Bone anchored hearing aid wearers with significant sensorineural hearing losses (borderline candidates): patients' results and opinions

1996 ◽  
Vol 110 (21) ◽  
pp. 41-46 ◽  
Author(s):  
S. H. Hartland ◽  
D. W. Proops
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Bone Conduction ◽  
Sensorineural Hearing ◽  
Queen Elizabeth Hospital ◽  
Frequency Range ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Bone Anchored Hearing Aid ◽  
Age Range

AbstractBone anchored hearing aids (BAHA) have been implanted in Birmingham since 1988. Since this time confidence has grown in the fitting and rehabilitation of BAHA wearers, with a corresponding increase in the implantation and rehabilitation of more difficult and borderline candidates.This study analyses the results of 16 borderline BAHA candidates who have been assessed and fitted with a BAHA at Birmingham Children's Hospital and Queen Elizabeth Hospital, and who have had at least one post-fitting review. All of these subjects had mean bone conduction (BC) thresholds, in the better hearing ear, in excess of 45 dBHL in the frequency range 0.5–4 kHz, when initially assessed. The age range at the time of the study was 10–84 years, with a mean age of 60 years. The study demonstrates the benefits that these patients achieved with the BAHA compared to their previous aid, both audiologically and in terms of comfort and reduction in ear discharge.

The bone anchored hearing aid—The third option for otosclerosis

1996 ◽  
Vol 110 (21) ◽  
pp. 31-37 ◽  
Author(s):  
S. P. Burrell ◽  
H. C. Cooper ◽  
D. W. Proops
Keyword(s):  
Hearing Loss ◽  
Treatment Option ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Queen Elizabeth Hospital ◽  
Suppurative Otitis Media ◽  
The Third ◽  
Hearing Ability ◽  
Bone Anchored Hearing Aid ◽  
Experience Difficulty

AbstractThe bone anchored hearing aid (BAHA) has mainly been used for the treatment of hearing loss in patients with congenital conductive problems or chronic suppurative otitis media.In a five-year period, 32 otosclerotic patients have been referred to the Queen Elizabeth Hospital for consideration of a BAHA. Ten of these patients have been fitted and gained benefit compared to their previous hearing aid. The benefits are not necessarily those in hearing ability but in some cases relate to cosmetic or comfort improvements. This paper demonstrates that the BAHA offers a third treatment option for otosclerosis in patients who cannot or will not undergo stapedectomy and experience difficulty with conventional hearing aids.

Osseointegrated implants in the management of childhood ear abnormalities: the initial Birmingham experience

1993 ◽  
Vol 107 (6) ◽  
pp. 502-509 ◽  
Author(s):  
D. S. Stevenson ◽  
D. W. Proops ◽  
M. J. C. Wake ◽  
M. J. Deadman ◽  
S. J. Worrollo ◽  
...  
Keyword(s):  
Hearing Aids ◽  
Marked Improvement ◽  
Hearing Aid ◽  
Sound Quality ◽  
Queen Elizabeth Hospital ◽  
Osseointegrated Implants ◽  
Osseointegrated Implant ◽  
Bone Anchored Hearing Aid

Over a four-year period 72 children with ear abnormalities have been referred for assessment by the extraoral osseointegrated implant team at The Queen Elizabeth Hospital, Birmingham. Thirty-two children have been judged suitable for rehabilitation. Twelve children have completed rehabilitation using bone-anchored hearing aids and/or auricular prostheses. Two fixtures (seven per cent of those loaded) have dislodged and required replacement. Audiological assessment of the bone-anchored hearing aid users shows only small improvements in their aided thresholds, compared to thresholds obtained with their previous aid. However all now have thresholds of 30 dB(A) or better and report a marked improvement in sound quality. When surveyed, hearing aid and prosthesis users report high levels of satisfaction with this form of rehabilitation. The technique adds a new dimension to the management of children with aural anomalies. The approach and results of a multidisciplinary programme are reported.

The Bone-Anchored Hearing Aid (BAHA) in Children with Auricular Malformations

1997 ◽  
Vol 76 (4) ◽  
pp. 238-247 ◽  
Author(s):  
Gösta Granström ◽  
Anders Tjellström
Keyword(s):  
Middle Ear ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Adult Population ◽  
Bone Conduction ◽  
Middle Ear Surgery ◽  
Ear Reconstruction ◽  
Skin Reactions ◽  
Bone Anchored Hearing Aid ◽  
Middle Ear Reconstruction

A retrospective study was undertaken to evaluate the outcome of the use of the bone-anchored hearing aid (BAHA) in children. All patients included in the study had bilateral auricular malformations. Previous alternatives had been conventional hearing aids or surgical middle ear reconstruction. Thirty-seven patients under 16 years of age were studied. The most common syndrome in the group was Treacher Collins. Sixteen of the patients had earlier middle ear reconstruction, the results of which did not produce social hearing. Of 40 inserted fixtures to anchor the BAHA, three were lost during the follow-up period because of failed osseointegration. Skin reactions were graded according to a clinical scoring system and were determined to be comparable in number and severity to those of an adult population. All patients in the study considered the BAHA to be superior to earlier bone-conduction devices. It is concluded that the BAHA is an excellent alternative to bone-conduction devices in children with auricular malformations. Middle ear surgery can be postponed until adulthood or abandoned, especially in syndromic patients in whom it is known to be difficult and unpredictable.

Bone-anchored hearing aids and unilateral sensorineural hearing loss: why do patients reject them?

2015 ◽  
Vol 129 (4) ◽  
pp. 321-325 ◽  
Author(s):  
D Siau ◽  
B Dhillon ◽  
R Andrews ◽  
K M J Green
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Uptake Rate ◽  
Hearing Aid ◽  
Significant Proportion ◽  
Sensorineural Deafness ◽  
Sensorineural Hearing ◽  
Device Implantation ◽  
Bone Anchored Hearing Aid

AbstractObjectives:This study aimed to report the bone-anchored hearing aid uptake and the reasons for their rejection by unilateral sensorineural deafness patients.Methods:A retrospective review of 90 consecutive unilateral sensorineural deafness patients referred to the Greater Manchester Bone-Anchored Hearing Aid Programme between September 2008 and August 2011 was performed.Results:In all, 79 (87.8 per cent) were deemed audiologically suitable: 24 (30.3 per cent) eventually had a bone-anchored hearing aid implanted and 55 (69.6 per cent) patients declined. Of those who declined, 26 (47.3 per cent) cited perceived limited benefits, 18 (32.7 per cent) cited reservations regarding surgery, 13 (23.6 per cent) preferred a wireless contralateral routing of sound device and 12 (21.8 per cent) cited cosmetic reasons. In all, 32 (40.5 per cent) suitable patients eventually chose the wireless contralateral routing of sound device.Conclusion:The uptake rate was 30 per cent for audiologically suitable patients. Almost half of suitable patients did not perceive a sufficient benefit to proceed to device implantation and a significant proportion rejected it. It is therefore important that clinicians do not to rush to implant all unilateral sensorineural hearing loss patients with a bone-anchored hearing aid.

Prescriptive Amplification Recommendations for Hearing Losses with a Conductive Component and Their Impact on the Required Maximum Power Output: An Update with Accompanying Clinical Explanation

2013 ◽  
Vol 24 (06) ◽  
pp. 452-460 ◽  
Author(s):  
Earl E. Johnson
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Compression Ratio ◽  
Hearing Aids ◽  
Power Output ◽  
Hearing Aid ◽  
Bone Conduction ◽  
Sensorineural Hearing ◽  
Maximum Power Output ◽  
Conductive Component

Background: Hearing aid prescriptive recommendations for hearing losses having a conductive component have received less clinical and research interest than for losses of a sensorineural nature; as a result, much variation remains among current prescriptive methods in their recommendations for conductive and mixed hearing losses (Johnson and Dillon, 2011). Purpose: The primary intent of this brief clinical note is to demonstrate differences between two algebraically equivalent expressions of hearing loss, which have been approaches used historically to generate a prescription for hearing losses with a conductive component. When air and bone conduction thresholds are entered into hearing aid prescriptions designed for nonlinear hearing aids, it was hypothesized that that two expressions would not yield equivalent amounts of prescribed insertion gain and output. These differences are examined for their impact on the maximum power output (MPO) requirements of the hearing aid. Subsequently, the MPO capabilities of two common behind-the-ear (BTE) receiver placement alternatives, receiver-in-aid (RIA) and receiver-in-canal (RIC), are examined. Study Samples: The two expressions of hearing losses examined were the 25% ABG + AC approach and the 75% ABG + BC approach, where ABG refers to air-bone gap, AC refers to air-conduction threshold, and BC refers to bone-conduction threshold. Example hearing loss cases with a conductive component are sampled for calculations. The MPO capabilities of the BTE receiver placements in commercially-available products were obtained from hearing aids on the U.S. federal purchasing contract. Results: Prescribed gain and the required MPO differs markedly between the two approaches. The 75% ABG + BC approach prescribes a compression ratio that is reflective of the amount of sensorineural hearing loss. Not all hearing aids will have the MPO capabilities to support the output requirements for fitting hearing losses with a large conductive component particularly when combined with significant sensorineural hearing loss. Generally, current RIA BTE products have greater output capabilities than RIC BTE products. Conclusions: The 75% ABG + BC approach is more appropriate than the 25% ABG + AC approach because the latter approach inappropriately uses AC thresholds as the basis for determining the compression ratio. That is, for hearing losses with a conductive component, the AC thresholds are not a measure of sensorineural hearing loss and cannot serve as the basis for determining the amount of desired compression. The Australian National Acoustic Laboratories has been using the 75% ABG + BC approach in lieu of the 25% ABG + AC approach since its release of the National Acoustic Laboratories—Non-linear 1 (NAL-NL1) prescriptive method in 1999. Future research may examine whether individuals with conductive hearing loss benefit or prefer more than 75% restoration of the conductive component provided adequate MPO capabilities to support such restoration.

Binaural Application of the Bone-Anchored Hearing Aid

1998 ◽  
Vol 107 (3) ◽  
pp. 187-193 ◽  
Author(s):  
Ad F. M. Snik ◽  
Andy J. Beynon ◽  
Catharina T. M. van der Pouw ◽  
Emmanuel A. M. Mylanus ◽  
Cor W. R. J. Cremers
Keyword(s):  
Speech Recognition ◽  
Sound Localization ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Bone Conduction ◽  
Listening Condition ◽  
Bone Anchored Hearing Aid ◽  
Bone Conduction Hearing ◽  
Bone Conduction Hearing Aid ◽  
Binaural Listening

Most, but not all, hearing-impaired patients with air conduction hearing aids prefer binaural amplification instead of monaural amplification. The binaural application of the bone conduction hearing aid is more disputable, because the attenuation (in decibels) of sound waves across the skull is so small (10 dB) that even one bone conduction hearing aid will stimulate both cochleas approximately to the same extent. Binaural fitting of the bone-anchored hearing aid was studied in three experienced bone-anchored hearing aid users. The experiments showed that sound localization, and speech recognition in quiet and also under certain noisy conditions improved significantly with binaural listening compared to the monaural listening condition. On the average, the percentage of correct identifications (within 45°) in the sound localization experiment improved by 53% with binaural listening; the speech reception threshold in quiet improved by 4.4 dB. The binaural advantage in the speech-in-noise test was comparable to that of a control group of subjects with normal hearing listening monaurally versus binaurally. The improvements in the scores were ascribed to diotic summation (improved speech recognition in quiet) and the ability to separate sounds in the binaural listening condition (improved sound localization and improved speech recognition in noise whenever the speech and noise signals came from different directions). All three patients preferred the binaural bone-anchored hearing aids and used them all day.

Audiological Results of the Bone-Anchored Hearing Aid HC200: Multicenter Results

1994 ◽  
Vol 103 (5) ◽  
pp. 368-374 ◽  
Author(s):  
Emmanuel A. M. Mylanus ◽  
Ad F. M. Snik ◽  
Frank F. Jorritsma ◽  
Cor W. R. J. Cremers ◽  
Hans Verschuure
Keyword(s):  
Speech Recognition ◽  
Hearing Aids ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Bone Conduction ◽  
Hearing Level ◽  
Mixed Hearing Loss ◽  
Bone Anchored Hearing Aid ◽  
Bone Conduction Hearing Aid ◽  
Speech Recognition In Noise

Sixty-two patients with conductive or mixed hearing loss (average bone conduction threshold at 0.5, 1, and 2 kHz ranged from 1 to 44 dB hearing level) were fitted with a bone-anchored hearing aid (BAHA type HC200). Previously, 52 of them had used a conventional bone conduction hearing aid (CBHA) and 10 of them an air conduction hearing aid (ACHA). Audiological tests were conducted to compare the patients' performance with the BAHA to that with their previous conventional hearing aid. In the speech recognition in quiet test, only 5 patients in the CBHA group improved significantly: the majority had 100% scores with both hearing aids. In the speech recognition in noise test, 28 patients improved significantly. The mean improvement in the signal to noise ratio (S/N) in the CBHA group was −2.3 ± 2.4 dB. That none of the patients in the CBHA group performed worse with the BAHA led us to the conclusion that the BAHA is superior to the CBHA. None of the patients in the ACHA group achieved a better speech recognition in quiet score using the BAHA. On average, there was no significant improvement in the S/N ratio in the ACHA group, although in 6 patients the S/N ratio improved significantly, and in 1 patient it worsened significantly. From the whole group, the performance of only 2 patients, both in the ACHA group, was significantly worse with the BAHA on one of the speech recognition tests.

An intra-individual comparison of the previous conventional hearing aid with the bone-anchored hearing aid: the Nijmegen group questionnaire

2002 ◽  
Vol 116 (S28) ◽  
pp. 15-19 ◽  
Author(s):  
Ann-Louise McDermott ◽  
Sunil N. Dutt ◽  
Andrew P. Reid ◽  
David W. Proops
Keyword(s):  
Hearing Aids ◽  
Response Rate ◽  
Hearing Aid ◽  
Bone Conduction ◽  
Total Response Rate ◽  
Individual Comparison ◽  
Assess Patient Satisfaction ◽  
Bone Anchored Hearing Aid ◽  
Bone Conduction Hearing ◽  
Retrospective Questionnaire

By spring 2000, a total of 351 patients were implanted in the Birmingham bone-anchored hearing aid (BAHA) programme. This group consisted of 242 adults and 109 children. The aim of this retrospective questionnaire study was to directly assess patient satisfaction with their current bone-anchored hearing aid in comparison with their previous conventional air and/or bone-conduction hearing aids.The Nijmegen group questionnaire was sent by post to 312 patients who used their BAHA for six months or longer. The questionnaire used was first described by Mylanus et al. (Nijmegen group) in 1998. The total response rate was 72 per cent (227 of 312 patients). The bone-anchored hearing aid was found to be significantly superior to prior conventional hearing aids in all respects.

scholarly journals 209 A Comparison of Soft Tissue Reactions Seen with Different Bone Anchored Hearing Aid Abutments: Smooth-Titanium Vs Hydroxyapatite-Coated

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R George ◽  
J Wasson
Keyword(s):  
Soft Tissue ◽  
Hearing Aids ◽  
Revision Surgery ◽  
Hearing Aid ◽  
Cohort Analysis ◽  
Bone Conduction ◽  
Skin Reactions ◽  
Soft Tissue Reactions ◽  
Bone Anchored Hearing Aid ◽  
Tissue Reactions

Abstract Aim Bone Anchored Hearing Aids allow hearing via stimulation of the cochlear through bone conduction. These devices are largely successful; however, soft tissue reactions often hinder their benefit. The type of abutment used could contribute to complications. We aimed to investigate whether using smooth-titanium abutments instead of hydroxyapatite-coated abutments reduced the rate of soft tissue reactions and need for revision surgery. Method A retrospective cohort analysis of all patients who received a Bone Anchored Hearing Aid during a 3-year period. An electronic database was screened for skin reactions and surgical revisions. A comparison was made between patients who received a hydroxyapatite-coated abutment and smooth-titanium abutments. The same surgical technique, linear incision skin preservation surgery, was used for inserting both abutments. Results Sixty-six patients received a Bone Anchored Hearing Aid. Forty-five patients received hydroxyapatite-coated abutments and twenty-one received smooth-titanium abutments, two patients had smooth-titanium inserted bilaterally. The groups were significantly similar with regards to age and gender. Significantly more patients who received hydroxyapatite-coated abutments recorded soft tissue reactions, 77.78% vs 23.81% (p < 0.0001). Significantly more patients who received hydroxyapatite-coated abutments required surgical revision, 40% vs 9.52% (p = 0.0197). 17.14% underwent skin revision and change of abutment. 5.7% had the abutments removed and were not immediately replaced. Conclusions When utilising skin preservation surgery for Bone Anchored Hearing Aid insertion smooth-titanium abutments have a favourable complication profile; with less soft tissue reactions and subsequent need for revision surgery, in comparison with hydroxyapatite-coated abutments. The reasons behind these differences warrant further investigations.

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong
Keyword(s):  
Clinical Practice ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Evidence Based ◽  
Future Directions ◽  
Major Barrier ◽  
Klang Valley ◽  
Age Range ◽  
Fitting Hearing Aids

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

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