Title [multistep multistep-3 "https://www.hearring.com/hct-bc-pt"]

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    BONE CONDUCTION | Active transcutaneous

    Audiological aspectAudiological aspect   Medical aspect  Medical aspect       User's report User's report




    Audiological aspect Audiological improvement / hearing outcomes

    "All outcomes reported and summarized here reflect beneficial audiological performance and high patient satisfaction, accompanied with a low complications rate." (Magele et al. 2019)

    "So, when comparing pre-surgical results of BahaV R5 Power with softband to postoperative surgical procedures with the OsiaTM system at 2months after activation, the average functional gain for all frequencies was statistically higher (p<.05) for OsiaTM System (36.88dB) than for Baha 5 Power (30,57dB)" (Goycoolea et al. 2020)

    "Statistically significant improvements in audibility, speech-understanding, speech-recognition and quality-of-sound in noise and quiet were found for the OsiaTM compared to preoperative unaided hearing and aided hearing with the Baha 5 PowerV R Sound Processor on a softband." (Goycoolea et al. 2020)

    "Speech perception as measured by WRS and SRT50% improved on average approximately 67.6% and 27.5 dB, respectively, 3 months after implantation." (Baumgartner et al. 2016)

    More: Skarzynski et al. 2019, Zernotti et al. 2016, 2019, Fan et al. 2017, 2019, Der et al. 2018, Ihler et al. 2016, Gerdes et al. 2016, Sprinzl et al. 2013, Lasaletta et al. 2016, Rader et al. 2018

    Audiological aspect Better high frequency hearing (compared to passive transc.)

    "The active vibration system provided improvement at low and high frequencies. (…) In the case of the passive device BAHA Attract, the performance drops gradually above 3000Hz because of the soft tissue attenuation of the externally generated vibration (...)" (Goycoolea et al. 2020)

    A comparative study of active and passive devices by Zernotti et al. also showed that active devices had a better performance than passive devices at medium and high frequencies. (conclusion / Zernotti et al. 2015)

    Medical aspect Best option for malformations

    "In our experience, bone conduction thresholds in children with a malformation (e.g., atresia) are normal and remain stable after the implantation of a [bone conduction implant]."(Schilde et al. 2017)

    Baumgartner et al. (2016) showed, that active transcutaneous devices as the Bonebridge are "an alternative option for congenital malformations of the external and middle ear based on its noticeable audiological efectiveness, especially for patients with bilateral conductive hearing loss." (conclusion / Baumgartner et al. 2016)

    Medical aspect Local anaesthesia

    "Implantation of the Bonebridge with local or general anesthesia is a safe and feasible procedure, with audiometric results that can come close with the ones provided by [bone anchored hearing device] users." (Manrique et al. 2014)

    No data for OSIA

    Medical aspect Simple surgery

    "All patients whose implantable part of the device was fixed to the skull bone and additionally compressed underlying dura and/or sinus for several millimeters (range 2 - 5 mm) had good hearing outcomes." (Vyskocil et al. 2016)

    "Using an image-guided surgical navigation system to aid in the placement of the BC-FMT on the simulated location is a simple procedure and is more effective that finding the exact coordinates. It also shortens the decision time for applying the implant." (Kong et al. 2017)

    Medical aspect MRI conditional

    "MRI of the brain can be performed in patients with active transcutaneous bone conduction implants (BB) at 1.5 T without sacrificing diagnostic imaging quality, provided that special MRI artifact reduction sequences, like the SEMAC-VAT metal artifact reduction sequences optimized in Bern, are acquired." (Wimmer et al. 2019)

    Other active transcutaneous Bone Conduction implants require surgical magnet removal before undergoing MRI at 1,5 or 3 Tesla. (HEARRING consensus)

    "This pilot study indicates that the present BCI [bone conduction implant] may withstand 1.5 Tesla MRI with only minor effects on its performance." (Jansson et al. 2015)

    More: Azadarmaki et al. 2014, Tisch 2017

    Medical aspect Intact skin

    "Advantages especially in children include the lack of a skin-penetrating abutment, which substantially removes the need for medical follow-up, the external device is compact, simple to use and is considerably better cosmetically." (Kulasegarah et al. 2018)

    "The main advantage of transcutaneous devices, both active and passive, is that they keep the skin intact." (Lasaletta et al. 2016)

    User's report All day wearing comfort (due to no skin pressure)

    Baumgartner et al. (2016) determined a mean of 11.2 hours wearing time per day (indirect citation / Baumgartner et al. 2016))

    Zernotti et al. (2016) concluded that BONEBRIDGE users (8-12 h/d) showed a significantly longer wearing time of the device compared to SOPHONO Alpha recipients (7-10 h/d) (conclusion / Zernotti et al. 2016)

    "All patients use their devices all day during their daily activities." (Goycoolea et al. 2020)

    "Since the external processor does not include a vibrator, the weight is quite low, which reduces the risk of the external device falling off, while increasing wearing comfort since less magnetic force is required for retention." (Westerkull 2018)

    More: Lasaletta et al. 2016

    User's report Subjective Benefit

    Improvement of subjective benefit in several different kind of questionnaires significantly shown (conclusion / Magele et al. 2019)

    "The SSQ-12 was completed at all intervals (pre, post-2 and post-6months). Statistically significant improvements (p<.05) were observed in the SSQ-12 Speech and Qualities scales when comparing pre to 2months and pre to 6months conditions, which may indicate that the reported benefit can be even greater after one year of use." (Goycoolea et al. 2020)

    More: Sprinzl et al. 2013, Baumgartner et al. 2016, Skarzynski et al. 2019




    Medical aspect MRI artefact to be expected

    "Magnetic resonance imaging (MRI) is often limited in patients with auditory implants because of the presence of metallic components and magnets." (Wimmer et al. 2019)

    "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." (Wimmer et al. 2019)

    Medical aspect Anatomical limitations / space requirements

    Performance with every implant that is fixed onto or into the temporal bone and lies subcutaneously is influenced (and therefore potentially lmited by) by the recipient's unique anatomy. (HEARRING consensus)

    User's report Headwear

    It is required to counsell the recipient about the importance of exact placement of the coil-section of the implant, due to the fact that the audioprocessor might be in the way of helmets, hats or other headwear. (HEARRING consensus)



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