The Bonebridge in Adults with Mixed and Conductive Hearing Loss: Audiological and Quality of Life Outcomes

Abstract

Background: Considering that hearing loss has a significant impact on social functioning, everyday activity and a person’s emotional state, one of the most important goals of hearing rehabilitation with bone conduction devices is improvement in a patient’s quality of life. Objectives: To measure self-assessed quality of life in patients implanted with the Bonebridge, a bone conduction device. Method: Prospective, observational, longitudinal study with one treatment group. Twenty-one patients with mixed or conductive hearing loss were included, and each individual served as its own control. The Abbreviated Profile of Hearing Aid Benefit (APHAB) was used to measure patient-reported quality of life before intervention and at 3 and 6 months after activation of the device. At the same time frames, pure-tone audiometry and speech understanding in quiet and in noise were tested. Results: Hearing-specific quality of life increased significantly after intervention and remained stable up to 6 months. Both word recognition in quiet and speech reception threshold in noise were significantly better after 6 months compared to before surgery. Outcomes of aided speech understanding were independent of initial bone conduction thresholds and equally high (word recognition score >75%) across the device’s indication range. Conclusions: The Bonebridge provides not only significant audiological benefit in both speech understanding in quiet and in noise, but also increases self-perceived quality of life in patients suffering from mixed and conductive hearing loss. Together with a very low rate and minor nature of adverse events, it is the state-of-the-art solution for hearing rehabilitation in patients with mixed or conductive hearing loss up to a bone conduction threshold of 45 dB HL.

Longitudinal economic analysis of Bonebridge 601 versus percutaneous bone‐anchored hearing devices over a 5‐year follow‐up period

“…Significant improvements in speech perception scores and perceived sound quality with Bonebridge are well documented 1,3,8,19,20 . The results from our study show comparable mean aided AB Word [phonemes] scores with both implants.…”

“…18 The Bonebridge, with its Bone Conduction Floating Mass transducer (BC-FMT) under the skin and coupled directly to the skull, minimises both post-surgical complications and avoids signal attenuation. 1,3,8,9 The significant benefit in speech perception scores, perceived sound quality and health-related quality of life with the Bonebridge system is well documented. For patients who would be both audiologically and anatomically appropriate candidates for either the pBAHD or Bonebridge system, the current practice in many centres is to offer the percutaneous system as the first line, based on the perception of increased costs associated with the Bonebridge.…”

“…In keeping with the reported literature, our study found no significant difference in perceived audiological benefit for the reported audiological inclusion criteria. 1,8,19,20 Completed pre-and post-APHAB data were recorded for only 37% of the Bonebridge and 39% of the pBAHD groups. Although it was adequate information, for the purpose of this particular study, to rule out any drastic deviation from established norms, we acknowledge the importance of robust patient-reported outcome measures and have since updated the departmental procedures to improve the rates of data capture.…”

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 ].…”

Audiological results and subjective benefit of an active transcutaneous bone-conduction device in patients with congenital aural atresia

“…The efficacy of percutaneous implants is well proved, but compared to transcutaneous devices, they more frequently cause skin problems, such as periabutment wound infections and overgrowing skin/soft tissue. In recent years, several reports on the use of transcutaneous devices, such as the Bonebridge, have been published and have shown promising results [9][10][11][12].…”