5 Discussion
In our study the ADHEAR system was applied to an inhomogeneous group of
patients with middle ear diseases of multiple etiologies suffering from
a uni- or bilateral CHL or MHL. As a control group, the ADHEAR system
was applied to healthy subjects with an artificial occluded outer ear
canal. The patients and healthy subjects were aided with the ADHEAR
system regardless of the indication criterion of the system.
In patients with a middle ear disease, 10 patients aided with a softband
BAHA 5 Power system and the ADHEAR system led to a significant
improvement of speech intelligibility in quiet and in noise, compared to
the unaided situation. Similar results were found in a pilot study by
Skarzynski et al.(17). Another study on 11 patients after middle ear
surgery showed a significant improvement of speech intelligibility for
monosyllables in quiet by 46% with the ADHEAR system compared to the
unaided situation. The authors concluded that this adhesive BCHD may
considerably improve treatment of patients with even short-term HL.
In patients with chronic inflammation of the outer ear canal and/or the
middle ear, a conventional hearing aid is often refused by the doctor
during conservative treatment. Even after middle ear surgery or surgery
of the outer ear canal there is also a need for a temporary alternative
for hearing improvement. In these cases, a softband BAHA system or an
adhesive BCHD may be an alternative to improve hearing.
A softband BAHA system is sometimes refused by the patients due to
social stigmatization and sweating, especially in summer. Therefore, we
initialized the study starting in summer to prove whether the ADHEAR
system is an alternative to a softband BAHA system or not.
According to the company information, the adhesive adapter is designed
for single use and can remain on the skin for 3-7 days(9, 12, 15, 18).
Considering the statements in the questionnaires, in four out of 33
participants of the study, the adhesive adapter detached more than 2
times per day due to sweating. The reported daily use and the comfort
level was high, suggesting good patients’ acceptance. Additionally, no
allergic reactions or other skin alteration were observed in all
participants. However, for a few patients the adhesive solution is not
satisfactory such that the softband BAHA remains an alternative.
Patients with long-time experience for the ADHEAR and the softband BAHA
system reported a higher wearing comfort and longer wearing time with
the ADHEAR system than the softband BAHA system. Similar results were
reported by Neumann et al.(16) and Dahm et al.(18). More data are needed
to conclude that an adhesive solution is the preferred option.