Bone Conduction Trial Device to Eliminate the Effect of Transcranial Attenuation: A Prospective Observational Study in Single-Sided Deaf Subjects.

OBJECTIVES: The contact miniTM (CM) is a nonimplantable, digital bone conduction device (BCD) consisting of 2 isolated units: an electronic housing, including the microphone, and a vibrator housing. The study investigated whether the CM can be used as an alternative test device for a BCD trial in single-sided deaf (SSD) adults with the microphone placed at the SSD ear and the vibrator at the normal-hearing (NH) ear (i.e., cross position). METHODS: Twenty SSD adults (mean age: 50 [±13.2] years) participated in a 2-week BCD trial with the CM on the headband in cross position. Prior to the trial, the subjects performed adaptive speech-in-noise tests in an unaided condition. After the trial, speech-in-noise tests were performed with the CM in cross position (CMcross) and ipsilateral position, i.e., both units at the SSD ear (CMipsi). Five different speech-in-noise configurations were used (S0N0; S0NNH; S0NSSD; S0°NNH+SSD; and SSSDNNH). Speech reception thresholds (SRT) were analyzed comparing the unaided, the CMcross condition, and the CMipsi condition. RESULTS: Friedman's test revealed no significant differences in SRTs between the CMcross, CMipsi, and the unaided condition for the S0N0, S0NNH, S0NSSD, and S0°NNH+SSD configuration. However, in the SSSDNNH configuration, a significant effect was found (p < 0.001). Wilcoxon pairwise comparisons with Bonferroni correction indicated that SRTs in the CMcross condition were significantly lower (i.e., better speech understanding) than those in the unaided (p < 0.001) and the CMipsi condition (p < 0.05). CONCLUSION: The CM may be a good alternative for patients with SSD, resulting in significantly better speech recognition when noise is presented to the NH ear and speech to the SSD ear. As the speech recognition results are better in the cross than the ipsilateral position, the CMcross might help to overcome the negative effect of transcranial attenuation during BCD trials.

A Prospective Randomized Crossover Study in Single Sided Deafness on the New Non-Invasive Adhesive Bone Conduction Hearing System.

BACKGROUND: Recently, an adhesive bone conduction hearing system has been developed for conductive hearing loss or single-sided deafness (SSD). In SSD cases, this device may be a good solution for patients who are unsuitable for, or who do not wish to undergo, bone conduction implant or cochlear implant surgery. The study aimed to investigate the hearing outcomes with the adhesive hearing system in SSD. PURPOSE OF THE STUDY: The study aimed to investigate the hearing outcomes with the adhesive hearing system in SSD. METHODS: A randomized crossover study was conducted in 17 SSD participants, using CROS (contralateral routing of signals) hearing aid as a control. Following outcome measurements were administered after a two-week trial: 1) Speech, Spatial and Qualities scale, Audio Processor Satisfaction Questionnaire, and a custom-made questionnaire about the use of the system, 2) sound localization, 3) speech perception in noise. RESULTS: 70% of the SSD subjects reported that the adhesive hearing system was partially useful or better. Using the APSQ, the adhesive test device was evaluated equally as the control device. Sound localization improved with the adhesive test device and deteriorated with the control device. There was no improvement in speech perception in noise measured with the adhesive test device. Speech perception in noise (SSSDNNH) with the control device improved significantly. CONCLUSION: To the best of our knowledge, this is the first study to report on the outcomes of the new adhesive system. Users' satisfaction of the adhesive hearing system was found to be comparable to the control device. Since the hearing outcomes vary highly between patients, trials with applicable hearing systems are recommended in SSD patients.

Clinical need for a Baha trial in patients with single-sided sensorineural deafness. Analysis of a Baha database of 196 patients.

A bone-anchored hearing aid (Baha) is used in patients with single-sided sensorineural deafness (SSD) to overcome the head shadow effect. Of all the patients with SSD, treated at our hospital, 196 patients used a Baha on trial between November 2001 and April 2010. The objective of this study is to evaluate what factors determine the decision of a SSD patient whether or not to opt for a Baha device following a Baha trial period. 196 patients with SSD were enrolled for a trial period of 2 weeks at the Antwerp University Hospital, a tertiary referral centre. 93% of these patients suffered from an acquired hearing loss. 44% of all the patients (87/196) chose to wear a Baha device after the trail period, either on an abutment or on a headband. The collected data were analysed to determine correlations between the decision of a patient following a Baha trial period on the one hand, and Fletcher Index ipsi- and contralaterally, bone conduction hearing thresholds at the better hearing ear, aetiology, age at the start of the trial period, duration of hearing loss at the start of the trial period and the type of device used during the trial period, on the other hand. Although 66% of all the patients (109/196) declined the Baha after a trial, reasons not to choose a Baha were diverse and no crucial factors could be found that determine the success of a Baha trial period. Lack of improvement concerning speech understanding in noise was the most important reason mentioned by patients who declined the Baha. The authors advocate that all patients, suffering from SSD, should be offered the opportunity to try a Baha device as no factors could be found that determine the decision of a patient following the trial period.