Evaluating speech perception of the MAXUM middle ear implant versus speech perception under inserts.

OBJECTIVES/HYPOTHESIS: To evaluate the speech perception of the Ototronix MAXUM middle ear implant relative to the cochlear potential for speech perception of patients. STUDY DESIGN: Clinical study chart review. METHODS: We performed an evaluation of data from a prospective clinical study of 10 MAXUM patients. Primary outcome measures included comparison of word recognition (WR) scores with MAXUM (WRMAXUM ) versus word recognition under inserts (WRinserts ), and the functional gain improvement for pure-tone average (PTA) (0.5, 1, and 2 kHz) and high-frequency pure-tone average (2, 3, and 4 kHz). RESULTS: Ten ears in 10 adult patients (six female; average age 68.7 years) were included. The average speech perception gap (difference between WRinserts and WRMAXUM ) with MAXUM was -9.2% (range, -26% to 4%). A negative number indicates that WRMAXUM was higher than the WRinserts . The average PTA with MAXUM was 23.1 dB (range, 18.7-30 dB), a 38.0-dB gain over the preoperative unaided condition (range, 20-53.3 dB). The average high-frequency pure-tone average with MAXUM was 34.4 dB (range, 26-43.3 dB), a 42.8-dB gain over the preoperative unaided condition (range, 32.3-58.7 dB). CONCLUSIONS: These data demonstrate that a significant, very strong correlation was observed between WRinserts and WRMAXUM scores (r = 0.86, P = .001), and a patient's WRinserts score may be used to reasonably predict the word recognition outcomes with MAXUM. LEVEL OF EVIDENCE: 4. Laryngoscope, 128:456-460, 2018.

Comparison of an Electromagnetic Middle Ear Implant and Hearing Aid Word Recognition Performance to Word Recognition Performance Obtained Under Earphones.

OBJECTIVE: To report the results of patients with the Maxum middle ear implant (MEI) and compare word recognition scores (WRS) and speech perception gap (SP Gap) of Maxum versus optimally fit hearing aids (HA). STUDY DESIGN: Case series with chart review. SETTING: Single, private otology clinic. PATIENTS: Eleven ears, in nine adult patients (two women; average age 62.7 yr). INTERVENTIONS: Twelve consecutive ears with moderate to severe sensorineural hearing loss (SNHL) underwent implantation of the Maxum system. One patient was not included due to inadequate preoperative testing. MAIN OUTCOME MEASURES: Primary outcome measures included word recognition score (WRS) and SP Gap (maximum word understanding [PB max] - WRSaided) improvement compared with HAs. RESULTS: The average Maxum WRS was 64.7% (range, 28-94%), a 41.6% improvement (range, 10-66%) over HAs (p < 0.001). The average Maxum SP Gap was 6.6% (range, -8 to 24%), a 41.6% improvement (range, 10-66%) over HAs (p < 0.001). CONCLUSION: These data demonstrate that the Maxum provides superior WRS than HAs for patients with significant aided SP Gaps. There is a significant, very strong correlation between Maxum WRS and PB max (r = 0.85, p = 0.001). This implies that PB max may reasonably predict WRS outcomes with Maxum before implantation, and the SP Gap can reasonably predict the degree of additional potential benefit with Maxum. In advising patients who may be candidates for both a CI and MEI, PB max and SP Gap measurements will provide useful predictive information to help clinicians counsel patients on their choice of hearing technology. LEVEL OF EVIDENCE: 4.