scholarly journals Three-year audiological outcomes of the latest generation middle ear transducer (MET) implant

2020 ◽  
Vol 277 (11) ◽  
pp. 3013-3019
Author(s):  
Henryk Skarżyński ◽  
Beata Dziendziel ◽  
Elżbieta Włodarczyk ◽  
Piotr H. Skarżyński
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Middle Ear ◽  
Pure Tone Audiometry ◽  
Mixed Hearing Loss ◽  
Speech Reception ◽  
Speech Reception Thresholds ◽  
Technical Complication ◽  
Bilateral Sensorineural Hearing Loss

Abstract Purpose To evaluate the long-term audiological outcomes and safety of the latest generation of middle ear transducer (MET) among a group of Polish patients. Methods Ten patients aged 48–72 years with bilateral sensorineural hearing loss (n = 8) and mixed hearing loss (n = 2) were included in this study. Pure tone audiometry, sound thresholds, word recognition scores in quiet and speech reception thresholds in noise were assessed. Medical and technical complication information was gathered. Results All the patients underwent unilateral implantation with the latest generation Cochlear MET between 2014 and 2016. Mean length of follow-up was 3.7 years. Compared to the unaided condition, the implant provided significant functional gain (mean M = 26.1 dB) at 12 months follow-up. Compared to before surgery, average word recognition in quiet at 65 dB and at 80 dB SPL, as well as speech reception threshold in noise, were significantly better at 12 months. However, postoperative air conduction thresholds 6 months after implantation worsened by 10.3 dB (standard deviation SD = 5.8 dB). Postoperatively, three patients had skin problems around the processor, and one of them completely resigned from using the device 5 months after activation. Technical failures occurred in 4 cases. There were 9 out of 10 patients who still used the MET, but only 5 of them used the processor regularly (every day). Conclusion Despite changes in the transducer implemented by the manufacturer, we observed a significant number of adverse events in users of the latest generation of MET.

scholarly journals The Bonebridge BCI 602 Active Transcutaneous Bone Conduction Implant in Children: Objective and Subjective Benefits

2021 ◽  
Vol 10 (24) ◽  
pp. 5916
Author(s):  
Katarzyna B. Cywka ◽  
Henryk Skarżyński ◽  
Bartłomiej Król ◽  
Piotr H. Skarżyński
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Middle Ear ◽  
Bone Conduction ◽  
Free Field ◽  
Subjective Assessment ◽  
Congenital Defects ◽  
Mixed Hearing Loss ◽  
Speech Reception ◽  
Bone Conduction Implant

Background: the Bonebridge hearing implant is an active transcutaneous bone conduction implant suitable for various types of hearing loss. It was first launched in 2012 as the BCI 601, with a newer internal part (BCI 602) released in 2019. With the new size and shape, the BCI 602 can be used in patients previously excluded due to insufficient anatomical conditions, especially in patients with congenital defects of the outer and middle ear. Objectives: the purpose of this study is to evaluate the objective and subjective benefits of the new Bonebridge BCI 602 in children who have hearing impairment due to conductive or mixed hearing loss. Safety and effectiveness of the device was assessed. Methods: the study group included 22 children aged 8–18 years (mean age 14.7 years) who had either conductive or mixed hearing loss. All patients were implanted unilaterally with the new Bonebridge BCI 602 implant. Pure tone audiometry, speech recognition tests (in quiet and noise), and free-field audiometry were performed before and after implantation. Word recognition scores were evaluated using the Demenko and Pruszewicz Polish Monosyllabic Word Test, and speech reception thresholds in noise were assessed using the Polish Sentence Matrix Test. The subjective assessment of benefits was carried outusing the APHAB (Abbreviated Profile of Hearing Aid Benefit) questionnaire. Results: after implantation of the Bonebridge BCI 602 all patients showed a statistically significant improvement in hearing and speech understanding. The mean word recognition score (WRS) changed from 12.1% before implantation to 87.3% after 6 months. Mean speech reception threshold (SRT) before implantation was +4.79 dB SNR and improved to −1.29 dB SNR after 6 months. All patients showed stable postoperative results. The APHAB questionnaire showed that difficulties in hearing decreased after implantation, with a statistically significant improvement in global score. Pre-operative scores (M = 35.7) were significantly worse than post-operative scores at 6 months (M = 25.7). Conclusions: the present study confirms that the Bonebridge BCI 602 is an innovative and effective solution, especially for patients with conductive and mixed hearing loss due to anatomical ear defects. The Bonebridge BCI 602 system provides valuable and stable audiological and surgical benefits. Subjective assessment also confirms the effectiveness of the BCI 602. The BCI 602 offers the same amplification as the BCI601, but with a smaller size. The smaller dimensions make it an effective treatment option for a wider group of patients, especially children with congenital defects of the outer and middle ear.

scholarly journals A Tympanic Membrane Cholesteatoma: A Case Report and Literature Review

2019 ◽  
pp. 1-3
Author(s):  
Hsing-Won Wang ◽  
Fei-Peng Lee ◽  
Pin-Zhir Chao ◽  
Hsing-Won Wang
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Squamous Epithelium ◽  
Soft Tissue Mass ◽  
Pure Tone Audiometry ◽  
Type I ◽  
Tissue Mass ◽  
Otoscopic Examination

A 45-year-old female complained of right hearing loss with fullness in recent months. She underwent right tympanoplasty type I about 4 years ago. On physical and otoscopic examination, a pearl-like mass about 3 x 4 mm in size over central part of right ear drum was noted. Pure tone audiometry test showed 35 decibel (dB) average hearing loss of right ear, and 20 dB of left ear. Tympanogram test showed bilateral type A. Computed tomography with thin cuts of the temporal bone revealed a 3 x 4 mm soft tissue mass over central part of right ear drum. Excision of the mass under microscope was smoothly done. A cholesteatoma was confirmed by pathology. She was uneventful during a regular follow-up. Cholesteatomas are benign collections of keratinized squamous epithelium within the middle ear. A cholesteatoma usually occurred in middle ear cavity or mastoid region, sometimes in external auditory canal. Tympanic membrane cholesteatomas were seldom reported.

An alternative approach to mixed hearing loss in otosclerosis: stapes surgery combined with an active middle-ear implant

2018 ◽  
Vol 132 (5) ◽  
pp. 457-460 ◽  
Author(s):  
H R F Powell ◽  
I Pai ◽  
H Ghulam ◽  
D Jiang
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Hearing Aids ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Stapes Surgery ◽  
Vibrant Soundbridge ◽  
Monosyllabic Word ◽  
Active Middle Ear Implant ◽  
Mixed Hearing Loss

AbstractObjective:To report a novel management strategy for mixed hearing loss in advanced otosclerosis.Methods:A 50-year-old male was referred to St Thomas’ Hearing Implant Centre with otosclerosis; he was no longer able to wear conventional hearing aids because of recurrent otitis externa. The patient underwent short process incus vibroplasty (using the Med-El Vibrant Soundbridge device), followed at a suitable interval (six weeks) by stapes surgery. The main outcome measures were: pure tone audiometry, functional gain and monosyllabic word recognition scores.Results:Post-operative pure tone audiometry showed a reduction of the mean air–bone gap from 55 dB HL to 20 dB HL. The residual mixed hearing loss was rehabilitated with the Vibrant Soundbridge, with an average device gain of 32 dB. The monosyllabic word recognition scores in quiet at 65 dB improved from 37 to 100 per cent when using the Vibrant Soundbridge at six months after switch-on of the device.Conclusion:Stapedotomy in conjunction with incus short process vibroplasty (i.e. inner-ear vibroplasty) is a safe and promising procedure for managing advanced otosclerosis with mixed hearing loss in selected patients.

Ossicular chain reconstruction: endoscopic or microscopic?

2021 ◽  
pp. 1-7
Author(s):  
E A Guneri ◽  
A Cakir Cetin
Keyword(s):  
Word Recognition ◽  
Middle Ear ◽  
Risk Index ◽  
Ossicular Chain ◽  
Recognition Score ◽  
Reconstruction Surgery ◽  
Ossicular Chain Reconstruction ◽  
Operation Duration ◽  
Air Conduction

Abstract Objective To compare the results of endoscopic and microscopic ossicular chain reconstruction surgery. Methods Patients undergoing ossicular chain reconstruction surgery via an endoscopic (n = 31) or microscopic (n = 34) technique were analysed for age, gender, Middle Ear Risk Index, ossicular chain defect, incision type, ossicular chain reconstruction surgery material, mean air conduction threshold, air–bone gap, air–bone gap gain, word recognition score, mean operation duration and mean post-operative follow up. Results Post-operative air conduction, air–bone gap and word recognition score improved significantly in both groups (within-subject p < 0.001 for air conduction and air–bone gap, and 0.026 for word recognition score); differences between groups were not significant (between-subject p = 0.192 for air conduction, 0.102 for air–bone gap, and 0.709 for word recognition score). Other parameters were similar between groups, except for incision type. However, endoscopic ossicular chain reconstruction surgery was associated with a significantly shorter operation duration (p < 0.001). Conclusion Endoscopic ossicular chain reconstruction surgery can achieve comparable surgical and audiological outcomes to those of microscopic ossicular chain reconstruction surgery in a shorter time.

Unchanged unilateral hearing loss and ipsilateral growth of an acoustic neuroma from 1 to 4 cm

1993 ◽  
Vol 107 (3) ◽  
pp. 230-232
Author(s):  
Jos P. P. M. van Leeuwen ◽  
Cor W. R. J. Cremers ◽  
Henk O. M. Thijssen ◽  
Henk E. Meyer
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
False Negative ◽  
Pure Tone Audiometry ◽  
Tumour Volume ◽  
Sensorineural Hearing ◽  
Speech Audiometry ◽  
Volume Doubling Time ◽  
Volume Doubling

Progressive sensorineural hearing loss is the most important early symptom of a cerebellopontine angle process. A case report is presented of a 42-year-old woman who was referred to our department in 1979. Oil cistemography showed non filling of the left internal acoustic canal. Audiometry was planned as the method of control, but she did not return until nine- years later. In 1988, an acoustic neurionoma of 4 cm diameter was found in the left CPA. Pure tone audiometry and speech audiometry showed that during the nine-year interval, her 60 dB flat sensorineural hearing loss and speech perception thresholds had remained almost unchanged. A follow-up with only tone and speech audiometry can lead to a false negative diagnosis in some of these cases. Calculation of the growth in tumour volume over nine years in this patient showed a tumour volume doubling time of about 15 months.

A new semi-implantable middle ear implant for sensorineural hearing loss: three-years follow-up in a pilot patient’s group

2017 ◽  
Vol 138 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Maurizio Barbara ◽  
Luigi Volpini ◽  
Chiara Filippi ◽  
Francesca Atturo ◽  
Simonetta Monini
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Middle Ear ◽  
Sensorineural Hearing ◽  
Middle Ear Implant

Total and Partial Ossicular Replacement Prostheses in Children

1994 ◽  
Vol 110 (3) ◽  
pp. 302-303 ◽  
Author(s):  
Alexander Kessler ◽  
William P. Potsic ◽  
Roger R. Marsh
Keyword(s):  
Success Rate ◽  
Middle Ear ◽  
Binaural Hearing ◽  
Surgical Success ◽  
Ossicular Reconstruction ◽  
Speech Reception ◽  
Ossicular Replacement ◽  
Middle Ear Disease ◽  
Speech Reception Thresholds ◽  
Early Reconstruction

Although ossicular reconstruction in children may carry a risk of failure because of recurrent middle ear disease, the procedure offers the potential for restoring binaural hearing during the school years when it is so critical. Of a series of 45 reconstructions with total and partial ossicular replacement prostheses, 6 were extruded for a surgical success rate of 87%. Of the successful cases, 74% had air-bone gaps of 30 dB or better, and 74% had speech reception thresholds of 30 dB or better on initial postoperative audiogram. Outcomes for these children were comparable with those reported for adults, supporting the value of early reconstruction.

scholarly journals Speech Understanding and Sound Localization with a New Nonimplantable Wearing Option for Baha

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Tom Gawliczek ◽  
Wilhelm Wimmer ◽  
Fabio Munzinger ◽  
Marco Caversaccio ◽  
Martin Kompis
Keyword(s):  
Hearing Loss ◽  
Sound Localization ◽  
Bone Conduction ◽  
Speech Understanding ◽  
Bilateral Hearing Loss ◽  
Speech Understanding In Noise ◽  
Speech Reception ◽  
Significant Difference ◽  
Speech Reception Thresholds ◽  
Sound Processor

Objective. To measure the audiological benefit of the Baha SoundArc, a recently introduced nonimplantable wearing option for bone conduction sound processor, and to compare it with the known softband wearing option in subjects with normal cochlear function and a purely conductive bilateral hearing loss.Methods. Both ears of 15 normal hearing subjects were occluded for the time of the measurement, yielding an average unaided threshold of 49 dB HL (0.5 – 4 kHz). Soundfield thresholds, speech understanding in quiet and in noise, and sound localization were measured in unaided conditions and with 1 or 2 Baha 5 sound processors mounted on either a softband or a SoundArc device.Results. Soundfield thresholds and speech reception thresholds were improved by 19.5 to 24.8 dB (p<.001), when compared to the unaided condition. Speech reception thresholds in noise were improved by 3.7 to 4.7 dB (p<.001). Using 2 sound processors rather than one improved speech understanding in noise for speech from the direction of the2nddevice and sound localization error by 23° to 28°. No statistically significant difference was found between the SoundArc and the softband wearing options in any of the tests.Conclusions. Bone conduction sound processor mounted on a SoundArc or on a softband resulted in considerable improvements in hearing and speech understanding in subjects with a simulated, purely conductive, and bilateral hearing loss. No significant difference between the 2 wearing options was found. Using 2 sound processors improves sound localization and speech understanding in noise in certain spatial settings.

scholarly journals Middle Ear Transducer: Long Term Stability of the Latest Generation T2

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Nils Kristian Prenzler ◽  
Eugen Kludt ◽  
Thomas Giere ◽  
Rolf Salcher ◽  
Thomas Lenarz ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Observation Time ◽  
Term Stability ◽  
Long Term Stability ◽  
Average Observation ◽  
Technical Failures

Objectives/Hypothesis. Comparing long term stability of the Middle Ear Transducers (MET) of the 1st generation T1 (Otologics LLC) with the current generation T2 (Cochlear Ltd.) in all our clinical cases with standard incus coupling. Study Design. Retrospective chart review. Methods. 52 ears implanted with a MET device between 2008 and 2016 were analyzed retrospectively. All patients suffered from sensorineural hearing loss and the actuator was coupled to the body of the incus (standard coupling). 23 ears were implanted with the transducer T1 (Otologics LLC) between 2008 and 2011 and 29 ears were implanted with the current transducer T2 since 2011 (Otologics LLC/Cochlear Ltd.). Latest available in situ and bone conduction (BC) thresholds were exploited for a follow-up period of up to 7 years after first fitting. Long term stability of coupling and actuator performance was evaluated by tracking differences between in situ and BC thresholds. Results. In the T1 group, 9 out of 23 implants were still used by the patients at their last follow-up visit (average observation time 3.7 yrs.; min 1.0 yrs., max 7.4 yrs.). In 9 patients a technical failure identified by a decrease of in situ threshold of more than 15 dB compared to BC thresholds [Δ (in situ – BC)] lead to non-usage of the implant and 7 explantations. Five other explantations occurred due to medical reasons such as BC threshold decrease, infection, or insufficient speech intelligibility with the device. In the T2 group, 23 out of 29 implants were still used at the most current follow-up visit (average observation time 3.3 yrs.; min 1.0 yrs., max 4.8 yrs.). No technical failures were observed up to more than 4 years after implantation. Five T2 patients discontinued using the device due to insufficient benefit; two of these patients were explanted. One patient had to be explanted before the activation of the device due to disorders of wound healing. Nevertheless, a small but significant decrease of hearing loss corrected coupling efficiency [Δ (in situ – BC)] was seen in the T2 group. Conclusions. In contrast to the T1 transducers of the earlier generation of MET systems where technical failures occurred frequently, no technical failures were detected after 29 implantations with the current T2 transducers. However, a small but significant decline of transmission efficiency was observable even in the T2 implanted group.

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