scholarly journals Hearing Aid Treatment in Patients with Mixed Hearing Loss. Part I: Expected Benefit and Limitations after Stapes Surgery

2020 ◽  
Vol 25 (3) ◽  
pp. 125-132
Author(s):  
Nina Wardenga ◽  
Victoria Diedrich ◽  
Bernd Waldmann ◽  
Thomas Lenarz ◽  
Hannes Maier
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Hearing Aids ◽  
State Of The Art ◽  
Treatment Success ◽  
Stapes Surgery ◽  
Pure Tone Average ◽  
Mixed Hearing Loss ◽  
Hearing Devices ◽  
Middle Ear Implants

Objective: The purpose of the present study was to determine the fraction of patients with mixed hearing loss who can or cannot expect benefit from power hearing aids (HAs) after stapes surgery. Design: The audiological outcome of 374 stapes surgeries was used to calculate the patients’ individual postoperative requirements in terms of gain and output of HAs. These requirements were compared to the available gain and output provided by state-of-the-art power HAs at 0.5, 1.0, 2.0, and 4.0 kHz. According to these comparisons, ears were divided into three groups. For G0, required gain and output lay within the corresponding technical limits of the HAs at all frequencies. In G1, one or both requirements could not be fulfilled at 1 frequency. G2 combined all ears where the requirements lay beyond the HA’s technical limitations at 2 or more frequencies. Results: Stapes surgery resulted in an improvement of air-bone gap (ABG) in 84.5% of the cases by 15.7 dB on average. Based on pure-tone average (0.5, 1.0, 2.0, 4.0 kHz), 40.6% of all cases showed an ABG ≤10 dB. 44.9% of all cases did no longer need a HA after stapes surgery. A power HA would fulfill both audiological criteria at all 4 frequencies in 81.6% of cases that needed a HA postoperatively. However, 18.4% would not be sufficiently treatable at 1 or more frequencies (15.0% in G1, 3.4% in G2). Conclusions: The present study identified a subset of patients with mixed hearing loss after stapes surgery that cannot be treated sufficiently with available power HAs. As the residual ABG is an important reason for this lack of treatment success, the advancement of alternative hearing devices that circumvent the middle ear, such as powerful active middle ear implants, is indicated.

Comparison of Carina active middle-ear implant with conventional hearing aids for mixed hearing loss

2016 ◽  
Vol 130 (4) ◽  
pp. 340-343 ◽  
Author(s):  
V A Savaş ◽  
B Gündüz ◽  
R Karamert ◽  
R Cevizci ◽  
M Düzlü ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Hearing Aids ◽  
Bone Conduction ◽  
Patient Acceptance ◽  
Life Questionnaire ◽  
Active Middle Ear Implant ◽  
Mixed Hearing Loss ◽  
Glasgow Benefit Inventory ◽  
Middle Ear Implants

AbstractObjective:To compare the auditory outcomes of Carina middle-ear implants with those of conventional hearing aids in patients with moderate-to-severe mixed hearing loss.Methods:The study comprised nine patients (six males, three females) who underwent middle-ear implantation with Carina fully implantable active middle-ear implants to treat bilateral moderate-to-severe mixed hearing loss. The patients initially used conventional hearing aids and subsequently received the Carina implants. The hearing thresholds with implants and hearing aids were compared.Results:There were no significant differences between: the pre-operative and post-operative air and bone conduction thresholds (p> 0.05), the thresholds with hearing aids and Carina implants (p> 0.05), or the pre-operative (mean, 72.8 ± 19 per cent) and post-operative (mean, 69.9 ± 24 per cent) speech discrimination scores (p> 0.05). One of the patients suffered total sensorineural hearing loss three months following implantation despite an initial 38 dB functional gain. All except one patient showed clinical improvements after implantation according to quality of life questionnaire (Glasgow Benefit Inventory) scores.Conclusion:Acceptance of Carina implants is better than with conventional hearing aids in patients with mixed hearing loss, although both yield similar hearing amplification. Cosmetic reasons appear to be critical for patient acceptance.

scholarly journals Hearing Aid Treatment for Patients with Mixed Hearing Loss. Part II: Speech Recognition in Comparison to Direct Acoustic Cochlear Stimulation

2020 ◽  
Vol 25 (3) ◽  
pp. 133-142
Author(s):  
Nina Wardenga ◽  
Ad F.M. Snik ◽  
Eugen Kludt ◽  
Bernd Waldmann ◽  
Thomas Lenarz ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Middle Ear ◽  
Hearing Aids ◽  
Dynamic Range ◽  
Hearing Aid ◽  
Middle Ear Surgery ◽  
Promising Alternative ◽  
Mixed Hearing Loss ◽  
Technical Specifications

Background: The conventional therapy for severe mixed hearing loss is middle ear surgery combined with a power hearing aid. However, a substantial group of patients with severe mixed hearing loss cannot be treated adequately with today’s state-of-the-art (SOTA) power hearing aids, as predicted by the accompanying part I of this publication, where we compared the available maximum power output (MPO) and gain from technical specifications to requirements for optimum benefit using a common fitting rule. Here, we intended to validate the theoretical assumptions from part I experimentally in a mixed hearing loss cohort fitted with SOTA power hearing aids. Additionally, we compared the results with an implantable hearing device that circumvents the impaired middle ear, directly stimulating the cochlea, as this might be a better option. Objectives: Speech recognition outcomes obtained from patients with severe mixed hearing loss supplied acutely with a SOTA hearing aid were studied to validate the outcome predictions as described in part I. Further, the results obtained with hearing aids were compared to those in direct acoustic cochlear implant (DACI) users. Materials and Methods: Twenty patients (37 ears with mixed hearing loss) were provided and fitted with a SOTA power hearing aid. Before and after an acclimatization period of at least 4 weeks, word recognition scores (WRS) in quiet and in noise were studied, as well as the speech reception threshold in noise (SRT). The outcomes were compared retrospectively to a second group of 45 patients (47 ears) using the DACI device. Based on the severity of the mixed hearing loss and the available gain and MPO of the SOTA hearing aid, the hearing aid and DACI users were subdivided into groups with prediction of sufficient, partially insufficient, or very insufficient hearing aid performance. Results: The patients with predicted adequate SOTA hearing aid performance indeed showed the best WRS in quiet and in noise when compared to patients with predicted inferior outcomes. Insufficient hearing aid performance at one or more frequencies led to a gradual decrease in hearing aid benefit, validating the criteria used here and in the accompanying paper. All DACI patients showed outcomes at the same level as the adequate hearing aid performance group, being significantly better than those of the groups with inadequate hearing aid performance. Whereas WRS in quiet and noise were sensitive to insufficient gain or output, showing significant differences between the SOTA hearing aid and DACI groups, the SRT in noise was less sensitive. Conclusions: Limitations of outcomes in mixed hearing loss individuals due to insufficient hearing aid performance can be accurately predicted by applying a commonly used fitting rule and the 35-dB dynamic range rule on the hearing aid specifications. Evidently, when outcomes in patients with mixed hearing loss using the most powerful hearing aids are insufficient, bypassing the middle ear with a powerful active middle ear implant or direct acoustic implant can be a promising alternative treatment.

New Perspectives for Middle Ear Implants: First Results in Otosclerosis With Mixed Hearing Loss

2007 ◽  
Vol 117 (3) ◽  
pp. 552-555 ◽  
Author(s):  
Frederic Venail ◽  
Jean Pierre Lavieille ◽  
Renaud Meller ◽  
Arnaud Deveze ◽  
Laurent Tardivet ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Mixed Hearing Loss ◽  
First Results ◽  
Middle Ear Implants

scholarly journals Subjective Outcomes With Bone Conduction and Middle Ear Implants for Patients Wth Conductive or Mixed Hearing Loss

2015 ◽  
Vol 18 (7) ◽  
pp. A364
Author(s):  
M Kosaner Kliess ◽  
R Zoehrer ◽  
B Schlick ◽  
M Mariacher ◽  
M Urban
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Bone Conduction ◽  
Mixed Hearing Loss ◽  
Middle Ear Implants ◽  
Subjective Outcomes

Totally implantable active middle-ear implants: a large, single-surgeon cohort

2021 ◽  
pp. 1-6
Author(s):  
E McCarty Walsh ◽  
D R Morrison ◽  
W J McFeely
Keyword(s):  
Hearing Loss ◽  
Word Recognition ◽  
Middle Ear ◽  
Pure Tone ◽  
Case Series ◽  
Recognition Score ◽  
Hearing Level ◽  
Pure Tone Average ◽  
Surgeon Experience ◽  
Middle Ear Implants

Abstract Objectives This study aimed to evaluate hearing outcomes and device safety in a large, single-surgeon experience with the totally implantable active middle-ear implants. Methods This was a retrospective case series review of 116 patients with moderate-to-severe sensorineural hearing loss undergoing implantation of active middle-ear implants. Results Mean baseline unaided pure tone average improved from 57.6 dB before surgery to 34.1 dB post-operatively, signifying a mean gain in pure tone average of 23.5 dB (p = 0.0002). Phonetically balanced maximum word recognition score improved slightly from 70.5 per cent to 75.8 per cent (p = 0.416), and word recognition score at a hearing level of 50 dB values increased substantially from 14.4 per cent to 70.4 per cent (p < 0.0001). Both revision and explant rates were low and dropped with increasing surgeon experience over time. Conclusion This study showed excellent post-operative hearing results with active middle-ear implants with regard to pure tone average and word recognition score at a hearing level of 50 db. Complication rates in this case series were significantly lower with increasing experience of the surgeon. Active middle-ear implants should be considered in appropriate patients with moderate-to-severe sensorineural hearing loss who have struggled with conventional amplification and are good surgical candidates.

scholarly journals Results of the Active Middle Ear Implantation in Patients With Mixed Hearing Loss After the Middle Ear Surgery: Prospective Multicenter Study (ROMEO Study)

2021 ◽  
Author(s):  
Chan Il Song ◽  
Hyong-Ho Cho ◽  
Byung Yoon Choi ◽  
Jae Young Choi ◽  
Jin Woong Choi ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Hearing Aids ◽  
User Satisfaction ◽  
Round Window ◽  
Secondary Outcome ◽  
Middle Ear Surgery ◽  
Mixed Hearing Loss ◽  
Age Range ◽  
Hearing Aid Benefit

Objectives. To evaluate the user satisfaction, efficacy, and safety of round window (RW) vibroplasty using the Vibrant Soundbridge (VSB) in patients with persistent mixed hearing loss after mastoidectomy.Methods. The study included twenty-seven patients (mean age, 58.7 years; age range, 28&#8211;76 years; 11 men and 16 women) with mixed hearing loss after mastoidectomy surgery from 15 tertiary referral centers in Korea. The VSB was implanted at the RW. The Korean translation of the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire and the Korean version of the International Outcome Inventory for Hearing Aids (K-IOI-HA) questionnaire were used to evaluate user satisfaction as the primary outcome. Secondary outcome measures were audiological test results and complication rates.Results. The mean scores on the Ease of Communication (61.3%

Efficacy of the active middle-ear implant in patients with sensorineural hearing loss

2013 ◽  
Vol 127 (S2) ◽  
pp. S8-S16 ◽  
Author(s):  
C L Butler ◽  
P Thavaneswaran ◽  
I H Lee
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Middle Ear ◽  
Hearing Aids ◽  
Sensorineural Hearing ◽  
Active Middle Ear Implant ◽  
Middle Ear Implant ◽  
Significant Difference ◽  
Middle Ear Implants ◽  
Better Than

AbstractIntroduction:This systematic review aims to advise on the effectiveness of the active middle-ear implant in patients with sensorineural hearing loss, compared with external hearing aids.Methods:A systematic search of several electronic databases, including PubMed and Embase, was used to identify relevant studies for inclusion.Results:Fourteen comparative studies were included. Nine studies reported on the primary outcome of functional gain: one found that the middle-ear implant was significantly better than external hearing aids (p < 0.001), while another found that external hearing aids were generally significantly better than middle-ear implants (p < 0.05). Six of the seven remaining studies found that middle-ear implants were better than external hearing aids, although generally no clinically significant difference (i.e. ≥10 dB) was seen.Conclusion:Generally, the active middle-ear implant appears to be as effective as the external hearing aid in improving hearing outcomes in patients with sensorineural hearing loss.

Application of Active Middle Ear Implants in Patients With Severe Mixed Hearing Loss

2012 ◽  
Vol 33 (3) ◽  
pp. 297-301 ◽  
Author(s):  
Veronique J. O. Verhaegen ◽  
Jef J. S. Mulder ◽  
Cor W. R. J. Cremers ◽  
Ad F. M. Snik
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Mixed Hearing Loss ◽  
Middle Ear Implants

scholarly journals Middle Ear Implantable Hearing Devices: An Overview

2009 ◽  
Vol 13 (3) ◽  
pp. 206-214 ◽  
Author(s):  
David S. Haynes ◽  
Jadrien A. Young ◽  
George B. Wanna ◽  
Michael E. Glasscock
Keyword(s):  
United States ◽  
Hearing Loss ◽  
Cochlear Implants ◽  
Middle Ear ◽  
The United States ◽  
Implantable Devices ◽  
The Social ◽  
Significant Interest ◽  
Hearing Devices ◽  
Middle Ear Implants

Hearing loss affects approximately 30 million people in the United States. It has been estimated that only approximately 20% of people with hearing loss significant enough to warrant amplification actually seek assistance for amplification. A significant interest in middle ear implants has emerged over the years to facilitate patients who are noncompliant with conventional hearing aides, do not receive significant benefit from conventional aides, or are not candidates for cochlear implants. From the initial studies in the 1930s, the technology has greatly evolved over the years with a wide array of devices and mechanisms employed in the development of implantable middle ear hearing devices. Currently, these devices are generally available in two broad categories: partially or totally implantable using either piezoelectric or electromagnetic systems. The authors present an up-to-date overview of the major implantable middle ear devices. Although the current devices are largely in their infancy, indications for middle ear implants are ever evolving as promising studies show good results. The totally implantable devices provide the user freedom from the social and practical difficulties of using conventional amplification.

Sign in / Sign up

Export Citation Format

Share Document