scholarly journals Postoperative Benefit of Bone Anchored Hearing Systems: Behavioral Performance and Self-Reported Outcomes

Author(s):  
Domenico Cuda ◽  
Alessandra Murri ◽  
Paolo Mochi ◽  
Anna Mainardi

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.

Author(s):  
Ann-Kathrin Rauch ◽  
Thomas Wesarg ◽  
Antje Aschendorff ◽  
Iva Speck ◽  
Susan Arndt

Abstract Purpose The new active transcutaneous partially implantable osseointegrated system Cochlear™ Osia® System is indicated in case of conductive or mixed hearing loss (CHL/MHL) with a maximum average bone conduction hearing loss of 55 dB, or in single-sided deafness (SSD). The implant directly stimulates the bone via a piezoelectric transducer and is directed by an external sound processor. We conducted a monocentric retrospective longitudinal within-subject clinical study at our tertiary academic referral center. The aim was to investigate long-term data (2017–2021) on audiological outcomes and hearing-related quality of life for the Osia system. Methods Between 2017 and 2020, 22 adults (18: CHL/MHL; 3: SSD) were implanted with the Osia100 implant; seven received bilateral implants. As of 10/2020, the sound processor was upgraded to Osia 2. Results Mean Osia system use by 04/2021 was 30.9 ± 8.6 months (range 17–40 months). Unaided bone conduction thresholds were unchanged postoperatively. One patient had to be explanted because of prolonged wound infection. Aided hearing thresholds were significantly lower compared to the unaided thresholds preoperatively, along with a marked increase in speech recognition in quiet. Speech processor upgrade resulted in a stable benefit. Patients with CHL/MHL and SSD showed a similar improvement in self-rated hearing performance revealed by SSQ, APHAB, and HUI questionnaires. Conclusion The Osia system is a safe, effective and sustainable option for treatment of conductive and mixed hearing loss or single-sided deafness.


2011 ◽  
Vol 7 (1) ◽  
pp. 8-14
Author(s):  
Robert Moore ◽  
Susan Gordon-Hickey

The purpose of this article is to propose 4 dimensions for consideration in hearing aid fittings and 4 tests to evaluate those dimensions. The 4 dimensions and tests are (a) working memory, evaluated by the Revised Speech Perception in Noise test (Bilger, Nuetzel, & Rabinowitz, 1984); (b) performance in noise, evaluated by the Quick Speech in Noise test (QSIN; Killion, Niquette, Gudmundsen, Revit, & Banerjee, 2004); (c) acceptance of noise, evaluated by the Acceptable Noise Level test (ANL; Nabelek, Tucker, & Letowski, 1991); and (d) performance versus perception, evaluated by the Perceptual–Performance test (PPT; Saunders & Cienkowski, 2002). The authors discuss the 4 dimensions and tests in the context of improving the quality of hearing aid fittings.


2021 ◽  
Vol 75 (4) ◽  
pp. 1-5
Author(s):  
Joanna Marszał ◽  
Renata Gibasiewicz ◽  
Magdalena Błaszczyk ◽  
Maria Gawlowska ◽  
Wojciech Gawęcki

Introduction: Nowadays, there are many options to treat hearing-impaired patients: tympanoplastic surgery, hearing aids and a wide range of implantable devices. Objective: The aim of this study is to present the mid-term audiological and quality of life benefits after the implantation of the Osia®, a new active piezoelectric bone conduction hearing implant. Material and methods: The state of the tissues in implanted area, as well as audiological and quality of life results were analyzed six, nine and twelve months after implantation in a group of four adult patients with bilateral mixed hearing loss. Results: In all the cases, no postoperative complications were found. One year after surgery the mean audiological gain in FF PTA4 (pure tone average for 0.5, 1, 2, and 4 kHz) was 52.2±3.5 dB in comparison to the unaided situation, the mean speech understanding with Osia® in quiet was 90±8.2% for 50dB SPL, 98.8±2.5% for 65dB SPL and 100±0% for 80dB SPL, and mean speech understanding with Osia® in noise was 37.5%±23.6 for 50dB SPL, 93.8±4.8% for 65dB SPL and 98.8±2.5% for 80dB SPL. There was also an evident improvement in the quality of hearing as well as in the quality of life, measured by the APHAB (Abbreviated Profile of Hearing Aid Benefit) and the SSQ (Speech, Spatial and Qualities of Hearing Scale). Conclusions: The Osia® is an effective treatment option for patients with bilateral mixed hearing loss. The mid-term audiological and quality of life results are excellent, but further observations including bigger groups of patients and a longer follow-up are required.


2019 ◽  
Vol 24 (4) ◽  
pp. 197-205 ◽  
Author(s):  
Eleonor Koro ◽  
Mimmi Werner

Background: A bone conducting implant is a treatment option for individuals with conductive or mixed hearing loss (CHL, MHL) who do not tolerate regular hearing aids, and for individuals with single-sided deafness (SSD). An active bone conducting implant (ABCI) was introduced in 2012 with indication in CHL, MHL, and SSD, and it is still the only ABCI available. With complete implantation of the active transducer and consequent intact skin, a decrease in infections, skin overgrowth, and implant losses, all common disadvantages with earlier passive bone conducting implants, could be expected. Our Ear, Nose and Throat Department, a secondary care center for otosurgery that covers a population of approximately 365,000 inhabitants, was approved to implant ABCIs in 2012. Objectives: Our aim was to conduct an evaluation of audiological and subjective outcomes after ABCIs. Method: A cohort study with retrospective and prospective data collection was performed.The first 20 consecutive patients operated with an ABCI were asked for informed consent. The main outcome measures werepure tone and speech audiometry and the Glasgow Benefit Inventory (GBI). Results: Seventeen patients accepted to participate and 15 were able to complete all parts. Six patients had CHL or MHL. In this group the pure tone audiometry tests are comparable with an average functional hearing gain of 29.8 dB HL. With bilateral hearing, the mean Word Recognition Score (WRS) in noise was 35.7% unaided and 62.7% aided. Ten patients had the indication SSD. With the hearing ear blocked, the pure tone average was >101 dB HL, compared to 29.3 dB HL in sound field aided. With bilateral hearing, the mean WRS in noise was 59.7% unaided and 72.8% aided. The mean of the total GBI score was 42.1 in the group with CHL or MHL and 20.6 in the group with SSD. Conclusions: The patients benefit from their implants in terms of quality of life, and there is a substantial hearing gain from the implant for patients with conductive or MHL. Patients with SSD benefit less from the implant than other diagnoses but the positive outcomes are comparable to other options for this group.


2020 ◽  
Vol 162 (6) ◽  
pp. 933-941 ◽  
Author(s):  
Nicholas J. Thompson ◽  
Margaret T. Dillon ◽  
Emily Buss ◽  
Meredith A. Rooth ◽  
English R. King ◽  
...  

Objective To investigate the influence of cochlear implant (CI) use on subjective benefits in quality of life in cases of asymmetric hearing loss (AHL). Study Design Prospective clinical trial. Setting Tertiary academic center. Subjects and Methods Subjects included CI recipients with AHL (n = 20), defined as moderate-to-profound hearing loss in the affected ear and mild-to-moderate hearing loss in the contralateral ear. Quality of life was assessed with the Speech, Spatial, and Qualities of Hearing Scale (SSQ) pragmatic subscales, which assess binaural benefits. Subjective benefit on the pragmatic subscales was compared to word recognition in quiet and spatial hearing abilities (ie, masked sentence recognition and localization). Results Subjects demonstrated an early, significant improvement ( P < .01) in abilities with the CI as compared to preoperative abilities on the SSQ pragmatic subscales by the 1-month interval. Perceived abilities were either maintained or continued to improve over the study period. There were no significant correlations between results on the Speech in Quiet subscale and word recognition in quiet, the Speech in Speech Contexts subscale and masked sentence recognition, or the Localization subscale and sound field localization. Conclusions CI recipients with AHL report a significant improvement in quality of life as measured by the SSQ pragmatic subscales over preoperative abilities. Reported improvements are observed as early as 1 month postactivation, which likely reflect the binaural benefits of listening with bimodal stimulation (CI and contralateral hearing aid). The SSQ pragmatic subscales may provide a more in-depth insight into CI recipient experience as compared to behavioral sound field measures alone.


2013 ◽  
Vol 24 (04) ◽  
pp. 258-273 ◽  
Author(s):  
Ken W. Grant ◽  
Therese C. Walden

Background: Traditional audiometric measures, such as pure-tone thresholds or unaided word-recognition in quiet, appear to be of marginal use in predicting speech understanding by hearing-impaired (HI) individuals in background noise with or without amplification. Suprathreshold measures of auditory function (tolerance of noise, temporal and frequency resolution) appear to contribute more to success with amplification and may describe more effectively the distortion component of hearing. However, these measures are not typically measured clinically. When combined with measures of audibility, suprathreshold measures of auditory distortion may provide a much more complete understanding of speech deficits in noise by HI individuals. Purpose: The primary goal of this study was to investigate the relationship among measures of speech recognition in noise, frequency selectivity, temporal acuity, modulation masking release, and informational masking in adult and elderly patients with sensorineural hearing loss to determine whether peripheral distortion for suprathreshold sounds contributes to the varied outcomes experienced by patients with sensorineural hearing loss listening to speech in noise. Research Design: A correlational study. Study Sample: Twenty-seven patients with sensorineural hearing loss and four adults with normal hearing were enrolled in the study. Data Collection and Analysis: The data were collected in a sound attenuated test booth. For speech testing, subjects' verbal responses were scored by the experimenter and entered into a custom computer program. For frequency selectivity and temporal acuity measures, subject responses were recorded via a touch screen. Simple correlation, step-wise multiple linear regression analyses and a repeated analysis of variance were performed. Results: Results showed that the signal-to-noise ratio (SNR) loss could only be partially predicted by a listener's thresholds or audibility measures such as the Speech Intelligibility Index (SII). Correlations between SII and SNR loss were higher using the Hearing-in-Noise Test (HINT) than the Quick Speech-in-Noise test (QSIN) with the SII accounting for 71% of the variance in SNR loss for the HINT but only 49% for the QSIN. However, listener age and the addition of suprathreshold measures improved the prediction of SNR loss using the QSIN, accounting for nearly 71% of the variance. Conclusions: Two standard clinical speech-in-noise tests, QSIN and HINT, were used in this study to obtain a measure of SNR loss. When administered clinically, the QSIN appears to be less redundant with hearing thresholds than the HINT and is a better indicator of a patient's suprathreshold deficit and its impact on understanding speech in noise. Additional factors related to aging, spectral resolution, and, to a lesser extent, temporal resolution improved the ability to predict SNR loss measured with the QSIN. For the HINT, a listener's audibility and age were the only two significant factors. For both QSIN and HINT, roughly 25–30% of the variance in individual differences in SNR loss (i.e., the dB difference in SNR between an individual HI listener and a control group of NH listeners at a specified performance level, usually 50% word or sentence recognition) remained unexplained, suggesting the need for additional measures of suprathreshold acuity (e.g., sensitivity to temporal fine structure) or cognitive function (e.g., memory and attention) to further improve the ability to understand individual variability in SNR loss.


2014 ◽  
Vol 19 (3) ◽  
pp. 164-174 ◽  
Author(s):  
Thomas Lenarz ◽  
Nicolas Verhaert ◽  
Christian Desloovere ◽  
Jolien Desmet ◽  
Christiane D'hondt ◽  
...  

2012 ◽  
Vol 126 (10) ◽  
pp. 1010-1015 ◽  
Author(s):  
V Possamai ◽  
G Kirk ◽  
A Scott ◽  
D Skinner

AbstractObjectives:To assess the feasibility of designing and implementing a speech in noise test in children before and after grommet insertion, and to analyse the results of such a test in a small group of children.Methods:Twelve children aged six to nine years who were scheduled to undergo grommet insertion were identified. They underwent speech in noise testing before and after grommet insertion. This testing used Arthur Boothroyd word lists read at 60 dB in four listening conditions presented in a sound field: firstly in quiet conditions, then in signal to noise ratios of +10 (50 dB background noise), 0 (60 dB) and −10 (70 dB).Results:Mean phoneme scores were: in quiet conditions, 28.1 pre- and 30 post-operatively (p = 0.04); in 50 dB background noise (signal to noise ratio +10), 24.2 pre- and 29 post-operatively (p < 0.01); in 60 dB background noise (signal to noise ratio 0), 22.6 pre- and 27.5 post-operatively (p = 0.06); and in 70 dB background noise (signal to noise ratio −10), 13.9 pre- and 21 post-operatively (p = 0.05).Conclusion:This small study suggests that speech in noise testing is feasible in this scenario. Our small group of children demonstrated a significant improvement in speech in noise scores following grommet insertion. This is likely to translate into a significant advantage in the educational environment.


2020 ◽  
Vol 29 (3S) ◽  
pp. 564-576 ◽  
Author(s):  
Alessia Paglialonga ◽  
Edoardo Maria Polo ◽  
Marco Zanet ◽  
Giulia Rocco ◽  
Toon van Waterschoot ◽  
...  

Purpose The aim of this study was to develop and evaluate a novel, automated speech-in-noise test viable for widespread in situ and remote screening. Method Vowel–consonant–vowel sounds in a multiple-choice consonant discrimination task were used. Recordings from a professional male native English speaker were used. A novel adaptive staircase procedure was developed, based on the estimated intelligibility of stimuli rather than on theoretical binomial models. Test performance was assessed in a population of 26 young adults (YAs) with normal hearing and in 72 unscreened adults (UAs), including native and nonnative English listeners. Results The proposed test provided accurate estimates of the speech recognition threshold (SRT) compared to a conventional adaptive procedure. Consistent outcomes were observed in YAs in test/retest and in controlled/uncontrolled conditions and in UAs in native and nonnative listeners. The SRT increased with increasing age, hearing loss, and self-reported hearing handicap in UAs. Test duration was similar in YAs and UAs irrespective of age and hearing loss. The test–retest repeatability of SRTs was high (Pearson correlation coefficient = .84), and the pass/fail outcomes of the test were reliable in repeated measures (Cohen's κ = .8). The test was accurate in identifying ears with pure-tone thresholds > 25 dB HL (accuracy = 0.82). Conclusion This study demonstrated the viability of the proposed test in subjects of varying language in terms of accuracy, reliability, and short test time. Further research is needed to validate the test in a larger population across a wider range of languages and hearing loss and to identify optimal classification criteria for screening purposes.


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