Hearing Outcomes with Percutaneous and Transcutaneous BAHA® Technology in Conductive and Mixed Hearing Loss

Abstract

Objectives: To evaluate outcomes of BAHA Connect 1 and BAHA Attract 1 implantations, and to examine the prognostic utility of a preimplantation Softband 1 -attached processor trial. Study Design: Retrospective case review Setting: Tertiary referral center. Patients: Patients who underwent Connect 1 (19 ears) and Attract 1 (25 ears) implantation between 2007 and 2017. Intervention: BAHA 1 implantation. Main Outcome Measures: Unaided air conduction (AC), bone conduction (BC), and speech reception thresholds (SRTs), as well as free field (FF) aided with Softband 1attached processor and with implant-attached processor thresholds. Results: Serviceable implant-attached processor PTA 0.5,1,2 kHz ( 35 dB HL) was achieved in 89 and 88% of the Connect 1 and the Attract 1 ears, respectively, while at 4 kHz this was achieved in 68 and 32% of the Connect 1 and the Attract 1 ears, respectively ( p ¼ 0.032). Significantly more Connect 1 ears showed alignment between FF aided with implant-attached processors thresholds and BC thresholds. The alignment between the Softband 1 -attached processors thresholds and implant-attached processors thresholds was similar in the two groups. Both groups exhibited similar positive improvement in the quality of life questionnaires Conclusions: Accessibility to sound with the implantattached processor is well predicted by the pre-implantation Softband 1 trial, both in the BAHA Connect 1 and in the BAHA Attract 1 ears. Hearing rehabilitation targets at 0.5, 1, and 2 kHz are met by most Connect 1 and Attract 1 ears, while at 4 kHz the outcome with Attract 1 is poorer. This information should be presented to the patient during consultation prior to a decision as to the type of BAHA 1 device to be implanted.

Reabilitação auditiva com sistemas Baha® transcutâneo e percutâneo

“…Teste t (p>0,05) Legenda: PAAO = prótese auditiva ancorada no osso; LRSS = limiar de reconhecimento de sentenças no silêncio Estes achados evidenciam que os sistemas transcutâneo e percutâneo são eficazes em transmitir o som por condução óssea, necessária para a reabilitação auditiva nesta população (20,23) , corroborando com estudos anteriores desenvolvidos com crianças (16,(24)(25)(26) e adultos (14,19,20) . Na mesma Figura 1, constata-se que os limiares tonais obtidos na ativação se mantiveram estáveis nos demais momentos de avaliação, pois não houve diferença significante quando analisadas todas as frequências (Tabela 2), para os sistemas transcutâneo e percutâneo.…”

“…Entretanto, foi observado que no sistema percutâneo os limiares tonais nas frequências de 3 e 4kHz são melhores quando comparados com os obtidos no sistema transcutâneo, diferença que se manteve nos três momentos: ativação, pós 1 e pós 2 (Tabela 3), apesar do componente sensorioneural observado nos indivíduos com Otite Média Crônica. Resultados semelhantes foram encontrados em estudos anteriores (16,19,20,25) .…”

“…Entretanto, poucos estudos tiveram como objetivo a comparação entre os sistemas Baha® Attract e Baha® Connect (19,20) . Os resultados observados indicaram melhora na audibilidade por meio da análise dos limiares em campo livre pré e pós adaptação, assim como no limiar de reconhecimento da fala (LRF) em ambos os sistemas.…”

“…Os resultados observados indicaram melhora na audibilidade por meio da análise dos limiares em campo livre pré e pós adaptação, assim como no limiar de reconhecimento da fala (LRF) em ambos os sistemas. Porém, na análise entre os sistemas, foi constatado desempenho melhor, com diferença significante, no limiar de 4kHz e no LRF para o sistema percutâneo (19,20) .…”

Comparison of Transcutaneous and Percutaneous Implantable Hearing Devices for the Management of Congenital Aural Atresia: A Systematic Review and Meta-Analysis

“…There were no studies among a CAA population that contained both a percutaneous and transcutaneous device group that compared quality-of-life outcomes. Although quality-of-life outcomes have been investigated with general use of pBCDs and tBCDs, results of individual studies have been mixed (79,80) and a comprehensive meta-analysis has yet to be conducted. This is an area of particular interest that could have a significant impact on decision making with BCDs moving forward.…”