Clinical Experience of Using Active Transcutaneous Bone Conduction Implants (Bonebridge) in Children Under 5 Years Old.

Active Transcutaneous Bone Conduction Implant: Audiometric Outcomes Following a Novel Middle Fossa Approach With Self-Drilling Screws.

Early Outcomes of a New Active Transcutaneous Bone Conduction Implant in Pediatric Patients.

Lifetime Real-World Evidence on Safety and Performance of the First Active Transcutaneous Bone Conduction Implant (BCI), the Bonebridge Covering Conductive to Mixed Hearing Loss (CMHL), and Single-Sided Deafness (SSD): Results From a Long-Term Retrospective Analysis.

Safety and Outcome of Piezoelectric Active Transcutaneous Bone Conduction Implants for Children Younger Than 5 Years: A Prospective Cohort Study.

Active Osseointegrated Transcutaneous Bone Conduction Implant: Results of a New Surgical Location in Children with Microtia and External Auditory Canal Atresia.

EE83 Cost-Effectiveness Analysis of an Active Transcutaneous Bone Conduction Implant for Patients With Conductive or Mixed Hearing Loss or Single-Sided Deafness in Turkey

Retrospective Analysis of Hearing-Impaired Adult Patients Treated With an Active Transcutaneous Bone Conduction Implant.

Introduction: Early pediatric conductive hearing loss intervention is crucial for ensuring optimal development outcomes. This study evaluated the impact of early access to bone conduction devices (BCDs) on children’s quality of life (QoL) and academic performance, comparing results between those who received BCDs and those who did not. Methods: We conducted a prospective cohort study involving children aged <12 years with congenital conductive hearing loss caused by external auditory canal atresia. The participants were categorized into three groups: those without BCDs, those using nonsurgical BCDs, and those implanted with active transcutaneous BCDs. QoL was assessed using the Arabic version of the Hearing Environments and Reflection on Quality of Life Measurement for Children Survey (HEAR-QL-AR) questionnaire at enrollment and during the last month of the study. School performance was evaluated based on annual academic results, grade repetition rates, and involvement in extracurricular activities. For children who were implanted with a piezoelectrive active transcutaneous bone conduction implant (OSI), data collection included age of implantation, duration of surgery, perioperative and long-term complications, and duration of device use. Results: A total of 57 children participated in the study and were categorized into three groups: 14 in the non-BCDs group, 17 in the nonsurgical BCDs group, and 27 in the active transcutaneous BCDs group. At enrollment, the median HEAR-QL-AR scores were significantly higher in both BCD groups (80 and 81 in the nonsurgical and implanted groups, respectively) than in the non-BCD group (66, p = 0.013). After 6 months, the implanted group achieved the highest median HEAR-QL-AR score (90, IQR = 8), followed by the nonsurgical group (76, IQR = 14) and the non-BCD group (64, IQR = 16; p < 0.001). Academic performance was better in the BCD groups, with a median grade of “A” compared to “B” in the non-BCD group (p = 0.004). Participation in extracurricular activities was also higher in the implant group (median = 1.5) than in the nonsurgical (median = 1) and non-BCD groups (median = 0; p < 0.001). No surgical complications occurred, and the median surgical duration was 38 min (IQR = 7.5). Conclusion: Early access to BCDs significantly improves QoL, academic performance, and social participation in children with conductive hearing loss. The implantation of active transcutaneous BCDs has been demonstrated to be both safe and effective, delivering superior auditory and developmental outcomes. These findings underscore the importance of advocating for timely intervention and expanding access to active transcutaneous BCDs for young children.

Active Transcutaneous Bone Conduction Implant: Middle Fossa Placement Technique in Children With Bilateral Microtia and External Auditory Canal Atresia.

Hearing aids and implants employing bone conduction (BC) stimulation have a long tradition in the treatment of conductive or mixed hearing loss, with their indications being extended in the 2000s to include single-sided deafness (SSD). Existing percutaneous bone conduction implants (BCI) provide significant audiological gain but are associated with a high rate of complications. This has led to the development of passive transcutaneous BCIs; however, audiological benefit may be compromised. An active transcutaneous BCI, the Bonebridge, was recently introduced and first implanted in 2011 as part of a clinical trial. To introduce and assess the safety and effectiveness of the Bonebridge for individuals with conductive or mixed hearing loss, and SSD. Systematic review. The Cochrane Library, PubMed and OVIDSP (MEDLINE) and EMBASE were searched to identify papers on the Bonebridge published as of June 2014. No exclusion criteria were set on publication language, study design or reported outcomes. The literature found was supplemented by presentations from relevant conferences. Study selection, data extraction and study quality assessment were carried out by a single reviewer with any uncertainties resolved with consulting a second reviewer. Studies were synthesised narratively and results were tabulated. A total of 29 studies, 17 published and 12 presentations, were identified. The highest quality evidence was from three single-arm trials. In those assessing the safety of implantation, 6 of 117 patients experienced a minor adverse event with superficial revision surgery being required in one case. Studies demonstrated improved hearing thresholds and speech recognition with the Bonebridge when compared to no aiding in adults and children with either type of hearing loss. This was reflected in high device satisfaction rates. Data collected in the second year of device use further suggest the benefit to remain constant. The transcutaneous BCI system Bonebridge provides a valuable and stable audiological benefit to patients suffering from conductive or mixed hearing loss and SSD. With its active transcutaneous design, the Bonebridge offers a lower complication rate to percutaneous systems and higher and more reliable hearing gain compared to other transcutaneous or percutaneous systems. Moreover, the fast activation of the implant system enables the recipient of the system to benefit in a short time frame postoperatively from the intervention.

Objective: The aim was to quantify the effect of the experimental active transcutaneous Bone Conduction Implant (BCI) on spatial release from masking (SRM) in subjects with bilateral or unilateral conductive and mixed hearing loss.Design: Measurements were performed in a sound booth with five loudspeakers at 0°, +/−30° and +/−150° azimuth. Target speech was presented frontally, and interfering speech from either the front (co-located) or surrounding (separated) loudspeakers. SRM was calculated as the difference between the separated and the co-located speech recognition threshold (SRT).Study Sample: Twelve patients (aged 22–76 years) unilaterally implanted with the BCI were included.Results: A positive SRM, reflecting a benefit of spatially separating interferers from target speech, existed for all subjects in unaided condition, and for nine subjects (75%) in aided condition. Aided SRM was lower compared to unaided in nine of the subjects. There was no difference in SRM between patients with bilateral and unilateral hearing loss. In aided situation, SRT improved only for patients with bilateral hearing loss.Conclusions: The BCI fitted unilaterally in patients with bilateral or unilateral conductive/mixed hearing loss seems to reduce SRM. However, data indicates that SRT is improved or maintained for patients with bilateral and unilateral hearing loss, respectively.

Introduction Atresia of the external auditory canal affects 1 in every 10 thousand to 20 thousand live births, with a much higher prevalence in Latin America, at 5 to 21 out of every 10 thousand newborns. The treatment involves esthetic and functional aspects. Regarding the functional treatment, there are surgical and nonsurgical alternatives like spectacle frames and rigid and softband systems. Active transcutaneous bone conduction implants (BCIs) achieve good sound transmission and directly stimulate the bone. Objective To assess the audiological performance and subjective satisfaction of children implanted with an active transcutaneous BCI for more than one year and to compare the outcomes with a nonsurgical adhesive bone conduction device (aBCD) in the same users. Methods The present is a prospective, multicentric study. The audiological performance was evaluated at 1, 6, and 12 months postactivation, and after a 1-month trial with the nonsurgical device. Results Ten patients completed all tests. The 4-frequency pure-tone average (4PTA) in the unaided condition was of 65 dB HL, which improved significantly to 20 dB HL after using the BCI for 12 months. The speech recognition in quiet in the unaided condition was of 33% on average, which improved significantly, to 99% with the BCI, and to 91% with the aBCD. Conclusion The aBCD demonstrated sufficient hearing improvement and subjective satisfaction; thus, it is a good solution for hearing rehabilitation if surgery is not desired or not possible. If surgery is an option, the BCI is the superior device in terms of hearing outcomes, particularly background noise and subjective satisfaction.

Objective: Magnetic resonance imaging (MRI) is often limited in patients with auditory implants because of the presence of metallic components and magnets. The aim of this study was to evaluate the clinical usefulness of a customized MRI sequence for metal artifact suppression for patients with implants in the temporal bone region, specifically patients with a transcutaneous bone conduction implant. Methods: Two whole head specimens were unilaterally implanted with a transcutaneous bone conduction implant. MRI examinations with and without a primarily self-build sequence (SEMAC-VAT WARP) for metal artifact suppression were performed. The diagnostic usefulness of the acquired MRI scans was rated independently by two neuroradiologists. The sequence was also used to acquire postimplantation follow-up MRI in a patient with a transcutaneous bone conduction implant. Results: The customized SEMAC-VAT WARP sequence significantly improved the diagnostic usefulness of the postimplantation MRIs. The image acquisition time was 12 min and 20 s for the T1-weighted and 12 min and 12 s for the T2-weighted MRI. There was good agreement between the two blinded raters (Cohen’s κ = 0.61, p < 0.001). Conclusion: The sequence for metal artifact reduction optimized in Bern enables MRI at 1.5 T in patients with active transcutaneous bone conduction implants without sacrificing diagnostic imaging quality. Particularly on the implanted side, imaging of intracranial and supra- and infratentorial brain pathologies is clinically more valuable than standard diagnostic MRI without any artifact reduction sequences.

Sound Localization in Active Transcutaneous Bone Conduction Implant Users with Single-Sided Deafness.

Surgical Experience and Early Audiological Outcomes With New Active Transcutaneous Bone Conduction Implant.