Conclusions:
Our study results allow the conclusion that the decision with modality
can be recommended to improve hearing in patients with middle ear
disease is not only audiologic but involves both audiological and
clinical assessment. Hearing results with the adhesive ADHEAR system
within and outside its indication criterion were compared to the
softband bone anchored hearing aid (BAHA) system in patients with
conductive or mixed hearing loss. Due to the pressure-less wearing
comfort we see the ADHEAR system as a permanent or temporary treatment
option in patients who are unable to receive or deny surgery. Outside
the indication criterion of the ADHEAR system, the use of the ADHEAR
system can be an option. Softband BAHA systems remain a solution for
patients were the adhesive wearing time is not satisfactory.
Figures
Fig. 1.
Air conduction (AC) and bone conduction (BC) hearing levels (PTA4) for
patients with middle ear disease (CHL or MHL – group 1). The dotted
line points the indication criterion of the ADHEAR system at a BC of
less than 25 dB HL and the dashed line points the indication criterion
of the BAHA 5 Power system at a BC less than 55 dB HL.
Fig. 2A
Speech intelligibility scores (free-field Freiburg monosyllables word
test results) in quiet at 65 dB SPL for the unaided situation and the
aided situation with the ADHEAR system for patients in group 1 (middle
ear disease) within and outside the indication criterion for ADHEAR (in:
n = 11 and out: n = 12).
Fig. 2B
Speech intelligibility scores (free-field Freiburg monosyllables word
test results) in noise at 5 dB SNR for the unaided situation and the
aided situation with the ADHEAR system for patients in group 1 (middle
ear disease) within and outside the indication criterion for ADHEAR (in:
n = 11 and out: n = 12).
Fig. 3A
Speech intelligibility scores (free-field Freiburg monosyllables word
test results) in quiet at 65 dB SPL for the unaided situation and the
aided situations with the ADHEAR system and the softband BAHA 5 Power
system for patients in group 1 (middle ear disease) within and outside
the indication criterion for ADHEAR (in: n = 6 and out: n = 4).
Fig. 3B
Speech intelligibility scores (free-field Freiburg monosyllables word
test results) in noise at 5 dB SNR for the unaided situation and the
aided situations with the ADHEAR system and the softband BAHA 5 Power
system for patients in group 1 (middle ear disease) within and outside
the indication criterion for ADHEAR (in: n = 6 and out: n = 4).
Tables
Table 1. Demographics and baseline characteristics for all patients with
middle ear disease and for the control group (subjects with bilateral
plugged ears).
Table 2. Mean speech intelligibility differences between the unaided
situation and the aided situations, using the ADHEAR system and a
softband BAHA 5 Power system.
1. Tjellstrom A, Hakansson B, Granstrom G. Bone-anchored hearing aids:
current status in adults and children. Otolaryngol Clin North Am.
2001;34(2):337-64.
2. Cedars E, Chan D, Lao A, Hardies L, Meyer A, Rosbe K. Conversion of
traditional osseointegrated bone-anchored hearing aids to the Baha((R))
attract in four pediatric patients. Int J Pediatr Otorhinolaryngol.
2016;91:37-42.
3. Gawecki W, Stieler OM, Balcerowiak A, Komar D, Gibasiewicz R, Karlik
M, et al. Surgical, functional and audiological evaluation of new
Baha((R)) Attract system implantations. Eur Arch Otorhinolaryngol.
2016;273(10):3123-30.
4. Oberlies NR, Castano JE, Freiser ME, McCoy JL, Shaffer AD, Jabbour N.
Outcomes of BAHA connect vs BAHA attract in pediatric patients. Int J
Pediatr Otorhinolaryngol. 2020;135:110125.
5. Mylanus EAM, Hua H, Wigren S, Arndt S, Skarzynski PH, Telian SA, et
al. Multicenter Clinical Investigation of a New Active Osseointegrated
Steady-State Implant System. Otol Neurotol. 2020;41(9):1249-57.
6. Sprinzl G, Lenarz T, Ernst A, Hagen R, Wolf-Magele A, Mojallal H, et
al. First European multicenter results with a new transcutaneous bone
conduction hearing implant system: short-term safety and efficacy. Otol
Neurotol. 2013;34(6):1076-83.
7. Labassi S, Beliaeff M, Pean V, Van de Heyning P. The Vibrant
Soundbridge((R)) middle ear implant: A historical overview. Cochlear
Implants Int. 2017;18(6):314-23.
8. Hol MK, Cremers CW, Coppens-Schellekens W, Snik AF. The BAHA
Softband. A new treatment for young children with bilateral congenital
aural atresia. Int J Pediatr Otorhinolaryngol. 2005;69(7):973-80.
9. Osborne MS, Child-Hymas A, McDermott AL. Longitudinal study of use of
the pressure free, adhesive bone conducting hearing system in children
at a tertiary centre. Int J Pediatr Otorhinolaryngol. 2020;138:110307.
10. Verhagen CV, Hol MK, Coppens-Schellekens W, Snik AF, Cremers CW. The
Baha Softband. A new treatment for young children with bilateral
congenital aural atresia. Int J Pediatr Otorhinolaryngol.
2008;72(10):1455-9.
11. Reinfeldt S, Hakansson B, Taghavi H, Eeg-Olofsson M. New
developments in bone-conduction hearing implants: a review. Med Devices
(Auckl). 2015;8:79-93.
12. Dahm V, Baumgartner WD, Liepins R, Arnoldner C, Riss D. First
Results With a New, Pressure-free, Adhesive Bone Conduction Hearing Aid.
Otol Neurotol. 2018;39(6):748-54.
13. Dobrev I, Farahmandi TS, Huber AM, Roosli C. Experimental Evaluation
of the Adhear, a Novel Transcutaneous Bone Conduction Hearing Aid.
Laryngorhinootologie. 2021;100(10):811-7.
14. Favoreel A, Heuninck E, Mansbach AL. Audiological benefit and
subjective satisfaction of children with the ADHEAR audio processor and
adhesive adapter. Int J Pediatr Otorhinolaryngol. 2020;129:109729.
15. Hirth D, Weiss R, Stöver T, Kramer S. Audiological benefit and
subjective satisfaction with the ADHEAR hearing system in children with
unilateral conductive hearing loss. Eur Arch Otorhinolaryngol.
2021;278(8):2781-8.
16. Neumann K, Thomas JP, Voelter C, Dazert S. A new adhesive bone
conduction hearing system effectively treats conductive hearing loss in
children. Int J Pediatr Otorhinolaryngol. 2019;122:117-25.
17. Skarzynski PH, Ratuszniak A, Osinska K, Koziel M, Krol B, Cywka KB,
et al. A Comparative Study of a Novel Adhesive Bone Conduction Device
and Conventional Treatment Options for Conductive Hearing Loss. Otol
Neurotol. 2019;40(7):858-64.
18. Dahm V, Auinger AB, Liepins R, Baumgartner WD, Riss D, Arnoldner C.
A Randomized Cross-over Trial Comparing a Pressure-free, Adhesive to a
Conventional Bone Conduction Hearing Device. Otol Neurotol.
2019;40(5):571-7.