New developments in bone-conduction hearing implants: a review

Abstract

The different kinds of bone-conduction devices (BCDs) available for hearing rehabilitation are growing. In this paper, all BCDs currently available or in clinical trials will be described in categories according to their principles. BCDs that vibrate the bone via the skin are referred to as skin-drive devices, and are divided into conventional devices, which are attached with softbands, for example, and passive transcutaneous devices, which have implanted magnets. BCDs that directly stimulate the bone are referred to as direct-drive devices, and are further divided into percutaneous and active transcutaneous devices; the latter have implanted transducers directly stimulating the bone under intact skin. The percutaneous direct-drive device is known as a bone-anchored hearing aid, which is the BCD that has the largest part of the market today. Because of some issues associated with the percutaneous implant, and to some extent because of esthetics, more transcutaneous solutions with intact skin are being developed today, both in the skin-drive and in the direct-drive category. Challenges in developing transcutaneous BCDs are mostly to do with power, attachment, invasiveness, and magnetic resonance imaging compatibility. In the future, the authors assume that the existing percutaneous direct-drive BCD will be retained as an important rehabilitation alternative, while the transcutaneous solutions will increase their part of the market, especially for patients with bone-conduction thresholds better than 35 dB HL (hearing level). Furthermore, the active transcutaneous direct-drive BCDs appear to be the most promising systems, but to establish more detailed inclusion criteria, and potential benefits and drawbacks, more extensive clinical studies are needed.

Effectiveness in Rehabilitation of Current Wireless CROS Technology in Experienced Bone-Anchored Implant Users

“…Although percutaneous implant systems disrupt the skin, they allow for the most direct path of bone conduction. Transcutaneous systems have been shown to further attenuate the signal with the most significant reduction in the high frequencies 33 . To control for this unknown variable, the present study was limited to percutaneous BAI users only.…”

Bonebridge Implantation for Conductive Hearing Loss in a Patient with Oval Window Atresia

“…Because Bonebridge is an active transcutaneous bone conduction device in which the external sound processor transmits electromagnetic signals through the skin into the implanted transducer, it can achieve bone conduction hearing gain without the occlusion effect in patients with oval window atresia [11] .…”

Fiatalkori hallásrehabilitáció Baha® Attract implantátumrendszerrel

“…Ezen tulajdonságai miatt gyerekkori alkalmazása jelentős előnyökkel bírhat. Reinfeldt és mtsai összefoglalója alapján ezek az új rendszerek feloszthatók úgynevezett aktív (transzducer implantálva) és passzív (mágnes implantálva) transcutan implantátumokra [1]. Előbbi aktív típusúak közé tartozik a MED-EL ® Bonebridge™, amelynek serdülőkori alkalmazásáról és eredményeiről hazai viszonylatban részletesen beszámolt Katona Gábor professzor [12,13].…”

“…Ekkor merül fel a csontvezetéses hallásjavító készülékek alkalmazása, amelyek klasszikus képviselői a szemüvegszárba épített készülékek. A később bekövetkezett paradigmaváltás alapját, azaz, hogy a csontvibrátor közvetlenül a koponyához horgonyozva továbbítson rezgési energiát, Per Ingvar Brånemark professzor titániumimplantátum osseointegrációról tett megfigyelései adták az 1950-es években [1]. Az első direkt csontvezetéses hallókészülék (Baha ® Connect implantátum) beültetése óta, amelyet 1977-ben Tjellström professzor végzett el, már több mint 150 000 implantáció történt világszerte [2].…”