Physical outcome measures for conductive and mixed hearing loss treatment: A systematic review.

BACKGROUND: The number of potential options for rehabilitation of patients with conductive or mixed hearing loss is continually expanding. To be able to inform patients and other stakeholders, there is a need to identify and develop patient-centred outcomes for treatment of hearing loss. OBJECTIVE OF REVIEW: To identify outcome measures in the physical core area used when reporting the outcome after treatment of conductive and mixed hearing loss in adult patients. TYPE OF REVIEW: Systematic review. SEARCH STRATEGY: Systematic review of the literature related to reported physical outcome measures after treatment of mixed or conductive hearing loss without restrictions regarding type of intervention, treatment or device. EVALUATION METHOD: Any measure reporting the physical outcome after treatment or intervention of mixed or conductive hearing loss was sought and categorised. The physical outcome measures that had been extracted were then grouped into domains. RESULTS: The literature search resulted in the identification of 1434 studies, of which 153 were selected for inclusion in the review. The majority (57%) of papers reported results from middle ear surgery, with the remainder reporting results from either bone conduction hearing devices or middle ear implants. Outcomes related to complications were categorised into 17 domains, whereas outcomes related to treatment success was categorised into 22 domains. CONCLUSIONS: The importance of these domains to patients and other stakeholders needs to be further explored in order to establish which of these domains are most relevant to interventions for conductive or mixed hearing loss. This will allow us to then assess which outcome measures are most suitable for inclusion in the core set.

Application of the advanced system for implant stability testing (ASIST) to natural teeth for noninvasive evaluation of the tooth root interface.

In this paper we present the development of the Advanced System for Implant Stability Testing (ASIST) for application to natural teeth. The ASIST uses an impact measurement combined with an analytical model of the system and surrounding support to provide a measure of the interface stiffness. In this study, an analytical model is developed for a single-rooted natural tooth allowing the ASIST to estimate the stiffness characteristics of the periodontal ligament (PDL). The geometry and inertia parameters of the tooth model are presented in two ways: (1) using full CT scans of the individual tooth and (2) using an approximate geometry model with estimates of only the tooth length and diameter. The developed system is evaluated with clinical data for patients undergoing orthodontic treatment. This study shows that ASIST technique can be applied to natural teeth to estimate the stiffness characteristics of the PDL. The developed system can provide a valuable clinical tool for assessment of tooth stability properties and PDL stiffness in a variety of clinical situations such as dental trauma, orthodontics, and periodontology.

Advanced System for Implant Stability Testing (ASIST).

This study presents the Advanced System for Implant Stability Testing (ASIST) which provides a non-invasive, quantitative measure of the stability of percutaneous implants used for craniofacial rehabilitation such as bone anchored hearing aids or dental implants. The ASIST uses an impact technique coupled with an analytical model which allows the measure to be independent of the system components. This paper presents a laboratory evaluation of the ASIST for the Oticon Medical Ponto and the Cochlear Baha Connect bone anchored hearing aid (BAHA) systems. There is minimal effect of abutment length on the ASIST Stability Coefficient (ASC) value, indicating that the method is able to isolate the interface properties from the overall system and the measurement is independent of attached components. Additionally, the ASIST was able to detect differences between different implant installations suggesting that it may be sensitive to changes in interface stiffness.