

RESUMEN

PURPOSE: This study aimed to evaluate the audiological benefits and subjective satisfaction in using a new adhesive bone conduction hearing aid in children with congenital unilateral microtia and atresia. METHODS: We evaluated the effectiveness of the hearing aid using the sound field hearing threshold, speech recognition ability under quiet and noise, and subjective questionnaires in 13 children (5-15 years old). RESULTS: The mean sound field hearing threshold significantly improved with a gain of 25.4 ± 4.9 dB HL. Mean word recognition scores were ameliorated in quiet and noise by 1.9 ± 2.5% and 7.3 ± 5.3%, respectively. Speech recognition ability results in noise varied; when the speech signal and noise were presented from the front, the mean speech recognition ability improved by 2.5 ± 1.6 dB signal-to-noise ratios (SNR). When noise was presented towards the normal hearing side, speech understanding was improved by 2.9 ± 1.6 dB SNR. When the speech signal was presented from the atretic side with noise from the normal hearing side, an improvement of 5.7 ± 3.4 dB SNR (p < 0.001) was noted. However, when noise was presented towards the newly aided atretic ear, no statistical significance was found. The questionnaire results indicated that the hearing device provided benefits in speech recognition ability in different complex situations, with high satisfaction rates. CONCLUSION: The adhesive bone conduction hearing aid investigated here offers a concealed and aesthetic method to improve hearing in children with congenital unilateral microtia and atresia during their early years, with high subjective satisfaction.

Asunto(s)

Microtia Congénita , Audífonos , Percepción del Habla , Adhesivos , Adolescente , Conducción Ósea , Niño , Preescolar , Microtia Congénita/cirugía , Pérdida Auditiva Conductiva/cirugía , Humanos

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OBJECTIVE: The ADHEAR system (MED-EL, Innsbruck, Austria) is a new adhesive bone conduction hearing aid. This study evaluates the audiological benefit and subjective satisfaction as well as the manageability in everyday life in children with unilateral conductive hearing loss. METHODS: Ten children with unilateral hearing loss of different origin were included in the study. The audiological assessment included sound field audiometry and speech intelligibility in quiet and in noise, which was tested unaided and after 4 weeks of wearing the hearing system. Subjective benefit and satisfaction with the system was assessed using the SSQ for parents. With a second system-specific questionnaire, suitability for everyday use and quality of life were queried. RESULTS: With ADHEAR, speech perception in quiet improved by 44%. The word recognition score in noise improved from 11.7% in the unaided situation to 46.7% with the ADHEAR system. The SSQ for parents demonstrates a subjective benefit and satisfaction with the system. CONCLUSION: ADHEAR is an effective treatment option for children with unilateral conductive hearing loss. Especially children who are not eligible for semi-implantable hearing systems or do not accept hearing devices on a softband can benefit from this device.

Asunto(s)

Audífonos , Pérdida Auditiva Unilateral , Percepción del Habla , Austria , Conducción Ósea , Niño , Audición , Pérdida Auditiva Conductiva , Humanos , Satisfacción Personal , Calidad de Vida

RESUMEN

Background: An adhesively attached bone conduction hearing device has been newly developed. This novel bone conduction hearing device is placed behind the ear and has an audio processor connected to the adapter to transmit sound through vibrations.Objective: To obtain preliminary results regarding the use of this device, we sought to apply it to patients with various types of hearing loss.Methods: Nine patients aged over 18 years and with hearing loss due to bilateral middle ear anomaly (n = 1), bilateral aural atresia (n = 3), unilateral aural atresia (n = 2), and single-sided deafness (n = 3) were recruited.Results: The functional gain provided by the adhesive bone conduction hearing device for the aided side was found to be sufficient. Although the results on speech perception in noise showed significant improvement for patients with conductive hearing loss, no improvement was found for patients with single-sided deafness. Subjective assessment showed that speech and spatial hearing-related issues were improved.Conclusion: The adhesive bone conduction hearing device was thought to provide a feasible option. Additionally, in patients considering the use of a surgically implanted hearing device, this device is a preferable option for preoperative assessment due to its non-invasiveness.

Asunto(s)

Conducción Ósea , Audífonos/estadística & datos numéricos , Adolescente , Adulto , Anciano , Umbral Auditivo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Localización de Sonidos , Percepción del Habla , Adulto Joven

RESUMEN

INTRODUCTION: The BAHA (bone-anchored hearing aid) Attract is a magnetic transcutaneous bone conduction device anchored into the temporal bone. The standard surgical technique for BAHA Attract is a multi-tools time-consuming process, which requires a large cutaneous incision. The objective of this study is to describe and test the feasibility of a minimally invasive pocket (MIP) technique for Magnet Bone Implant Hearing Aid (MBIHA) with a modified magnet of BAHA Attract without fixation and without any tissue reduction. We use a 3-cm vertical skin incision and a subperiosteal pocket. METHOD: A study of 10 patients with conductive or mixed hearing loss who benefited from a MBIHA using the MIP technique is presented. The pure tone average (PTA) (dB) for air-conduction thresholds and the speech recognition threshold (SRT) (dB) in speech audiometry in quiet are calculated. The Entific Medical Systems (EMS) questionnaire and the postoperative clinical outcomes are realized. RESULTS: We found a significant improvement of 33.8 dB on average for the PTA and 44.8 dB for the SRT with MBIHA at 3 months, compared with unaided situation. No implant was removed or displaced after 2 years of follow-up. The skin condition remains intact in all the cases. CONCLUSION: The minimally subperiosteal pocket surgical technique MIP without fixation and with tissue preservation for the MBIHA is safe, rapid and effective for patients with conductive or mixed hearing loss. It opens new perspectives of development and modify conventional concept in magnetic coupling of bone-conducted device.

Asunto(s)

Prótesis Anclada al Hueso , Audífonos , Pérdida Auditiva Conductiva/cirugía , Perdida Auditiva Conductiva-Sensorineural Mixta/cirugía , Implantación de Prótesis/métodos , Adolescente , Adulto , Percepción Auditiva , Niño , Estudios de Factibilidad , Femenino , Pérdida Auditiva Bilateral/diagnóstico , Pérdida Auditiva Bilateral/fisiopatología , Pérdida Auditiva Bilateral/cirugía , Pérdida Auditiva Conductiva/diagnóstico , Pérdida Auditiva Conductiva/fisiopatología , Perdida Auditiva Conductiva-Sensorineural Mixta/diagnóstico , Perdida Auditiva Conductiva-Sensorineural Mixta/fisiopatología , Pérdida Auditiva Unilateral/diagnóstico , Pérdida Auditiva Unilateral/fisiopatología , Pérdida Auditiva Unilateral/cirugía , Humanos , Imanes , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos , Implantación de Prótesis/instrumentación , Colgajos Quirúrgicos , Resultado del Tratamiento , Adulto Joven

RESUMEN

OBJECTIVE: The objective of this prospective, single-subject, repeated measures study was to evaluate the audiological benefit and patient satisfaction with an adhesive, pressure-free bone conduction hearing system (ADHEAR; MED-EL, Innsbruck, Austria) in patients who underwent middle ear surgery with transient hearing loss due to auditory canal tamponade. METHODS: Eleven adult subjects suffering from transient conductive hearing loss were enrolled in the study and followed up to 3 weeks after middle ear surgery. Bone and air conduction thresholds were measured pre and postoperatively to evaluate eligibility for enrollment. Postoperative unaided and aided sound-field thresholds, as well as speech tests in quiet and noise were compared to confirm hearing improvement with the hearing system. To determine patient satisfaction, the SSQ12 and a system-specific quality of life questionnaire was administered to all subjects. RESULTS: Speech perception for monosyllables in quiet improved by 46%, with statistical significance for the ADHEAR system compared to the unaided condition after one week. The functional hearing gain improved by 19 dB. Speech perception in noise with the device was - 6.7 dB SNR on average, with a statistically significant improvement of 2.7 dB SNR. The results of the questionnaire showed a high level of patient satisfaction and subjective hearing improvement. No serious skin reactions or other severe complications occurred. CONCLUSION: As long as the auditory canal is blocked due to tamponade, patients benefit from hearing rehabilitation. This adhesive hearing system is a safe and effective device to treat transient conductive hearing loss and may considerably improve treatment for patients even with short-term hearing loss.

Asunto(s)

Conducto Auditivo Externo/cirugía , Oído Medio/cirugía , Audífonos , Pérdida Auditiva Conductiva/terapia , Tampones Quirúrgicos/efectos adversos , Adulto , Conducción Ósea , Femenino , Audición , Pérdida Auditiva Conductiva/diagnóstico , Pérdida Auditiva Conductiva/etiología , Pruebas Auditivas , Humanos , Masculino , Persona de Mediana Edad , Ruido , Procedimientos Quirúrgicos Otológicos , Satisfacción del Paciente , Estudios Prospectivos , Calidad de Vida , Percepción del Habla , Encuestas y Cuestionarios , Adhesivos Tisulares , Adulto Joven

RESUMEN

OBJECTIVES: To evaluate the hearing benefit, advantages, and disadvantages in a series of children using a new, nonimplantable, pressure-free, adhesive bone conduction hearing aid. METHODS: Seventeen children were included in the study. 5 children suffered from bilateral conductive hearing loss (CHL), 6 children with unilateral CHL and 6 children with unilateral sensorineural hearing loss. An audiological tests were provide. Additionally, sound quality (SSQ10) and quality of life (AQoL-6D) were assessed using questionnaires. RESULTS: The average value of speech audiometry with bubble noise in children with SNHL is 21.33 (±5.72) dB HL with the device and 27.67 (±4.59) dB HL without the device, which is a statistically significant gain (p = 0.027). The analysis showed the average value of hearing threshold in sound field in the group of children with CHL supported 20.23 (±16.84) dB HL and not supported 33.52 (±27.27) by the hearing aid for bone conduction, which i a statistically significant gain (p = 0.008). The average value of speech audiometry is 23.45 (±14.45) dB HL with the device and 37.27 (±26.65) dB HL without the device, which is a statistically significant gain (p = 0.012). The average value of speech audiometry with bubble noise is 30.55 (±10.03) dB HL with the device and 45.45 (±18.41) dB HL without the device, which is a statistically significant gain (p = 0.008). No patient referred pain or irritation. CONCLUSION: This new device for bone conduction show a hearing benefit for a paediatric patient, without any concomitant aesthetic and other complications.

Asunto(s)

Conducción Ósea , Audífonos , Pérdida Auditiva Conductiva/rehabilitación , Pérdida Auditiva Sensorineural/rehabilitación , Percepción del Habla , Adhesivos , Adolescente , Audiometría del Habla , Niño , Preescolar , Femenino , Humanos , Masculino , Proyectos Piloto , Calidad de Vida , Encuestas y Cuestionarios

RESUMEN

BACKGROUND: Bone conduction hearing aids can be worn as noninvasive devices using a clip or soft band that exerts pressure on the skin, or they can be surgically implanted. ADHEAR (MED-EL GmbH, Innsbruck, Austria) is a novel noninvasive bone conduction hearing aid that is attached behind the ear using an adhesive adapter and does not exert pressure on the skin. ADHEAR is indicated for patients with conductive hearing loss and normal inner ear function. The aim of this study was to evaluate the achievable hearing improvement with ADHEAR. MATERIALS AND METHODS: Twelve subjects with normal hearing participated in this study. To mimic conductive hearing loss, the participants' ear canals were occluded unilaterally with a foam ear plug. The resultant conductive hearing loss was assessed with pure tone air- and bone-conduction threshold audiometry. Hearing ability was tested with and without ADHEAR via free-field tone audiometry, number perception, and monosyllable perception, with the contralateral ear plugged depending on test requirements. RESULTS: Using ADHEAR, the free-field hearing threshold improved by 13.7 dB at 500 Hz, by 17.9 dB at 1 kHz, by 17.2 dB at 2 kHz, and by 9.8 dB at 4 kHz. In the higher frequencies, a significant pure-tone gain of 14.4 dB at 6 kHz and of 16.5 dB at 8 kHz was observed. Number perception with ADHEAR was mean 69.2% at 35 dB, 97.9% at 50 dB, 100% at 65 dB, and 100% at 80 dB. Monosyllable perception with the ADHEAR was mean 35.0% at 35 dB, 72.3% at 50 dB, 93.5% at 65 dB, and 98.8% at 80 dB. CONCLUSION: Hearing performance was significantly better with ADHEAR under all test conditions except those where maximum perception was already achieved without ADHEAR.

Asunto(s)

Audífonos , Pérdida Auditiva Conductiva , Percepción del Habla , Audiometría de Tonos Puros , Umbral Auditivo , Austria , Conducción Ósea , Pérdida Auditiva Conductiva/rehabilitación , Humanos

RESUMEN

Hearing loss is common in the geriatric population. Most hearing loss is associated with presbycusis or age-related hearing loss, impacting one-third of individuals over 65 years and increasing in prevalence with age. Hearing loss impacts quality of life, psychological health, and cognition. Implantable auditory devices are an exceptional option to improve hearing and quality of life. Various implantable auditory devices have been implemented safely with significant improvement in communication and performance on auditory tasks. Counseling is essential to establishing realistic expectations. Rehabilitation may be required to optimize outcomes and auditory performance with use.

Asunto(s)

Prótesis Anclada al Hueso , Presbiacusia/psicología , Presbiacusia/rehabilitación , Calidad de Vida , Anciano , Evaluación Geriátrica , Audífonos , Humanos , Presbiacusia/epidemiología , Diseño de Prótesis , Percepción del Habla

RESUMEN

OBJECTIVES: Evaluation of the transfer function efficiency of a newly-developed piezo-electric actuator for active subcutaneous bone conduction hearing aid. METHODS: The experiments were conducted on four Thiel embalmed whole head cadaver specimens. A novel actuator based on piezo-electric transduction (PZTA), part of a subcutaneous bone conduction hearing aid device, was sequentially implanted on three locations: 1) Immediately posterior to pinna; 2) 50-60 mm posterior to pinna, approximately the same distance as between the BAHA (bone anchored hearing aid) location and the ear canal, but the same horizontal level as location 1; 3) the traditional BAHA location. Using a single point 3-dimensional laser Doppler vibrometer (LDV) system, three types of motion measurements were performed at the cochlear promontory for each stimulation location: 1) ipsilateral side, 2) contralateral side, 3) measurements 1 and 2 were repeated after mastoidectomy on the ipsilateral side. RESULTS: On average, stimulation at locations 1 and 2 show a trend for higher promontory motion relative to location 3 (BAHA location) above 1 kHz. Stimulation at location 1 had an average improvement of 1-6 dB at 2-4 kHz, and 1-18 dB at 6-8 kHz. The spatial composition of the motion showed significant contributions from both in-plane and out-of-plane (along ear canal) motion components, with in-plane components being dominant at mid and high frequencies for locations 2 and 3. Stimulation at locations 1 and 3 produced similar transcranial attenuation at mid frequencies (0.6-4 kHz), with a potential trend of higher attenuation (seen in 3 or the 4 samples) for location 1 at higher frequencies (>4 kHz). The mastoidectomy affected negatively mostly the high frequencies (6-8 kHz) for stimulation at location 1, with no significant change for location 3. CONCLUSION: The sound transfer function efficacy of a novel subcutaneous bone conduction device has been quantified, and the influence of stimulation location and mastoidectomy have been analyzed based on promontory motion in Thiel-preserved cadaver heads.

Asunto(s)

Conducción Ósea , Prótesis Anclada al Hueso , Audífonos , Cráneo/fisiología , Estimulación Acústica , Cadáver , Humanos , Mastoidectomía , Ensayo de Materiales , Movimiento (Física) , Diseño de Prótesis , Cráneo/cirugía , Sonido , Vibración

RESUMEN

The cross sectional study was conducted in Universiti Kebangsaan Malaysia Medical Center (UKMMC), Malaysia from August 2012 to December 2013. All patients implanted with in UKMMC from December 2001 until December 2012 was included. Glasgow Benefit Inventory (GBI) questionnaires and UKMMC questionnaires were used as part of the assessment tool. The GBI is a scoring which measures the change in health status produced by surgical interventions. UKMMC questionnaires was invented by our department to assess questions related to social and life style of patients and also the cosmetic perspective Baha implant and other daily related activities. The audiological assessment was assessed using hearing aid gain threshold. Complication with regards to skin reaction was graded using Holger Skin Classification. A total of 40 patients underwent Baha implant were recruited but only 35 patients fulfilled the criteria and included in this study for analysis. Age of patients ranged from 5 year old to 38 year old, with median of 13 years old. There were 22 patients (62.8%) were male and 13 patients (37.1%) were females. Almost all cases were canal atresia except one adult patient was a case of bilateral chronic discharging ear with chronic irritation with ear mould. Majority of patients 21 (60%) have hearing level of moderate to severe hearing loss (40-89 dB) and 14 patients (40%) have mild to moderate hearing loss (20-39 dB). The level of hearing was retested post operatively. All of the patients have improvement in their aided hearing with the range of 10-25 dBL which is statistically significant at p value of <0.05. The GBI was scored positively in all subscales. Majority of patients (91.4%) used BAHA more than 4 h per day and 88.6% agreed that BAHA is cosmetically acceptable. All patients experienced some form of skin irritation (Holger grade 1-2) however only 20% required surgical intervention. All our patients have range of 10-25 dB improvement of their aided hearing which is statistically significant at p value of <0.05. BAHA has been proven to show significant benefit in audiological improvement and quality of life.

RESUMEN

Objective To investigate the speech recognition in noise in patients with unilateral conductive or mixed hearing impaired using Sophonotron Alpha 2 softband.Methods A total of 12 patients (12 ears) with unilateral conductive or mixed hearing loss participated in the survey and fitted with Sophonotron Alpha 2.The aided hearing threshold test and speech recognition test in noise were evaluated in both unaided and aided conditions.Results The average aided hearing threshold using Sophonotron Alpha 2 softband was 35.0±10.8 dB HL,showing significant improvement compared to that of unaided(P＜0.05).The average signal-to noise ratio loss was 5.9± 6.1 dB using Sophonotron Alpha 2 softband in noise,showing a more significant benefit than that of the unaided (13.6±10.9 dB).Conclusion The Sophonotron Alpha 2 softband can significantly improve speech recognition in noise for the patients with unilateral conductive or mixed hearing loss.