Background: Considering that hearing loss has a significant impact on social functioning, everyday activity and a person’s emotional state, one of the most important goals of hearing rehabilitation with bone conduction devices is improvement in a patient’s quality of life. Objectives: To measure self-assessed quality of life in patients implanted with the Bonebridge, a bone conduction device. Method: Prospective, observational, longitudinal study with one treatment group. Twenty-one patients with mixed or conductive hearing loss were included, and each individual served as its own control. The Abbreviated Profile of Hearing Aid Benefit (APHAB) was used to measure patient-reported quality of life before intervention and at 3 and 6 months after activation of the device. At the same time frames, pure-tone audiometry and speech understanding in quiet and in noise were tested. Results: Hearing-specific quality of life increased significantly after intervention and remained stable up to 6 months. Both word recognition in quiet and speech reception threshold in noise were significantly better after 6 months compared to before surgery. Outcomes of aided speech understanding were independent of initial bone conduction thresholds and equally high (word recognition score >75%) across the device’s indication range. Conclusions: The Bonebridge provides not only significant audiological benefit in both speech understanding in quiet and in noise, but also increases self-perceived quality of life in patients suffering from mixed and conductive hearing loss. Together with a very low rate and minor nature of adverse events, it is the state-of-the-art solution for hearing rehabilitation in patients with mixed or conductive hearing loss up to a bone conduction threshold of 45 dB HL.

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Objective: To compare the audiological performance with the novel adhesive bone conduction hearing device (ADHEAR) to that with a passive bone conduction (BC) implant and to that with a bone conduction device (BCD) on a softband. Study Design: Prospective study in an acute setting, single-subject repeated measure in three situations: unaided, with conventional BCDs (passive implant or on softband), and with the ADHEAR. Setting: Tertiary referral center. Patients: Ten subjects with conductive hearing loss were evaluated with the ADHEAR. Five of these were users of a passive BC implant (Baha Attract with Baha4); five received a BCD (Baha4) on a softband for test purposes. Intervention: Use of non-invasive adhesive bone conduction system for the treatment of conductive hearing loss. Main Outcome Measures: Air and bone conduction thresholds, sound field thresholds, word recognition scores in quiet, and speech recognition thresholds in quiet and noise were assessed. Results: Users of the passive BC implant received comparable hearing benefit with the ADHEAR. The mean aided thresholds in sound field measurements and speech understanding in quiet and noise were similar, when subjects were evaluated either with the ADHEAR or the passive BC implant. The audiological outcomes for the non-implanted group were also comparable between the ADHEAR and the BCD on softband. Conclusions: Based on our initial data, the ADHEAR seems to be a suitable alternative for patients who need a hearing solution for conductive hearing loss but for medical reasons cannot or do not want to undergo surgery for a passive BC implant.

The Bonebridge implant can be a satisfactory solution for patients with conductive or mixed hearing loss (CHL or MHL), or with single-sided deafness (SSD). The aim of the study was to assess patients’ self-reported benefits with the Bonebridge and characterize the relationships between pre-implantation audiometric data, auditory functioning, and satisfaction after implantation. A focus was to see whether different types of hearing loss were associated with particular benefits. The study sample consisted of 81 patients. Procedures comprised pure tone audiometry before implantation, the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, and a structured interview asking about satisfaction. Statistically significant improvements after implantation were found in all groups (CHL, MHL, SSD) on the APHAB questionnaire. In the structured interview, patients with SSD were the least satisfied. No significant correlation was found between pre-operative air-bone gap and bone conduction thresholds or with APHAB score. Bonebridge implantation is beneficial to patients with CHL or MHL, or with SSD. Assessment of patients for Bonebridge implantation is complex, and audiometric data should be complemented by patient-reported outcomes to provide deeper insight into their individual needs and attitudes.

Nowadays, several options are available to treat patients with conductive or mixed hearing loss. Whenever surgical intervention is not possible or contra-indicated, and amplification by a conventional hearing device (e.g., behind-the-ear device) is not feasible, then implantable hearing devices are an indispensable next option. Implantable bone-conduction devices and middle-ear implants have advantages but also limitations concerning complexity/invasiveness of the surgery, medical complications, and effectiveness. To counsel the patient, the clinician should have a good overview of the options with regard to safety and reliability as well as unequivocal technical performance data. The present consensus document is the outcome of an extensive iterative process including ENT specialists, audiologists, health-policy scientists, and representatives/technicians of the main companies in this field. This document should provide a first framework for procedures and technical characterization to enhance effective communication between these stakeholders, improving health care.

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Objective: Chronic obstructive inflammation of the external ear canal after different kinds of surgeries often leads to restenosis. There are different approaches to treatment of such cases, and one solution is a middle ear implant. Here we analyze the efficacy of using the Vibrant Soundbridge middle ear implant with a new incus short process (SP) coupler in this type of case. Materials and Methods:We present a case study of a 29-year old patient with bilateral mixed hearing loss caused by bilateral obstructive inflammation of the external ear canals. He had undergone meatoplasty with very short-lived improvement. Afterwards he qualified for middle ear implantation to restore hearing, and the Vibrant Soundbridge was implanted with a new SP coupler to which the floating mass transducer (FMT) is attached. Postoperative hearing tests included pure tone audiometry, free field audiometry, speech recognition, and APHAB questionnaire.Results: Speech recognition after implantation improved to 100%. Pre-and postoperative bone conduction thresholds were unchanged. Vibrometry thresholds 10 months after surgery did not deteriorate. There was a decrease in global APHAB score by 61% from 2 to 10 months after implantation. Conclusion:Application of the Vibrant Soundbridge middle ear implant can be an effective treatment in cases of hearing loss caused by obstructive inflammation of the external ear canals. The new incus SP coupler seems to be an effective method of stimulating the middle ear in mixed hearing loss.

Wstęp: Urządzenia na przewodnictwo kostne znajdują zastosowanie u pacjentów z różnymi zaburzeniami słuchu. Często również w przypadkach, kiedy interwencja w obrębie ucha środkowego jest ryzykowna. Cel pracy: Celem pracy jest porównanie wyników audiologicznych uzyskanych po zastosowaniu systemu aktywnego implantu na przewodnictwo kostne Bonebridge u pacjentów wymagających zmodyfikowanego podejścia chirurgicznego do wyników uzyskanych po zastosowaniu procedury typowej. Materiał i metody: Materiał pracy stanowią dwa przypadki pacjentów, u których przeprowadzono zmodyfikowaną procedurę chirurgiczną wszczepienia systemu Bonebridge. Zmiana w standardowym postępowaniu chirurgicznym podyktowana była w pierwszym przypadku względami anatomicznymi -przodującą zatoką esowatą oraz w drugim -koniecznością przeprowadzenia rekonstrukcji ściany przewodu słuchowego zewnętrznego ze względu na wcześniej przebyte zabiegi w obrębie wyrostka sutkowatego, w tym operację radykalną zmodyfikowaną. Grupę kontrolną stanowi 9 osób, u których procedura chirurgiczna przebiegła w sposób typowy. Porównawczą ocenę korzyści słuchowych przeprowadzono na podstawie wyników badań audiometrii tonalnej wykonanej przed zabiegiem i po nim oraz audiometrii wolnego pola wykonanej bez urządzenia oraz w urządzeniu 12 miesięcy po jego wszczepieniu. Wyniki: Wartości uzyskane w analizowanych pomiarach dla opisywanych przypadków z niewielkimi odstępstwami mieszczą się w typowym przedziale zmienności uzyskanym dla grupy kontrolnej. Wnioski: Zmodyfikowana z uwagi na warunki anatomiczne i stan miejscowy procedura chirurgiczna w analizowanych przypadkach nie wpłynęła istotnie na stopień pozyskanych korzyści w stosunku do grupy kontrolnej.