scholarly journals Hearing Rehabilitation Implementing a Transcutaneous Bone Conduction Device: Single-Center Experience

2019 ◽  
pp. 014556131987048
Author(s):  
Tom Shokri ◽  
Beth Czarnecki ◽  
Aaron Baker ◽  
Huseyin Isildak
Keyword(s):  
Patient Satisfaction ◽  
Soft Tissue ◽  
Hearing Aids ◽  
Bone Conduction ◽  
Wound Complications ◽  
Minimal Risk ◽  
Hearing Rehabilitation ◽  
Single Center Experience ◽  
Device Use ◽  
Soft Tissue Changes

Bone conduction implants based on percutaneous abutment acoustic transmission have been implemented in patients with satisfactory outcomes. However, adverse soft tissue outcomes present a limitation. Transcutaneous bone conduction devices (t-BCDs) are an alternative that may mitigate these complications. A retrospective review was performed of patients who underwent implantation of a t-BCD from 2013 to 2017. Surgical outcomes were reviewed including wound complications, frequency of device use, patient concerns regarding the device, and reported patient satisfaction. A total of 37 patients were implanted with the bone-anchored hearing aids, BAHA Attract (Cochlear™ Baha® Implant System). Average follow-up time was 271.8 days. Postoperatively, 7 (18.9%) patients complained of soft tissue changes or issues with wound healing. Twelve (32.4%) patients requested adjustment of their devices. The t-BCD is an excellent option for hearing rehabilitation. Overall, the complication rate is low, patient satisfaction is high, and successful conversion from a percutaneous device is possible with minimal risk.

A comparison study of complications and initial follow-up costs of transcutaneous and percutaneous bone conduction devices

2017 ◽  
Vol 131 (8) ◽  
pp. 667-670 ◽  
Author(s):  
J Godbehere ◽  
S D Carr ◽  
J Moraleda ◽  
P Edwards ◽  
J Ray
Keyword(s):  
Soft Tissue ◽  
Hearing Aids ◽  
Bone Conduction ◽  
Cost Effective ◽  
Retrospective Case ◽  
Hearing Rehabilitation ◽  
Cost Effective Method ◽  
Percutaneous Device ◽  
Bone Conduction Device

AbstractBackground:The percutaneous osseointegrated bone conduction device can be associated with more soft tissue complications when compared to the magnetic transcutaneous osseointegrated bone conduction device. This study aimed to determine whether fewer soft tissue complications may result in the transcutaneous osseointegrated bone conduction device being a lower cost option in hearing rehabilitation.Methods:This retrospective case note review included adult patients who underwent implantation with the transcutaneous Cochlear Attract (n = 22) or percutaneous Cochlear DermaLock (n = 25) bone-anchored hearing aids between September 2013 and December 2014. The number of post-operative clinic appointments, complications and treatments undertaken, and calculated cost average, were compared between the two groups.Results:Although the transcutaneous device was slightly more expensive than the percutaneous device, the percutaneous device was associated with a greater number of soft tissue complications and, as a result, the percutaneous device had significantly higher follow-up costs in the first six months following surgery.Conclusion:The transcutaneous osseointegrated bone conduction device may represent a more cost-effective method of hearing rehabilitation compared to the percutaneous osseointegrated bone conduction device.

Auditory Outcomes with Hearing Rehabilitation in Children with Unilateral Hearing Loss: A Systematic Review

2017 ◽  
Vol 157 (4) ◽  
pp. 565-571 ◽  
Author(s):  
Swathi Appachi ◽  
Jessica. L. Specht ◽  
Nikhila Raol ◽  
Judith E. C. Lieu ◽  
Michael S. Cohen ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Sound Localization ◽  
Hearing Aids ◽  
Bone Conduction ◽  
Unilateral Hearing Loss ◽  
Hearing Rehabilitation ◽  
Hearing Devices ◽  
Bone Conduction Hearing ◽  
Speech Recognition In Noise

Objective Options for management of unilateral hearing loss (UHL) in children include conventional hearing aids, bone-conduction hearing devices, contralateral routing of signal (CROS) aids, and frequency-modulating (FM) systems. The objective of this study was to systematically review the current literature to characterize auditory outcomes of hearing rehabilitation options in UHL. Data Sources PubMed, EMBASE, Medline, CINAHL, and Cochrane Library were searched from inception to January 2016. Manual searches of bibliographies were also performed. Review Methods Studies analyzing auditory outcomes of hearing amplification in children with UHL were included. Outcome measures included functional and objective auditory results. Two independent reviewers evaluated each abstract and article. Results Of the 249 articles identified, 12 met inclusion criteria. Seven articles solely focused on outcomes with bone-conduction hearing devices. Outcomes favored improved pure-tone averages, speech recognition thresholds, and sound localization in implanted patients. Five studies focused on FM systems, conventional hearing aids, or CROS hearing aids. Limited data are available but suggest a trend toward improvement in speech perception with hearing aids. FM systems were shown to have the most benefit for speech recognition in noise. Studies evaluating CROS hearing aids demonstrated variable outcomes. Conclusions Data evaluating functional and objective auditory measures following hearing amplification in children with UHL are limited. Most studies do suggest improvement in speech perception, speech recognition in noise, and sound localization with a hearing rehabilitation device.

scholarly journals Medical, Technical and Audiological Outcomes of Hearing Rehabilitation with the Bonebridge Transcutaneous Bone-Conduction Implant: A Single-Center Experience

2019 ◽  
Vol 8 (10) ◽  
pp. 1614 ◽  
Author(s):  
Brkic ◽  
Riss ◽  
Scheuba ◽  
Arnoldner ◽  
Gstöttner ◽  
...  
Keyword(s):  
Hearing Aids ◽  
Bone Conduction ◽  
Technical Failure ◽  
Single Center ◽  
Hearing Rehabilitation ◽  
Device Failure ◽  
Hearing Gain ◽  
Bone Conduction Implant ◽  
The Mean

Bone-conduction implants are a standard therapeutic option for patients with conductive, unilateral, or mixed hearing loss who either do not tolerate conventional hearing aids or can benefit from surgery. The aim of this study was to evaluate long-term medical and technical outcomes, and audiological results with the Bonebridge transcutaneous bone-conduction implant. This retrospective study included all patients implanted with a bone-conduction hearing implant at a tertiary medical referral center between March 2012 and October 2018. Medical and technical outcomes included the mean length of implant usage, medical and technical complications (skin and wound infection, lack of benefit, technical failure), explantations and revisions, coupling approaches, implant failure rate, implant survival and the implant loss for added follow-up years. Auditory results were measured by functional hearing gain and the Freiburger monosyllabic test at 65 dB sound pressure level. Sixty-four patients were included in the study; five of these were implanted bilaterally (69 devices). Five unilaterally implanted patients were lost to follow-up. The mean follow-up was 27.1 months (range: 0.2 months–6.3 years). The mean implant usage was 25.9 months (range: 0.2 months–6.3 years). Fifty-seven implants (89.1%) were in use at the end of the follow-up period. Complications occurred in six ears (9.4%). Five implants (7.8%) were explanted without reimplantation. Device failure occurred in one implant (1.6%), which was possibly caused by recurrent head trauma. The rate of implant loss due to technical device failure (damage to device) was 1 per 72 follow-up years. The mean improvement on the Freiburger monosyllabic test (52.1%, p = 0.0001), and in functional hearing gain across frequencies (26.5 dB, p = 0.0001) was significant. This single-center follow-up reveals the medical and technical reliability of a transcutaneous bone-conduction implant for hearing rehabilitation because complication and revision rates were low. The majority of patients still used the device at the end of the observation period. Implantation resulted in favorable hearing outcomes in comparison to that of unaided conditions. Cautious patient selection mainly regarding co-morbidities, the history of chronic otologic diseases and proper surgical technique seems to be crucial in reducing complications.

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.

Soft-tissue changes after Class II malocclusion treatment using the Sander bite-jumping appliance: a retrospective study

2019 ◽  
Vol 68 (3) ◽  
Author(s):  
Michele Tepedino ◽  
Maria V. Della Noce ◽  
Domenico Ciavarella ◽  
Patrizia Gallenzi ◽  
Massimo Cordaro ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Soft Tissue ◽  
Class Ii ◽  
Class Ii Malocclusion ◽  
Tissue Changes ◽  
Soft Tissue Changes

Malar augmentation with zygomatic osteotomy in orthognatic surgery: Bone and soft tissue changes threedimensional evaluation

2021 ◽  
Vol 49 (3) ◽  
pp. 223-230
Author(s):  
Giovanni Gerbino ◽  
Umberto Autorino ◽  
Claudia Borbon ◽  
Federica Marcolin ◽  
Elena Olivetti ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tissue Changes ◽  
Orthognatic Surgery ◽  
Soft Tissue Changes

scholarly journals Hemoglobin A1c and preoperative glycemia as a decision tool to help minimise sternal wound complications: a retrospective study in OPCAB patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jef Van den Eynde ◽  
Abel Van Vlasselaer ◽  
Annoushka Laenen ◽  
Delphine Szecel ◽  
Bart Meuris ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Hemoglobin A1c ◽  
Clinical Decision Making ◽  
Artery Bypass ◽  
Clinical Decision ◽  
Wound Complications ◽  
Minimal Risk ◽  
Off Pump ◽  
Increased Risk ◽  
Diabetes Patients

Abstract Background Poor glycemic control has been associated with an increased risk of wound complications after various types of operations. However, it remains unclear how hemoglobin A1c (HbA1c) and preoperative glycemia can be used in clinical decision-making to prevent sternal wound complications (SWC) following off-pump coronary artery bypass grafting (OPCAB). Methods We conducted a retrospective study of 1774 consecutive patients who underwent OPCAB surgery between January 2010 and November 2016. A new four-grade classification for SWC was used. The associations of HbA1c and preoperative glycemia with incidence and grade of SWC were analysed using logistic regression analysis and proportional odds models, respectively. Results During a median follow-up of 326 days (interquartile range (IQR) 21–1261 days), SWC occurred in 133/1316 (10%) of non-diabetes and 82/458 (18%) of diabetes patients (p < 0.001). Higher HbA1c was significantly associated with a higher incidence of SWC (odds ratio, OR 1.24 per 1% increase, 95% confidence interval, CI 1.04;1.48, p = 0.016) as well as a higher grade of SWC (OR 1.25, 95% CI 1.06;1.48, p = 0.010). There was no association between glycemia and incidence (p = 0.539) nor grade (p = 0.607) of SWC. Significant modifiers of these effects were found: HbA1c was associated with SWC in diabetes patients younger than 70 years (OR 1.41, 95% CI 1.17;1.71, p < 0.001), whereas it was not in those older than 70 years. Glycemia was associated with SWC in patients who underwent non-urgent surgery (OR 2.48, 95% CI 1.26;4.88, p = 0.009), in diabetes patients who received skeletonised grafts (OR 4.83, 95% CI 1.28;18.17, p = 0.020), and in diabetes patients with a BMI < 30 (OR 2.19, 95% CI 1.01;4.76, p = 0.047), whereas it was not in the counterparts of these groups. Conclusions Under certain conditions, HbA1c and glycemia are associated SWC following OPCAB. These findings are helpful in planning the procedure with minimal risk of SWC.

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