PMD66 - HEARING RESTORATION, QUALITY OF LIFE, AND SAFETY OUTCOMES IN BONE-CONDUCTION DEVICES FOR PATIENTS WITH CONDUCTIVE OR MIXED HEARING LOSS OR SINGLE-SIDE DEAFNESS

Abstract

To provide a comprehensive literature review on the various bone-conduction devices (BCDs) available, including bone-anchored hearing aids (BAHAs). A comprehensive search strategy was defined to perform a literature review of the data available to date on the different types of marketed BCDs for hearing rehabilitation in patients presenting with conductive hearing loss (CHL), mixed hearing loss (MHL), or single-side deafness (SSD). A search was conducted on December 22nd, 2015 on the PubMed, EMBASE and Google Scholar databases. Search criteria included patients presenting with CHL, MHL or SSD, and implanted with percutaneous (pBCI) or transcutaneous (tBCI) bone conduction implants. Non-systematic reviews, case reports and clinical studies on <5 patients were excluded. The literature analysis specifically examined the type of implantation (pBCI vs. tBCI), the principle of operation (active device, i.e. direct drive to the skull bone vs. passive device, i.e. skin drive), or by indication. 1,223 potentially relevant publications were identified; on full review, 95 studies met eligibility criteria. Hearing restoration, QoL and patient-reported outcomes measures have been increasingly documented for each technology in recent years. While the tBCIs seemed to be associated with a lower rate of skin complications than pBCIs, all the other parameters (clinical outcomes and QoL) seemed to be similarly distributed across all devices. The available data are still insufficient and the measurements’ sensitivities do not allow for a robust comparison between the different types of implants. The evidence base to support any differentiation between ‘passive’ and ‘active’ implants is insufficient, and direct comparison data is scarce. Future clinical studies and case reports should continue to investigate the clinical efficacy and safety outcomes related to the use of these devices, so as to provide physicians a more refined patient selection rationale and evidence-based practice pathways according to each device’s characteristics.