A Comparative Study of a Novel Adhesive Bone Conduction Device and Conventional Treatment Options for Conductive Hearing Loss.

OBJECTIVE: To compare the audiological performance with the novel adhesive bone conduction hearing device (ADHEAR) to that with a passive bone conduction (BC) implant and to that with a bone conduction device (BCD) on a softband. STUDY DESIGN: Prospective study in an acute setting, single-subject repeated measure in three situations: unaided, with conventional BCDs (passive implant or on softband), and with the ADHEAR. SETTING: Tertiary referral center. PATIENTS: Ten subjects with conductive hearing loss were evaluated with the ADHEAR. Five of these were users of a passive BC implant (Baha Attract with Baha4); five received a BCD (Baha4) on a softband for test purposes. INTERVENTION: Use of non-invasive adhesive bone conduction system for the treatment of conductive hearing loss. MAIN OUTCOME MEASURES: Air and bone conduction thresholds, sound field thresholds, word recognition scores in quiet, and speech recognition thresholds in quiet and noise were assessed. RESULTS: Users of the passive BC implant received comparable hearing benefit with the ADHEAR. The mean aided thresholds in sound field measurements and speech understanding in quiet and noise were similar, when subjects were evaluated either with the ADHEAR or the passive BC implant. The audiological outcomes for the non-implanted group were also comparable between the ADHEAR and the BCD on softband. CONCLUSIONS: Based on our initial data, the ADHEAR seems to be a suitable alternative for patients who need a hearing solution for conductive hearing loss but for medical reasons cannot or do not want to undergo surgery for a passive BC implant.

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

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.

Preservation of Hearing Following Cochlear Implantation Using Different Steroid Therapy Regimens: A Prospective Clinical Study.

BACKGROUND A prospective clinical study was conducted to assess different regimens of steroid therapy and preservation of hearing following cochlear implantation. MATERIAL AND METHODS Study participants were ≥18 years-of-age, with a cochlear duct length ≥27.1 mm measured by computed tomography (CT), with hearing sound levels in the range of 10-120 decibels (dB) and sound frequencies of 125-250 hertz (Hz); sound levels of 35-120 dB and frequencies of 500-1,000 Hz; sound levels of 75-120 dB and frequencies of 2,000-8,000 Hz. Study exclusion criteria included diseases with contraindications for steroid therapy or medications that increased the effects of steroids. Patients had cochlear implantation and were divided into three treatment groups: intravenous (IV) steroid therapy (standard steroid therapy): combined oral and IV steroid therapy (prolonged steroid therapy); and a control group (cochlear implantation without steroid therapy). Hearing preservation was established by pure tone audiometry based on the pre-operative and postoperative average hearing thresholds according to the formula developed by the HEARRING Network. RESULTS There were 36 patients included in the study. In all cases, the cochlear implant electrode was inserted via the round window approach with a straight electrode length of 28 mm. Patients with combined oral and IV steroid therapy (prolonged steroid therapy) had better results when compared with patients with intravenous (IV) steroid therapy (standard steroid therapy) and the control group. CONCLUSIONS Prolonged steroid therapy using combined oral and IV steroids stabilized hearing thresholds and preserved hearing in adult patients following cochlear implantation.

Osteogenesis Imperfecta: Phenotypic and Intraoperative Findings Observed in Patients Treated Surgically at the World Hearing Centre.

OBJECTIVES: Osteogenesis imperfecta (OI) is a systemic connective tissue disease that affects many systems and organs. Features of the disease are bone deformities, blue sclerae, and changes in the teeth, all of which may be accompanied by hearing loss. Bone fragility also affects structures of the ear, with half the patients developing changes in the auditory ossicles, which manifest as hearing loss. The most typical malformation affects the stapes, although the site of malformation within the middle ear varies. This study aims to characterize patients with OI who underwent surgery due to hearing loss and to find factors that affect the hearing results. MATERIALS AND METHODS: This study presents an analysis of phenotypic and intraoperative changes among 20 patients with OI, treated surgically for hearing loss. RESULTS: Hearing loss typically affects type I patients with OI. The most common changes concern stapes footplate, arms, and tympanic cavity lining. During reoperations, osseous regrowth was typically detected. CONCLUSION: The greater the changes induced systemically by OI, the greater the risk of significant malformations in the middle ear. Patients with OI are at an increased risk of needing revision surgery and of suffering intraoperative complications such as bleeding, which hinders safe completion of the procedure.