The evaluation of a surgery and the short-term benefits of a new active bone conduction hearing implant - the Osia®.

INTRODUCTION: Modern medicine offers a wide spectrum of different hearing devices, and bone conduction implants can be found among them. OBJECTIVE: The presentation of the outcomes of the implantation of a new active bone conduction hearing implant - the Osia®, and its comparison with the well-known passive transcutaneous system - the Baha® Attract. METHODS: Eight adult patients with bilateral mixed hearing loss were randomly divided into two groups. Group 1 was implanted with the Osia®, and group 2 was implanted with the Baha® Attract. The details of the surgery were analyzed, along with the functional and audiological results. RESULTS: In all the cases, the surgery was successful, and the healing uneventful. In both groups, it was observed that pure tone audiometry and speech audiometry in free field improved significantly after the implantation (mean gain in pure tone audiometry for the Osia group 42.8 dB SPL and for the Baha group 38.8 dB SPL). In the Osia group, the results after the surgery were much better than with the Baha® 5 Power processor on the Softband. The patients implanted with the Osia® evaluated the quality of their hearing as being superior to those implanted with the Baha® Attract. There was an evident improvement in the abbreviated profile of hearing aid benefit questionnaire and in the speech, spatial and qualities of hearing scale for both systems. In the abbreviated profile of hearing aid benefit, changes were more evident in the Osia group (in global score 49% vs. 37.2%). CONCLUSION: Implantation of the Osia® is an effective treatment option for the patients with bilateral mixed hearing loss. The surgery is safe but more complex and time-consuming than the Baha® Attract implantation. The preliminary audiological results as well as the overall quality of life indicate that the Osia® is a better solution than the Baha® Attract. However, future studies should be carried out to make further observations in a larger group of patients, and with longer follow-up.

Piezoelectric bone conduction hearing implant Osia® - audiological and quality of life benefits.

<b>Introduction:</b> Nowadays, there are many options to treat hearing-impaired patients: tympanoplastic surgery, hearing aids and a wide range of implantable devices.</br></br> <b>Aim:</b> The aim of this study is to present the mid-term audiological and quality of life benefits after the implantation of Osia®, an active piezoelectric bone conduction hearing implant. </br></br> <b>Material and methods:</b> The state of the tissues in the implanted area, as well as audiological and quality of life results were analyzed at six, nine and twelve months after implantation in a group of four adult patients with bilateral mixed hearing loss (1 after bilateral canal-wall-down mastoidectomy, 2 with chronic simple otitis media and after myringoplasty in the opposite ear, 1 with bilateral otosclerosis and after stapedotomy in the opposite ear). </br></br> <b>Results:</b> No postoperative complications were found in any of the cases. One year after surgery the mean audiological gain in FF PTA4 (pure tone average for 0.5, 1, 2, and 4 kHz) was 52.2 ± 3.5 dB in comparison to the unaided situation, the mean speech understanding with Osia® in quiet was 90 ± 8.2% for 50 dB SPL, 98.8 ± 2.5% for 65 dB SPL and 100 ± 0% for 80 dB SPL, and the mean speech understanding with Osia® in noise was 37.5% ± 23.6 for 50 dB SPL, 93.8 ± 4.8% for 65 dB SPL and 98.8 ± 2.5% for 80 dB SPL. There was also an evident improvement in the quality of hearing as well as in the quality of life, measured by APHAB (Abbreviated Profile of Hearing Aid Benefit) and SSQ (Speech, Spatial and Qualities of Hearing Scale). </br></br> <b>Conclusions:</b> The Osia® is an effective treatment option for patients with bilateral mixed hearing loss. The mid-term audiological and quality of life results are excellent, but further observations including bigger groups of patients and a longer follow- -up are required.

The Impact of Virtual Reality Training on the Quality of Real Antromastoidectomy Performance.

BACKGROUND: The aim of this paper is to analyze the results of virtual reality (VR) antromastoidectomy simulation training and the transferability of the obtained skills to real temporal bone surgery. METHODS: The study was conducted prospectively on a group of 10 physicians, and was composed of five VR simulation training sessions followed by live temporal bone surgery. The quality of performance was evaluated with a Task-Based Checklist (TBC) prepared by John Hopkins Hospital. Additionally, during every VR session, the number and type of mistakes (complications) were noted. RESULTS: The quality of performance measured by the TBC increased significantly during consecutive VR sessions. The mean scores for the first and fifth sessions were 1.84 and 4.27, respectively (p < 0.001). Furthermore, the number of mistakes in consecutive VR sessions was gradually reduced from 11 to 0. During supervised surgery, all the participants were able to perform at least part of an antromastoidectomy, and the mean TBC score was 3.57. There was a significant strong positive correlation between the individual results of the fifth VR session and the individual results of supervised surgery in the operating room (rp = 0.89, p = 0.001). CONCLUSIONS: Virtual reality for temporal bone training makes it possible to acquire surgical skills in a safe environment before performing supervised surgery. Furthermore, the individual final score of virtual antromastoidectomy training allows a prediction of the quality of performance in real surgery.

The survey of parents' and adults recipients' satisfaction with cochlear implantation determined by the place of residence.

<b>Introduction:</b> The use of cochlear implants (CI) has been a remarkable success in reducing disabilities in patients with impaired hearing. The definition of success for those patients means improvement of hearing ability for adults, possibility to develop speech and language for children, quality of life improvement and satisfaction with the whole CI implantation procedure. <br><b>The aim:</b> To examine patient satisfaction, determined by their place of residence, with all activities in progress during CI implantation including care in subsequent years. Material and methods: The study was conducted prospectively. Online surveys were sent to 1,906 CI patients, with the response rate reaching 33%; thus 630 surveys were analyzed. Demographic data of the respondents were collected: gender, age of implantation, one- or two-sided implantation, place of residence and implanting clinic. A detailed statistical analysis of the obtained data was performed. <br><b>Results:</b> One of the problems observed was the aspect of waiting time for qualification, implantation and replacement of the speech processor. The second problem was the travel time to the CI center and that was strictly connected with the place of the residence of a patient. Patients' satisfaction with the control visit was high for majority of them. <br><b>Conclusions:</b> This research highlighted the limitations of the current CI service delivery. Significant differences concerning the CI pathway were found for particular regions of Poland. One of the future goals for healthcare providers should be to level out the differences in access to CI services between different regions of Poland.

Evaluation of quality of life in patients after cochlear implantation surgery in 2014-2017.

INTRODUCTION: Profound hearing loss significantly affects the quality of life of deaf people as well as their families. Observation of the benefit from the use of cochlear implants in deaf patients allows to assess the success of treatment with this method and its impact on the quality of life of these patients. The aim of this study was to determine the quality of life in patient after the cochlear implantation in the material of Department of Phoniatrics and Audiology of the Medical University in Poznan. MATERIAL AND METHODS: The study involved implanted patients who voluntarily joined to the project entitled "Observational study of the implanted patient (Cochlear-IROS)". It has a prospective character, it is an international and long-term study, covering the observation of patients up to three years after implantation. Standardized HUI and SSQ questionnaires were used. 70 patients were included in the analysis, the mean age at the time of the cochlear implantation was 47.6 years. In the research group there were 33 men and 37 women. In the whole group, the patients' age at implantation was at least 18 years, max. 80 years. RESULTS: The results of the SSQ questionnaire, which deals with the self-assessment of hearing ability in everyday situations, indicate that in the subjective assessment of patients one year after surgery the speech hearing improved by 77%, spatial hearing by 84%, and the quality of hearing by 49%. The general quality of life before the first connection of the sound processor according to the HUI questionnaire, the patients rated at 0.49 (0-1 scale, where 0 - corresponds to the death condition and 1 - full health). After one year from the implantation, this rating increased to 0.56. CONCLUSIONS: The implantation of the cochlear implant significantly increases the patient's quality of life, its physical and emotional functioning. Statistically significant better self-assessment of patients mainly concerned hearing speech and spatial hearing - especially after 1 year of connecting the speech processor.

Quality of life and hearing after cochlear implant placement in patients over 60 years of age.

OBJECTIVE: Multicenter evaluation of the quality of life and quality of hearing after Nucleus® cochlear implant placement in patients over 60 years of age. REFERENCE AND METHOD: Evaluation was performed in patients receiving cochlear implants after the age of 60 years as a part of the Cochlear-Implanted Recipient Observational Study (Cochlear-IROS). This study is a prospective, international and long-term assessment which enables observation of recipients for up to three years after implantation. Data regarding subjective evaluation of the quality of life and quality of hearing were gathered before the first switch-on of the sound processor and one year afterwards. Standardized questionnaires were used in this evaluation, including Health Utility Index (HUI mk. III) and Speech, Spatial and Qualities of Hearing (SSQ) Scale. Data were also gathered regarding the aetiology of hearing loss, hearing aid usage, tinnitus and vertigo, as well as on the telephone usage and the professional status of recipients. RESULTS: Included in the evaluation, were 20 subjects who were over 60 years old at the moment of the cochlear implant surgery. The study group consisted of 12 men and 8 female patients. The average age of CI recipients at the moment of implantation was 67.8 years (min. 60, max. 80 years). The SSQ questionnaire outcomes regarding self-assessment in the field of ability to hear in everyday situations one year after the surgery indicate that speech understanding increased by 180%, spatial hearing increased by 135 % and quality of hearing increased by 98%. Overall quality of life before the first sound processor switch-on as assessed using the HUI questionnaire was at the level of 0.38 (on 0-1 scale, where 0 equals death, and 1 equals full health). One year after the implantation, this assessment increased by 33% (up to 0.5 on the scale). CONCLUSION: The effectiveness of the cochlear implantation in patients with severe hearing loss after 60 years of age with respect to the quality of life and hearing was confirmed. Statistically significant improvement was demonstrated in the self-assessment of patients in relation to the speech understanding, spatial hearing and quality of hearing, as well as quality of life.