Active Middle Ear Implant Patient Outcomes With Adaptive Feedback Canceller.

Abstract

Evaluation of the audiological patient performance with an upgrade of the firmware from the fixed feedback canceller (FFC) to the adaptive feedback canceller (AFC) on an active middle ear implant. Retrospective observational nonrandomized group study. Private hospital. From March 2018 to September 2019, 15 patients implanted with an active middle ear implant, with 6 or more months of experience with a FFC system, were upgraded to an AFC algorithm. Functional gain, speech perception in silence and in noise, and sound localization capacities were examined. Feedback reduction was also analyzed. Thirteen patients were analyzed. Pure tone audiometric evaluation with FFC (mean value of 48.02 dB) compared with AFC at 1 (mean value of 49.12 dB) and 6 months (mean value of 42.75 dB) revealed no statistically significant differences (p = 0.889 and p = 0.358 respectively).In speech discrimination in silence, clinically relevant improvements were observed with AFC at 1 and 6 months, with a mean value of 41.5 and 38.3 dB, respectively (p = 0.03 and p = 0.021 correspondingly). In speech discrimination in noisy environments, we observed an improvement of the different conditions tested. No differences were found in localization capacities between FFC and AFC at the two different moments of evaluation. AFC is more effective than FFC in cancelling feedback and improving sound quality, allowing for better speech understanding in silence and in noise.