Comparison of Audiologic Results and Patient Satisfaction for Two Osseointegrated Bone Conduction Devices

Background Bone‐anchored hearing systems (BAHSs) are widely used for hearing rehabilitation and are indicated in cases of conductive and mixed hearing loss and in single‐sided deafness. The Ponto system, that is one available option, has been on the market since 2009. Objective of review The aim of this study is to systematically review the literature reporting on the Ponto system, with regard to audiological and surgical outcomes and patient's quality‐of‐life scores. Type of review A systematic literature search was performed in the PubMed database 2009‐July 2019. Search strategy Search term: ((osseointegrated hearing aid) OR (bone conduction implant) OR (bone anchored hearing) OR BAHA OR BAHS OR BAHI). Pre‐defined inclusion and exclusion criteria were applied. Evaluation method English‐language articles reporting original clinical data (audiological, surgical or quality‐of‐life outcomes) on the Ponto system were included. Articles reporting on Ponto and another BAHS system where the results on Ponto constituted less than 50% of the patient population or including only results on testband or softband devices were excluded. Results Audiological outcomes were discussed in 20 publications. Improvement against the unaided thresholds was demonstrated. The functional improvement was on average 33.9 dB. The effective gain or remaining air‐bone gap was on average 6.7 dB. All evaluated data showed aided speech reception thresholds significantly below normal speech level. Twenty‐seven publications reported surgical and follow‐up data for the Ponto system. Implant survival was 97.7%, adverse skin reactions (Holgers ≥ 2) were 5% across visits and 15% across patients. No complications were life‐threatening, causing permanent disability/damage or requiring a hospitalisation. Five studies reported quality of life using the Glasgow benefit inventory, 98% reported an improvement when analysing the score on an individual level. Conclusions The outcomes of this systematic review confirm that percutaneous systems provide consistent audiological benefits and improved quality of life for patients. Further, the review demonstrates that the percutaneous systems are safe, with relatively low complication rates. Skin‐related complications are the most common complication type and are experienced by approximately one patient out of seven, or in less than one of 20 follow‐up visits.

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“…Functional gain, the improvement compared to the unaided condition, was significant in all studies that reported this measure 13,16,17,23–26 …”

Section: Resultsmentioning

confidence: 92%

“…12 the ability to perform lexical decision tasks, the ability to detect nonsense words in context, rapid word learning,27 memory recall by the sentence-final Word Identification and Recall Test (SWIR) test,28 the Abbreviated Profile of Hearing Aid Benefit[13][14][15][16][17]21,26 and the Speech Spatial and Qualities of Hearing scale [13][14][15][16][17]22. …”

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confidence: 99%

Ten years of experience with the Ponto bone‐anchored hearing system—A systematic literature review

Lagerkvist¹,

Carvalho

Holmberg³

et al. 2020

Clinical Otolaryngology

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“…In clinical trials with other types of transcutaneous implants, average functional gain compared to unaided hearing was 18.4 dB to 42.3 dB (Barbara, Perotti, Gioia, Volpini, & Monini, 2013; Bianchin, Bonali, Russo, & Tribi, 2015; Briggs et al., 2015; Busch, Giere, Lenarz, & Maier, 2015; Centric & Chennupati, 2014; Escorihuela-Garcia, Llopez-Carratala, Pitarch-Ribas, Latorre-Monteagudo, & Marco-Algarra, 2014; Hassepass et al., 2015; Hol, Nelissen, Agterberg, Cremers, & Snik, 2013; Ihler, Volbers, et al., 2014; Iseri et al., 2015; Lustig et al., 2001; Magliulo, Turchetta, Iannella, Valperga di Masino, & de Vincentiis, 2015; Manrique, Sanhueza, Manrique, & de Abajo, 2014; Monini et al., 2015; Rahne et al., 2015; Reinfeldt, Hakansson, Taghavi, Fredén Jansson, et al., 2015; Riss et al., 2014; Siegert & Kanderske, 2013). So, 28.9 ± 4.2 dB achieved with the implant here fits well within the published range, while systems on an osseointegrated post tend to achieve higher values.…”

Section: Discussionmentioning

confidence: 99%

The Prediction of Speech Recognition in Noise With a Semi-Implantable Bone Conduction Hearing System by External Bone Conduction Stimulation With Headband

et al. 2016

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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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“…Comparative studies are used to determine how different devices affect the individual rehabilitation of patients with similar hearing condition. In the literature, it is common to find comparative studies where the devices are fitted to the same patient (12)(13)(14)(15), or retrospective studies (16,17). For implanted BCDs, an alternative method is to select two patients who are using different devices but have similar hearing loss, and compare the rehabilitation provided by their respective devices.…”

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confidence: 99%

Audiometric Comparison Between the First Patients With the Transcutaneous Bone Conduction Implant and Matched Percutaneous Bone Anchored Hearing Device Users

Rigato

Reinfeldt²,

Hȧkansson³

et al. 2016

Otology &Amp; Neurotology

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Comparison of Audiologic Results and Patient Satisfaction for Two Osseointegrated Bone Conduction Devices

Cited by 14 publications

References 9 publications

Ten years of experience with the Ponto bone‐anchored hearing system—A systematic literature review

Ten years of experience with the Ponto bone‐anchored hearing system—A systematic literature review

The Prediction of Speech Recognition in Noise With a Semi-Implantable Bone Conduction Hearing System by External Bone Conduction Stimulation With Headband

Audiometric Comparison Between the First Patients With the Transcutaneous Bone Conduction Implant and Matched Percutaneous Bone Anchored Hearing Device Users

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