Abstract
Objective. To compare hearing and speech understanding between a new, nonskin penetrating Baha system (Baha Attract) to the current Baha system using a skin-penetrating abutment. Methods. Hearing and speech understanding were measured in 16 experienced Baha users. The transmission path via the abutment was compared to a simulated Baha Attract transmission path by attaching the implantable magnet to the abutment and then by adding a sample of artificial skin and the external parts of the Baha Attract system. Four different measurements were performed: bone conduction thresholds directly through the sound processor (BC Direct), aided sound field thresholds, aided speech understanding in quiet, and aided speech understanding in noise. Results. The simulated Baha Attract transmission path introduced an attenuation starting from approximately 5 dB at 1000 Hz, increasing to 20–25 dB above 6000 Hz. However, aided sound field threshold shows smaller differences and aided speech understanding in quiet and in noise does not differ significantly between the two transmission paths. Conclusion. The Baha Attract system transmission path introduces predominately high frequency attenuation. This attenuation can be partially compensated by adequate fitting of the speech processor. No significant decrease in speech understanding in either quiet or in noise was found.
Highlights
With more than 100,000 implantations so far, bone anchored hearing implants [1] belong to the widest used implantable hearing aids to date, second only to cochlear implants
Hearing thresholds were measured twice through each of the 4 transmission paths: once using bone conduction (BC) Direct, that is, measuring the BC thresholds with the sound processor as the signal generator, and once as aided sound field thresholds, where the sound processor acts as a hearing amplifier in its clinically intended way
The most important difference between the two measures was that any additional damping in the transmission path may be compensated by suitably fitting the sound processor in the sound field measurement, but not in BC Direct measurement
Summary
With more than 100,000 implantations so far, bone anchored hearing implants [1] belong to the widest used implantable hearing aids to date, second only to cochlear implants. The principle of operation is shown in Figure 1(a): a skin penetrating abutment is attached to an osseointegrated titanium implant. Its attractiveness is based on the relatively simple surgery and on the excellent results in adults and children with conductive or mixed hearing loss or, more recently, in single sided deafness [6,7,8]. Despite this success, some drawbacks are well known. Some patients who could benefit significantly from a system such as the Baha depicted in Figure 1(a) decline because of the skin penetrating implant behind the ear
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