Profound Mixed Hearing Loss: Bone-Anchored Hearing Aid System or Cochlear Implant?

2009 ◽  
Vol 118 (10) ◽  
pp. 693-697 ◽  
Author(s):  
Veronique J. O. Verhaegen ◽  
Jef J. S. Mulder ◽  
Emmanuel A. M. Mylanus ◽  
W. R. J. Cremers ◽  
Ad F. M. Snik
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Hearing Aid ◽  
Mixed Hearing Loss ◽  
Bone Anchored Hearing Aid

Successful bone-anchored hearing aid implantation in a patient with osteogenesis imperfecta

2015 ◽  
Vol 129 (11) ◽  
pp. 1133-1136 ◽  
Author(s):  
M B Coutinho ◽  
C Marques ◽  
G J Mendes ◽  
C Gonçalves
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Osteogenesis Imperfecta ◽  
Frequency Analysis ◽  
Hearing Aid ◽  
Resonance Frequency Analysis ◽  
Implant Stability ◽  
Type Iii ◽  
Mixed Hearing Loss ◽  
Bone Anchored Hearing Aid

AbstractObjective:To report a case of successful bone-anchored hearing aid implantation in an adult patient with type III osteogenesis imperfecta, which is commonly regarded as a contraindication to this procedure.Case report:A 45-year-old man with type III osteogenesis imperfecta presented with mixed hearing loss. There was a mild sensorineural component in both ears, with an air–bone gap between 45 and 50 dB HL. He was implanted with a bone-anchored hearing aid. The audiological outcome was good, with no complications and good implant stability (as measured by resonance frequency analysis).Conclusion:To our knowledge, this is the first recorded case of bone-anchored hearing aid implantation in a patient with osteogenesis imperfecta.

Challenges in Fitting a Hearing Aid to a Severely Collapsed Ear Canal and Mixed Hearing Loss

2012 ◽  
Vol 23 (04) ◽  
pp. 276-282
Author(s):  
Kristi Oeding ◽  
Michael Valente ◽  
Richard Chole
Keyword(s):  
Hearing Loss ◽  
Hearing Aid ◽  
External Pressure ◽  
Ear Canal ◽  
Mixed Hearing Loss ◽  
History Of ◽  
Ear Infections ◽  
Bone Anchored Hearing Aid ◽  
Ear Canals ◽  
The Right

Background: Collapsed ear canals typically occur when an outside force, such as a headset for audiometric testing, is present. However, when a collapsed ear canal occurs without external pressure, this creates a challenge not only for performing audiometric testing but also for coupling a hearing aid to the ear canal. Purpose: This case report highlights the challenges associated with fitting a hearing aid on a patient with a severe anterior-posterior collapsed ear canal with a mixed hearing loss. Research Design: A 67-yr-old female originally presented to Washington University in St. Louis School of Medicine in 1996 with a long-standing history of bilateral otosclerosis. She had chronic ear infections in the right ear and a severely collapsed ear canal in the left ear and was fit with a bone anchored hearing aid (BAHA®) on the right side in 2003. However, benefit from the BAHA started to decrease due to changes in hearing, and a different hearing solution was needed. It was proposed that a hearing aid be fit to her collapsed left ear canal; however, trying to couple a hearing aid to the collapsed ear canal required unique noncustom earmold solutions. Conclusions: This case study highlights some of the obstacles and potential solutions for coupling a hearing aid to a severely collapsed ear canal.

scholarly journals The Effect of Hearing Aid Bandwidth and Configuration of Hearing Loss on Bimodal Speech Recognition in Cochlear Implant Users

2019 ◽  
Vol 40 (3) ◽  
pp. 621-635 ◽  
Author(s):  
Arlene C. Neuman ◽  
Annette Zeman ◽  
Jonathan Neukam ◽  
Binhuan Wang ◽  
Mario A. Svirsky
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Cochlear Implant ◽  
Hearing Aid

An approach to bilateral bone-anchored hearing aid surgery in children: contralateral placement of sleeper fixture

2008 ◽  
Vol 123 (5) ◽  
pp. 555-557 ◽  
Author(s):  
J M Bernstein ◽  
P Z Sheehan
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Conductive Hearing Loss ◽  
Hearing Aid ◽  
Contralateral Side ◽  
Two Stage ◽  
Calvarial Bone ◽  
Optimal Position ◽  
Bone Anchored Hearing Aid ◽  
Conductive Hearing

AbstractObjective:Bone-anchored hearing aid surgery in younger children is a two-stage procedure, with a titanium fixture being allowed to osseointegrate for several months before an abutment is fitted through a skin graft. In the first procedure, it has been usual to place a reserve or sleeper fixture approximately 5 mm from the primary fixture as a backup in case the primary fixture fails to osseointegrate. This ipsilateral sleeper fixture is expensive, is often not used, and is placed in thinner calvarial bone where it is less likely to osseointegrate successfully. The authors have implanted the sleeper fixture on the contralateral side, with the additional objective of reducing the number of procedures for bilateral bone-anchored hearing aid implantation, providing a cost-effective use for the sleeper.Methods:The authors implanted the bone-anchored hearing aid sleeper fixture in the contralateral temporal bone instead of on the ipsilateral side in seven successive paediatric cases with bilateral conductive hearing loss requiring two-stage bone-anchored hearing aids, treated at the Royal Manchester Children's Hospital, UK.Results:The seven patients ranged in age from five to 15 years, with a mean age of 10 years; in addition, a 20-year-old with learning disability was also treated. In each case, the contralateral sleeper fixture was not needed as a backup fixture, but was used in four patients (57 per cent) as the basis for a second-side bone-anchored hearing aid.Conclusions:In children with bilateral conductive hearing loss, in whom a bilateral bone-anchored hearing aid is being considered and the second side is to be operated upon at a later date, we recommend placing the sleeper fixture on the contralateral side at the time of primary first-side surgery. Our technique provides a sleeper fixture located in an optimal position, where it also offers the option of use for a second-side bone-anchored hearing aid and reduces the number of procedures needed.

Successful Placement of a BAHA Implant in a Patient With Epidermolysis Bullosa: A Case Report and Review of the Literature

2017 ◽  
Vol 126 (11) ◽  
pp. 778-780 ◽  
Author(s):  
Jason R. Brown ◽  
D. Micah Milgraum ◽  
Farhaad R. Riyaz ◽  
Marla N. Jahnke ◽  
Prasad John Thottam
Keyword(s):  
Hearing Loss ◽  
Epidermolysis Bullosa ◽  
Hearing Aids ◽  
External Auditory Canal ◽  
Skin Irritation ◽  
Minor Trauma ◽  
Mixed Hearing Loss ◽  
Osseointegrated Implant ◽  
Bone Anchored Hearing Aid ◽  
Conductive Hearing

Introduction: Epidermolysis bullosa (EB) is a spectrum of mechanobullous disorders characterized by blistering following minor trauma or traction to the skin. Hearing loss in this population is poorly described in the otolaryngology literature, and its treatment oftentimes results in external auditory canal skin irritation. Case Presentation: We present the case of a 26-year-old female with EB and mixed hearing loss unable to wear conventional hearing aids due to sequelae of the external auditory canals. An osseointegrated implant was used as other hearing aids were deemed to be too destructive of the external auditory canal skin. Management and Outcome: Our patient underwent placement of a right bone-anchored hearing aid with minimal disruption of the surrounding skin using a minimally invasive punch technique. Over 1 year of follow-up, her course was complicated by 1 simple cellulitic infection at the surgical site treated successfully with oral antibiotics. Discussion: The literature regarding the otolaryngologic manifestations of EB is sparse. The otologic sequelae are particularly overlooked in the workup and management. Based on the results of this case study, it appears that an osseointegrated implant can be safely utilized to treat significant mixed or conductive hearing loss in patients with EB.

Monosyllable speech perception of Japanese hearing aid users with prelingual hearing loss: implications for surgical indication of cochlear implant

2003 ◽  
Vol 67 (10) ◽  
pp. 1061-1067 ◽  
Author(s):  
Shoichiro Fukuda ◽  
Kunihiro Fukushima ◽  
Naomi Toida ◽  
Keiko Tsukamura ◽  
Yukihide Maeda ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Cochlear Implant ◽  
Hearing Aid ◽  
Surgical Indication

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.

scholarly journals Minimal invasive pocket technique for magnet bone implant hearing aid without fixation

2019 ◽  
Vol 277 (3) ◽  
pp. 715-725
Author(s):  
Pierre Dolhen ◽  
Samuel Lipski ◽  
Rachid Touijar ◽  
Juliette Van Bogaert
Keyword(s):  
Hearing Loss ◽  
Surgical Technique ◽  
Hearing Aid ◽  
Bone Conduction ◽  
Magnetic Coupling ◽  
Skin Incision ◽  
Medical Systems ◽  
Bone Implant ◽  
Mixed Hearing Loss ◽  
Baha Attract

Abstract Introduction The BAHA (bone-anchored hearing aid) Attract is a magnetic transcutaneous bone conduction device anchored into the temporal bone. The standard surgical technique for BAHA Attract is a multi-tools time-consuming process, which requires a large cutaneous incision. The objective of this study is to describe and test the feasibility of a minimally invasive pocket (MIP) technique for Magnet Bone Implant Hearing Aid (MBIHA) with a modified magnet of BAHA Attract without fixation and without any tissue reduction. We use a 3-cm vertical skin incision and a subperiosteal pocket. Method A study of 10 patients with conductive or mixed hearing loss who benefited from a MBIHA using the MIP technique is presented. The pure tone average (PTA) (dB) for air-conduction thresholds and the speech recognition threshold (SRT) (dB) in speech audiometry in quiet are calculated. The Entific Medical Systems (EMS) questionnaire and the postoperative clinical outcomes are realized. Results We found a significant improvement of 33.8 dB on average for the PTA and 44.8 dB for the SRT with MBIHA at 3 months, compared with unaided situation. No implant was removed or displaced after 2 years of follow-up. The skin condition remains intact in all the cases. Conclusion The minimally subperiosteal pocket surgical technique MIP without fixation and with tissue preservation for the MBIHA is safe, rapid and effective for patients with conductive or mixed hearing loss. It opens new perspectives of development and modify conventional concept in magnetic coupling of bone-conducted device.

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