ABSTRACT
CONCLUSION: Hearing restoration using an active middle ear implant (AMEI) is a highly cost-effective treatment for a selected group of patients with no other possibilities for auditory rehabilitation. OBJECTIVES: To evaluate the cost-utility of using an AMEI for hearing rehabilitation. METHODS: This was a prospective, multicenter, single-subject repeated study in six tertiary referral centers. Twenty-four patients with sensorineural (SNHL), conductive (CHL), and mixed hearing loss (MHL) were implanted with the AMEI Vibrant Soundbridge® (VSB) for medical reasons. All patients were previously rehabilitated with conventional hearing aids. Multiple validated quality of life patient questionnaires, Health Utilities Index (HUI 2 and 3), and Glasgow Hearing Aid Benefit Profile (GHABP) were used to determine the utility gain and quality adjusted life years (QALY). Directly related treatment costs for the implantation were calculated and related to utility gain and QALY. RESULTS: The cost/QALY for patients with SNHL was estimated at 7260/QALY, and for patients with C/MHL at 12 503/QALY.
Subject(s)
Hearing Loss/surgery , Ossicular Prosthesis/economics , Ossicular Replacement/economics , Hearing Loss/economics , Humans , Middle Aged , Norway , Patient Satisfaction , Prospective Studies , Quality-Adjusted Life Years , SwedenSubject(s)
Auditory Brain Stem Implantation , Auditory Brain Stem Implants , Hearing Disorders/therapy , Age Factors , Auditory Brain Stem Implantation/adverse effects , Auditory Brain Stem Implants/adverse effects , Child , Cochlear Diseases/congenital , Contraindications , Deafness/therapy , Electrodes , Electrophysiology , Hearing Disorders/diagnostic imaging , Humans , Neurofibromatosis 2 , Otologic Surgical Procedures , Patient Care Team , RadiographyABSTRACT
CONCLUSIONS: The results indicate that SOM of extreme duration, and maybe also the treatment of SOM, are risk factors for developing permanent hearing loss, both conductive and sensorineural. OBJECTIVE: Fluctuating or persisting hearing loss of varying degrees is known to accompany secretory otitis media (SOM). The aim of this study was to detect possible hearing sequelae in young adults who had suffered from "refractory" SOM during childhood. MATERIAL AND MEDTHODS: A total of 33 subjects (age 16-25 years) with previous SOM that had persisted for a mean of 11 years (range 6-19 years) were retrospectively examined at a mean of 18 years after their first myringotomy or tube insertion and compared to 15 healthy controls. The follow-up included audiometric examinations (pure-tone audiometry, distorted speech and impedance audiometry), otomicroscopy and scrutiny of medical records. RESULTS: The SOM group had poorer hearing at all frequencies with the exception of 1.5 kHz in the range 0.125-16 kHz. Those with the greatest number of myringotomies and tube insertions and those with the longest duration of SOM had significantly poorer hearing at high frequencies (8-16 kHz) than those with fewer tube insertions and a shorter duration of SOM. The SOM group scored lower on distorted speech tests than the controls.
Subject(s)
Hearing Loss, High-Frequency/etiology , Otitis Media with Effusion/complications , Adolescent , Adult , Audiometry , Auditory Threshold , Bone Conduction , Case-Control Studies , Female , Follow-Up Studies , Humans , Male , Microscopy , Middle Ear Ventilation/statistics & numerical data , Otoscopy , Retrospective Studies , Speech Perception , Time FactorsABSTRACT
To investigate whether recurrent purulent otitis media results in permanent hearing loss, we studied 2 subgroups of children from a cohort, earlier prospectively followed from birth to the age of 3 years. One subgroup had recurrent acute otitis media (n = 12), and the other had no acute otitis media at all ("healthy" children; n = 21). At follow-up of these subgroups at the age of 10, no child had acute otitis media or secretory otitis media. There was no difference between the groups in hearing level thresholds at the frequencies 125 Hz to 8 kHz. However, in the children with recurrent acute otitis media, as compared with the controls, the hearing levels at high frequencies (8 to 16 kHz) and the acoustic middle ear reflex thresholds were elevated, the middle ear compliance was higher, and click-evoked otoacoustic emission response levels and middle ear pressures were lower. The results suggest that the middle ear mechanics of children with recurrent acute otitis media are affected, and also that their cochlear function might be disturbed.
