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Abstract Introduction Bone anchored hearing solutions are a well-known option for patients with a conductive, mixed conductive-sensorineural hearing loss and those with single-sided deafness. Objective The aim of the present study was to evaluate the Ponto bone-anchored hearing system in terms of behavioral performance and self-reported outcomes, by comparing unaided and aided performance (softband and abutment), as well as aided performance with the sound processor on softband (preoperatively) versus abutment (postoperatively). Methods Fourteen adult bone-anchored candidates, with either a bilateral (n = 12) or unilateral (n = 2) conductive or mixed hearing loss, participated in the present study. Sound-field hearing thresholds were evaluated unaided and aided (softband and abutment). A speech-in-noise test was also performed unaided and aided for two spatial configurations (S0N90; implanted side; S0N90; nonimplanted side). The Glasgow Health Status Inventory and the Speech, Spatial and Quality of sound questionnaires were administered pre- and postsurgery to compare quality of life and perceived unaided and aided performance. Skin reaction (Holgers scores) was evaluated at 15 days, 6 weeks, and 10 weeks after surgery. Results Significant improvements postoperatively relative to unaided were obtained for sound-field thresholds at all tested frequencies. Additionally, sound-field thresholds were significantly improved with the sound processor on abutment relative to the softband at frequencies > 1 kHz. Improved performance postoperatively relative to unaided was also obtained in the speech-in-noise test and in self-reported outcomes. Conclusions Improvements in behavioral performance and self-reported outcomes were obtained with the sound processor mounted on abutment.
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It is challenging to achieve sufficient hearing gain in patients with mixed hearing loss. In chronic middle ear diseases, conventional passive reconstructive surgeries often result in suboptimal hearing gain and additional hearing aids may have limitations due to insufficient sound amplification, occlusion effect, acoustic feedback, and skin irritation. Middle ear implantation (MEI) using Vibrant Soundbridge (VSB) is another option for auditory rehabilitation in mixed hearing loss as well as sensorineural hearing loss. The floating mass transducer of VSB can be placed on various middle ear structures either directly or using different types of couplers in order to deliver vibratory mechanical energy to the cochlea. We report a patient who presented with bilateral mixed hearing loss due to chronic otitis media and had limitations using conventional hearing aids in the worse hearing ear. The patient was successfully treated with MEI using the Bell coupler together with middle ear surgery in a single step.
Subject(s)
Humans , Acoustics , Cochlea , Ear , Ear, Middle , Hearing , Hearing Aids , Hearing Loss, Mixed Conductive-Sensorineural , Hearing Loss, Sensorineural , Ossicular Prosthesis , Otitis Media , Rehabilitation , Skin , TransducersABSTRACT
Objective To investigate the speech recognition in noise in patients with unilateral conductive or mixed hearing impaired using Sophonotron Alpha 2 softband.Methods A total of 12 patients (12 ears) with unilateral conductive or mixed hearing loss participated in the survey and fitted with Sophonotron Alpha 2.The aided hearing threshold test and speech recognition test in noise were evaluated in both unaided and aided conditions.Results The average aided hearing threshold using Sophonotron Alpha 2 softband was 35.0±10.8 dB HL,showing significant improvement compared to that of unaided(P＜0.05).The average signal-to noise ratio loss was 5.9± 6.1 dB using Sophonotron Alpha 2 softband in noise,showing a more significant benefit than that of the unaided (13.6±10.9 dB).Conclusion The Sophonotron Alpha 2 softband can significantly improve speech recognition in noise for the patients with unilateral conductive or mixed hearing loss.
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Introduction Bone conduction implants are indicated for patients with conductive and mixed hearing loss, as well as for patients with single-sided deafness (SSD). The transcutaneous technology avoids several complications of the percutaneous bone conduction implants including skin reaction, skin growth over the abutment, and wound infection. The Bonebridge (MED-EL, Austria) prosthesis is a semi-implantable hearing system: the BCI (Bone Conduction Implant) is the implantable part that contains the Bone Conduction-Floating Mass Transducer (BC-FMT), which applies the vibrations directly to the bone; the external component is the audio processor Amadé BB (MED-EL, Austria), which digitally processes the sound and sends the information through the coil to the internal part. Bonebridge may be implanted through three different approaches: the transmastoid, the retrosigmoid, or the middle fossa approach. Objective This systematic review aims to describe the world́ s first active bone conduction implant system, Bonebridge, as well as describe the surgical techniques in the three possible approaches, showing results from implant centers in the world in terms of functional gain, speech reception thresholds and word recognition scores. Data Synthesis The authors searched the MEDLINE database using the key term Bonebridge. They selected only five publications to include in this systematic review. The review analyzes 20 patients that received Bonebridge implants with different approaches and pathologies. Conclusion Bonebridge is a solution for patients with conductive/mixed hearing loss and SSD with different surgical approaches, depending on their anatomy. The system imparts fewer complications than percutaneous bone conduction implants and shows proven benefits in speech discrimination and functional gain.(AU)
Subject(s)
Bone Conduction/physiology , Hearing Loss, Conductive , Cochlear Implants , TympanoplastyABSTRACT
This study aimed to demonstrate the diagnosis of profound mixed hearing loss which is inappropriate to be studied vigorously to prove that at the level of profound degree of severity there is a little contribution of conductive pathology. Two groups of 15 subjects each in the age range of 18-25 years with mean age of 21 years were included. Group I consisted of pure sensorineural hearing loss of profound degree and Group II was made up of pure sensorineural hearing loss of profound degree who later reported with middle ear disorder. Pure tone measurements were conducted on all the subjects following standard procedures. Conductive hearing loss was induced with insertion of the insert ear plugs/ear moulds without sound bore for subjects in Group I and pure tone threshold measurements were repeated. Air-conduction and bone-conduction thresholds were compared for subjects in Group II prior and later to check for any middle ear pathology. Results showed that when Group I was induced with conductive hearing loss, the pure tone average did not change and for Group II, there was no change in air-conduction thresholds by later developed outer ear/middle ear pathologies. Diagnosis of profound sensorineural hearing loss with the overlay of middle ear pathology will bring insights into physiology of hearing and highlight the important issues of management of middle ear pathology, not for the purpose of improvement of absolute hearing thresholds but for the case of wearing of amplification device restricting the further growth of pathology, etc.
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Middle ear implantation is an effective treatment for sensorineural, conductive and mixed hearing loss. The active middle ear implant's floating mass transducer (FMT) is placed on the middle ear structure or coupled to the inner ear fluid. Since the device is not directly placed on the external auditory canal, patients are free from feedback phenomenon and occlusion effect resulting from hearing aids. A 66-year-old patient suffered from bilateral hearing loss. The patient had difficulties in adapting to a conventional hearing aid because of feedback phenomenon in the right ear. The patient underwent a middle ear implantation using a CliP-Coupler to connect stapes head and FMT in the left ear. To our knowledge, this is the first case reported in Korea on middle ear implantation with CliP-Coupler at the stapes, for which hearing results were successful at postoperative 7 months.
Subject(s)
Aged , Humans , Ear , Ear Canal , Ear, Inner , Ear, Middle , Head , Hearing , Hearing Aids , Hearing Loss, Bilateral , Hearing Loss, Mixed Conductive-Sensorineural , Korea , Ossicular Prosthesis , Stapes , TransducersABSTRACT
Objective To investigate audiological characteristics of patients with intact tympanic membranes and conductive or mixed hearing loss .Methods A retrospective study was carried out among 30 patients (42 ears) with intact tympanic membranes and conductive or mixed hearing loss who underwent exploratory tympanotomy . The preoperative outcomes of pure tone audiometry ,tympanometry ,resonant frequency of middle ear and temporal bone CT scan were analyzed .Results Among 42 ears ,30 ears with otosclerosis and 12 ears with ossicular chain dis-ruption were confirmed in exploratory tympanotomy ,but only 5 ears showed positive findings in CT scan .The mean thresholds of bone conduction ,air conduction and air -bone gap at frequencies of 0 .5 ,1 and 2 kHz were 27 .5 ± 1 .3 dB HL ,67 .0 ± 1 .8 dB HL ,39 .5 ± 1 .1 dB HL ,respectively .An analysis of tympanometric data of all patients re-vealed that 50% of all ears (21/42) were type A tympanograms ,42 .9% (18/42) were type As tympanograms ,and 7 .1% (3/42) were type Ad tympanograms .The mean of the resonant frequency of the middle ear in otosclerositic patients (1 079 .0 ± 67 .4 Hz) was significantly higher than ossicular chain disruption patients (633 .3 ± 43 .6 Hz) . Conclusion Otosclerosis is the most common in the patients with intact tympanic membranes and conductive or mixed hearing loss .The middle ear resonant frequency of otosclerositic patients is significantly higher than that of ossicular chain disruption patients .
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Objective To summarize and analyze the pathogenesis ,methods of hearing reconstruction and curative effect of mixed hearing loss .Methods Patients with mixed hearing loss who underwent hearing reconstruc-tion from Jan 2009 to Dec 2011 in the ENT department of PLA General hospital were reviewed retrospectively .Af-ter the operation ,air conduction (AC) ,bone conduction (BC) ,air-bone gap (ABG) at main frequencies and audi-ometry changes were analyzed .Results Among 32 cases ,15 cases were chronic otitis media ,13 cases otosclerosis , 2 cases Van der Hoeve ,and 2 cases congenital middle ear malformations .There were 26 cases with significantly im-proved hearing after surgery ,and the effective rate was 81 .25% .AC showed great improvement at 0 .25~4 kHz (P0 .05) .BC showed improvements at 1 and 2 kHz and improved significantly only at 2 kHz .After operation ,pure tone audiometry at AC and BC separately improved 24 .94 ± 8 .15 dB and 5 .90 ± 7 .96 dB;ABG narrowed down to 19 .04 ± 11 .06 dB .Conclusion Mixed hearing losses are mostly seen in chronic otitis media and tympanosclerosis .After auditory rehabilitation ,patients can experience improved hearing .
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OBJECTIVES: To investigate the aided benefits, speech recognition in quiet and in noise, change in hearing and subjective report of satisfaction on mixed hearing loss adults implanted with Vibrant Soundbridge (VSB) middle ear implant. METHODS: Eight Cantonese speaking adult patients with mixed hearing loss were enrolled in a single-subject, repeated measures prospective study design. Audiometric testing, including air and bone conduction and word recognition under sound-field were conducted before surgery. Device activation was arranged 8 weeks after operation. Audiometric testing was taken to evaluate the change in hearing. Patients were asked to wear the device and come back for fine tuning as needed. Outcome measurements were undertaken at 3 and 6 months after device activation. The outcome measures included sound-field thresholds, Cantonese Hearing in Noise Test (CHINT), Abbreviated Profile of Hearing Aid Benefit (APHAB) and International Outcome Inventory for Hearing Aids (IOI-HA). RESULTS: The application of the VSB improved the aided thresholds and improved speech intelligibility in quiet and noise without significant changes in hearing thresholds. CONCLUSION: VSB is considered as a safe, effective and reliable auditory rehabilitation option for Cantonese speaking adults with mixed hearing loss.
Subject(s)
Adult , Humans , Bone Conduction , Ear, Middle , Hearing , Hearing Aids , Hearing Loss, Mixed Conductive-Sensorineural , Noise , Ossicular Prosthesis , Outcome Assessment, Health Care , Prospective Studies , Speech IntelligibilityABSTRACT
OBJECTIVES: The problem of noise-induced hearing loss (NIHL) was objectively and systematically investigated by diagnosing three workers who complained of tinnitus and hearing disturbance. METHODS: Atypical hearing loss is diagnosed as a work-related disease by using general medical methods, such as environmental survey, neurological examination, otoscopy, pure-tone audiometry, speech audiometry, otoacoustic emissions (OAE), auditory-evoked potentials, and interview on the history of past disease, family and occupation. RESULTS: Three results were found according to the work-related hearing loss as follows; (1) hearing loss that is caused by exposure to continuous noise of less than 85 dB(A) or impact noise of greater than 135 dB peak, (2) mixed hearing loss that has progressed due to noise with past otitis media, and (3) atypical hearing loss that showed remarkable differences between air and bone conduction due to tinnitus. CONCLUSIONS: The criteria for work-related hearing loss should be carefully investigated by considering exposure to impact noise, the effect of continuous noise on mixed hearing loss patients, and the hearing loss caused by tinnitus.