Improvement of speech perception in quiet and in noise without decreasing localization abilities with the bone conduction device Bonebridge

Abstract

The aim of this study was to examine the functional hearing results regarding speech perception and auditory sound localization in a high-resolution directional hearing setup following implantation with a new bone conduction device (MED-EL Bonebridge, Innsbruck, Austria). In addition, we assessed the patient acceptance of the Bonebridge system using a questionnaire. The study design is retrospective study. The setting is University Hospital Frankfurt. 18 patients implanted with a Bonebridge device from May 2012 to January 2015 were participated in this study. Speech perception in quiet was tested with the Freiburg monosyllable test at a presentation level of 65 dB SPL. Speech perception in noise was tested post-operatively with the Oldenburg sentence test (OLSA) in best-aided condition. We assessed auditory sound localization with a high-resolution directional hearing setup. To evaluate the acceptance by patients using the Bonebridge in daily life, we used a modified questionnaire. The overall average of functional hearing gain (n = 18) was 29.3 dB (±20.7 dB). Speech perception of monosyllabic words in quiet improved by 20.7% on average, compared with the pre-operative aided condition. Mean speech reception thresholds (SRTs) of the Oldenburg sentence test (OLSA) improved significantly from -3.8 dB SNR (range -5.7 to 5.8 dB SNR) to -5.2 dB SNR (range -6.3 to -0.6 dB SNR) after implantation. Regarding localization abilities, no significant difference was found between the unaided and aided conditions following Bonebridge implantation. A survey of patients' acceptance and handling of the Bonebridge implant in daily life revealed high patient satisfaction. All patients accepted and benefited from the implanted system. No infections or adverse surgical effects occurred. Speech perception significantly improved in quiet and in noise. No significant difference in sound localization was observed. Acceptance of the Bonebridge implant, tested with a modified questionnaire, was high.

A Bone Conduction Implantable Device as a Functional Treatment Option in Unilateral Microtia with Bilateral Stapes Ankylosis: A Report of Two Cases

“…As far as we know, there have no previously published reports that have applied and compared the Speech, Spatial and Qualities (SSQ). However, in contrast with the findings of Weiss et al, [ 41 ], the two patients reported, showed an improvement in spatial localization with the Bonebridge BCI system, but this finding was less prominent than the increase in perception of speech and noise and the quality of the perceived sound. However, the use of subjective patient questionnaires for treatment response is a limitation in the assessment of the responses to the use of the Bonebridge BCI system in these two cases.…”

“…Also, no specific rehabilitation was needed, and soon after activation and fitting of the audio processor, both patients were able to understand a conversation, even in a non-native language. Importantly, the functional gain in hearing following implantation was comparable to previously published cases in the literature in terms of pure-tone thresholds (+39.25 vs. +26.1±13.7; 29.3±20.7) [ 40 , 41 ], whereas speech recognition scores were higher(100% at +70 dB, vs. +36.25 dB and 95% at +21%) [ 28 ]. The 2.5 dB hearing loss and 3.5 dB hearing loss bone conduction improvement observed in both cases was not surprising, given the known Carhart effect due to stapes ankylosis in congenital middle ear malformation [ 42 ].…”

Active transcutaneous bone conduction hearing implants: Systematic review and meta-analysis

“…The preoperative and postoperative results can be seen in the S2 Table. Speech understanding in quiet was assessed in 27 publications [16, 26, 27, 7, 28, 22, 29, 24, 30, 10, 31, 25, 32–34, 18, 12, 13, 35, 36, 20, 14, 37, 38, 21, 39], resulting in a mean unaided WRS score of 25.73±23.64% improving to 84.48±15.09% in the aided condition, resulting in an overall mean improvement of almost 60% (S2 Table).…”

“…Results for speech in noise tests could not be compared directly in a meta-analysis due to the individual test set-up and inconsistency in reporting for the different studies. However, an improvement in speech understanding in noise was observed with the atBCI in all studies for subjects with CHL or MHL (S2 Table) [23, 8, 13, 20, 38, 21].…”

Patient-reported long-term benefit with an active transcutaneous bone-conduction device

“…Our audiological results are in line with previous studies [ 4 , 13 , 14 , 23 , 24 , 26 , 27 , 30 , 35 , 36 ]. The mean gain in speech understanding was very high compared to the results in other studies, which also used the German monosyllabic Freiburger test at 65 dB [ 23 – 25 , 29 , 35 , 36 ].…”