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      Results of a 2-Year Prospective Multicenter Study Evaluating Long-term Audiological and Clinical Outcomes of a Transcutaneous Implant for Bone Conduction Hearing

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          Objective(s):

          To evaluate 2-year audiological and clinical outcomes of a transcutaneous implant for bone conduction hearing of a previously published 6-month evaluation.

          Design:

          Fifty-four unilaterally implanted adult patients with conductive or mild mixed hearing loss or single-sided sensorineural deafness were included in this prospective multicenter study. Follow-up visits were scheduled post-surgery at 10 days; 4, 6, and 12 weeks; 6, 12, and 24 months. Main outcomes were audiological benefit, patient-reported outcomes (PROs), soft tissue status, pain, numbness, implant survival, and daily usage.

          Results:

          In the study population, the transcutaneous implant resulted in statistically significant improvement in objective hearing test and PROs compared with the unaided situation. Soft tissue complications were observed in 4.6% of the patients per visit. Pain/discomfort and numbness were initially reported in the majority of the patients, but declined over time; approximately 9% of patients reported some degree of numbness and 15% (slight) pain/discomfort after 2 years. During the 24-month period, two implant magnets were removed (3.7%), while two other implants were converted to the percutaneous counterpart (3.7%). At the final visit, 89.6% (n = 42 out of 47) of the patients used their sound processor, with a median daily usage of 6 h/d (range, 0–18 h/d).

          Conclusions:

          After 24 months, the transcutaneous implant provided statistically significant mean improvement in objective and subjective hearing performance as well as PROs compared with the preoperative unaided condition and had a low soft tissue complication rate. The test device could be considered as an alternative treatment option for appropriately selected and counseled patients.

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          Most cited references22

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          • Abstract: found
          • Article: not found

          The abbreviated profile of hearing aid benefit.

          To develop and evaluate a shortened version of the Profile of Hearing Aid Benefit, to be called the Abbreviated Profile of Hearing Aid Benefit, or APHAB. The Profile of Hearing Aid Benefit (PHAB) is a 66-item self-assessment, disability-based inventory that can be used to document the outcome of a hearing aid fitting, to compare several fittings, or to evaluate the same fitting over time. Data from 128 completed PHABs were used to select items for the Abbreviated PHAB. All subjects were elderly hearing-impaired who wore conventional analog hearing aids. Statistics of score distributions and psychometric properties of each of the APHAB subscales were determined. Data from 27 similar subjects were used to examine the test-retest properties of the instrument. Finally, equal-percentile profiles were generated for unaided, aided and benefit scores obtained from successful wearers of linear hearing aids. The APHAB uses a subset of 24 of the 66 items from the PHAB, scored in four 6-item subscales. Three of the subscales, Ease of Communication, Reverberation, and Background Noise address speech understanding in various everyday environments. The fourth subscale, Aversiveness of Sounds, quantifies negative reactions to environmental sounds. The APHAB typically requires 10 minutes or less to complete, and it produces scores for unaided and aided performance as well as hearing aid benefit. Test-retest correlation coefficients were found to be moderate to high and similar to those reported in the literature for other scales of similar content and length. Critical differences for each subscale taken individually were judged to be fairly large, however, smaller differences between two tests from the same individual can be significant if the three speech communication subscales are considered jointly. The APHAB is a potentially valuable clinical instrument. It can be useful for quantifying the disability associated with a hearing loss and the reduction of disability that is achieved with a hearing aid.
            • Record: found
            • Abstract: found
            • Article: not found

            Assessment of more than 1,000 implanted percutaneous bone conduction devices: skin reactions and implant survival.

            This study assesses soft tissue reactions and implant stability of 1,132 percutaneous titanium implants (970 patients) for bone conduction devices (BCDs). In addition, it examines BCD usage and comparisons between different patient groups.
              • Record: found
              • Abstract: found
              • Article: not found

              Amplification in the rehabilitation of unilateral deafness: speech in noise and directional hearing effects with bone-anchored hearing and contralateral routing of signal amplification.

              Vibromechanical stimulation with a semi-implantable bone conductor (Entific BAHA device) overcomes some of the head-shadow effects in unilateral deafness. What specific rehabilitative benefits are observed when the functional ear exhibits normal hearing versus moderate sensorineural hearing loss (SNHL)? The authors conducted a prospective trial of subjects with unilateral deafness in a tertiary care center. This study comprised adults with unilateral deafness (pure-tone average [PTA] > 90 dB; Sp.D. 75%) in the contralateral functional ear (n = 5). Subjects were fit with contralateral routing of signal (CROS) devices for 1 month and tested before (mastoid) implantation, fitting, and testing with a bone-anchored hearing aid (BAHA). Outcome measures were: 1) subjective benefit; 2) source localization tests (Source Azimuth Identification in Noise Test [SAINT]); 3) speech discrimination in quiet and in noise assessed with Hearing In Noise Test (HINT) protocols. There was consistent satisfaction with BAHA amplification and poor acceptance of CROS amplification. General directional hearing decreased with CROS use and was unchanged by BAHA and directional microphone aids. Relative to baseline and CROS, BAHA produced significantly better speech recognition in noise. Twenty-two of 23 subjects followed up in this study continue to use their BAHA device over an average follow-up period of 30.24 months (range, 51-12 months). BAHA amplification on the side of a deaf ear yields greater benefit in subjects with monaural hearing than does CROS amplification. Advantages likely related to averting the interference of speech signals delivered to the better ear, as occurs with conventional CROS amplification, while alleviating the negative head-shadow effects of unilateral deafness. The advantages of head-shadow reduction in enhancing speech recognition with noise in the hearing ear outweigh disadvantages inherent in head-shadow reduction that can occur by introducing noise from the deaf side. The level of hearing impairment correlates with incremental benefit provided by the BAHA. Patients with a moderate SNHL in the functioning ear perceived greater increments in benefit, especially in background noise, and demonstrated greater improvements in speech understanding with BAHA amplification.

                Author and article information

                Journal
                Otol Neurotol
                Otol. Neurotol
                MAO
                Otology & Neurotology
                Lippincott Williams & Wilkins
                1531-7129
                1537-4505
                August 2020
                16 April 2020
                : 41
                : 7
                : 901-911
                Affiliations
                []Department of Otorhinolaryngology, Donders Center for Neurosciences, Radboud University Medical Centre, Nijmegen, The Netherlands
                []Department of Otorhinolaryngology, Queen Elizabeth Hospital, Birmingham
                []Department of Otorhinolaryngology, Manchester Royal Infirmary, Manchester, England
                [§ ]Department of Otorhinolaryngology, Medical College of Wisconsin, Milwaukee Wisconsin
                [|| ]Department of Otorhinolaryngology, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany
                []Department of Heart Failure and Cardiac Rehabilitation, Medical University of Warsaw, Poland
                [# ]Cochlear Bone Anchored Solutions AB, Mölnlycke, Sweden
                Author notes
                Address correspondence and reprint requests to Ivo J. Kruyt, M.D., Department of ENT, Radboudumc, PO Box 9101, 6500 HB Nijmegen, The Netherlands; E-mail: Ivo.Kruyt@ 123456radboudumc.nl
                Article
                ON-19-663 00008
                10.1097/MAO.0000000000002689
                7373438
                32310837
                07ffb066-5ea7-4a11-b167-701226bd9c75
                Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of Otology & Neurotology, Inc.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

                History
                Categories
                Audiology
                Custom metadata
                TRUE

                attract,baha,bone conduction,bone conduction devices,bone-anchored hearing,health related quality of life,hearing loss,implant loss,soft tissue reactions,transcutaneous

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