Evaluation of the Benefits of Bilateral Fitting in Bone-Anchored Hearing System Users: Spatial Resolution and Memory for Speech

Abstract

Objectives: The purpose of this study was to evaluate the benefits of bilateral implantation for bone-anchored hearing system (BAHS) users in terms of spatial resolution abilities and auditory memory for speech. Design: This is a prospective, single-center, comparative, single-blinded study where the listeners served as their own control. Twenty-four experienced bone-anchored users with a bilateral conductive or mixed hearing loss participated in the study. After fitting the listeners unilaterally and bilaterally with BAHS sound processor(s) (Ponto 3 SuperPower), spatial resolution was estimated by measuring the minimum audible angle (MAA) to achieve an 80% correct response via a two-alternative-forced choice task (right-left discrimination of noise bursts) in two conditions: both sound processors active (bilateral condition) and only one sound processor active (unilateral condition). In addition, a memory recall test, the Sentence-final Word Identification and Recall (SWIR) test was performed with five lists of seven sentences for each of the two conditions (unilateral and bilateral). Self-reported performance in everyday life with the listener’s own sound processors was also evaluated via a questionnaire (the abbreviated version of the Speech, Spatial and Qualities of Hearing scale). Results: The MAA to discriminate noise bursts improved significantly from 75.04° in the unilateral condition to 3.61° in the bilateral condition ( p < 0.0001). The average improvement in performance was 54.28°. The SWIR test results showed that the listeners could recall, on average, 55.03% of the last words in a list of seven sentences in the unilateral condition and 57.23% in the bilateral condition. While the main effect of condition was not significant, there was a significant interaction between condition and repetition (list), revealing a significantly higher recall performance in the bilateral condition than in the unilateral condition for the second repetition/list out of five (10.2% difference; p = 0.022). Self-reported performance with bilateral BAHS obtained via the Speech, Spatial and Qualities of Hearing scale questionnaire was, on average, 4.4 for speech, 3.7 for spatial, and 5.1 for qualities of hearing. There was no correlation between self-reported performance in everyday life and bilateral performance in the MAA test, while significant correlations were obtained between self-reported performance and recall performance in the SWIR test. Conclusions: These results showed a large benefit in spatial resolution for users with symmetric BC thresholds when being fitted with two BAHS, although their self-reported performance with bilateral BAHS in everyday life was rather low. In addition, there was no overall benefit of bilateral fitting on memory for speech, despite observing a benefit in one out of five repetitions of the SWIR test. Performance in the SWIR test was cor...

Adaptação bilateral de próteses auditivas ancoradas no osso: reconhecimento de fala e localização sonora

“…O presente estudo também concluiu que a adaptação bilateral é melhor, porém, diferente da literatura, foi utilizado um estímulo verbal ao invés de um estímulo de ruído. Todos os estudos citados (Snik et al, 1998;Bosman et al, 2001;Priwin et al, 2004;Priwin et al, 2007;Dun et al, 2013;Snapp et al, 2020;den Besten et al, 2020, Caspers et al, 2022Brassington et al, 2023) utilizaram estímulo de ruído, enquanto no presente estudo utilizamos a palavra gravada "cadeira". Os bursts de ruído utilizados nos trabalhos variaram entre as frequências de 500 a 3000Hz, por ser a faixa de frequência onde as PAAO tem melhor amplificação efetiva.…”

“…Outros estudos consideravam uma pontuação "boa" se o paciente referisse o alto-falante certo ou o imediatamente adjacente, a 45° de distância (Snik et al, 1998) ou a 30° (Bosman et al, 2001), dependendo da quantidade de alto-falantes utilizados na pesquisa. Alguns estudos ainda consideraram a lateralização correta (Bosman et al, 2001;Dun et al, 2013;den Besten et al, 2020;Caspers et al, 2022;Brassington et al, 2023).…”