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    BONE CONDUCTION | Non-implantable


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

    Benefits

    Statement

    Literature


    Audiological aspect Audiological benefit / Good hearing
    outcomes

    "Users of the passive [bone conduction] implant received comparable hearing benefit with the ADHEAR. The mean aided thresholds in sound field measurements and speech understanding in quiet and noise were similar, when subjects were evaluated either with the ADHEAR or the passive [bone conduction] implant. The audiological outcomes for the non-implanted group were also comparable between the ADHEAR and the [bone conduction device] on softband." (Skarzynski et al. 2019)

    In two studies by Gawliczek et al. the ADHEAR showed the same audiological performance as BAHA5 on SoundArc, but has the advantage of superior wearing comfort due to the lack of pressure. (conclusion / Gawliczek et al. 2018)

    "The mean unaided free field hearing threshold of 50 dB HL(...), improved significantly by 22 dB (13.0-29.9) with the ADHEAR and by 23 dB (13.6-32.9) with the [bone conduction hearing aids] (p < 0.001). Furthermore, the mean unaided speech recognition threshold (SRT) in quiet improved significantly by 19 dB (10.3-28.1) with the ADHEAR and by 21 dB (12.6-29.4) with the [bone conduction hearing aids] (p < 0.001). For both audiological tests, there were no significant differences between the ADHEAR and the [bone conduction hearing aids]." (Favoreel et al. 2020)

    "The mean aided threshold of the 12 children with Baha Softband is 27 dBHL ±6 dBHL. In the reference group, with the conventional bone conductor, this is 25 dBHL ±6 dBHL." (Verhagen et al. 2008)

    More: Gavilán et al. 2019, Zernotti et al. 2019, Brill et al. 2019, Dahm et al. 2019, Weiss et al. 2019, Neumann et al. 2019, Urik et al. 2019, Dahm et al. 2018, Hol et al. 2005


    Medical aspect No age limitation

    As non implantable devices are non-invasive and easy to use, every group of age can benefit from this treatment option. (HEARRING consensus)

    "For very young children with congenital bilateral aural atresia, in whom surgical intervention is not an option (for the time being), bone conduction hearing aids are the recommended method of hearing rehabilitation." (Verhagen et al. 2008)


    Medical aspect No surgical procedure / non-invasive / reversible

    "It provides an excellent alternative in the treatment (…) without the possible complications and costs of a surgical intervention." (Osborne et al. 2019)

    "As all these systems employ passive or skin-drive [bone conduction] to improve hearing, the vibrations emitted by the [bone conduction] transducer have to be relayed through the intact skin to the bone." (Skarzynski et al. 2019)

    More: Gawliczek et al. 2018, Westerkull 2018


    Medical aspect MRI safe

    The simple removal of the whole device is the only necessity to undergo a MRI. (HEARRING consensus)


    User's report Easy testing

    As non-implantable devices are always attached to the skin via an external fixation, the device can be taken off whenever necessary or wanted. (HEARRING consensus)

    "The use of [bone anchored hearing aids] on a softband (elastic fabric) or headband (diadem type) (…) is the gold standard for preoperative assessment." (Reinfeldt et al. 2015)

    "The headband or test rod, although crude in many ways, still offers an easy, fast and objective way of assessing bone conduction capacity which allows the patient to directly experience bone conducted sound, and so helps in decision making for him/her." (Hagr et al. 2007)

    It is possible to predict the hearing outcomes of an active [bone conduction] implant through the pre op use of a non implantable device (Adhear) (conclusion / Canale et al. 2019)

    "This adhesive hearing system is a safe and effective device to treat transient conductive hearing loss and may considerably improve treatment for patients even with short-term hearing loss." (Weiss et al. 2019)

    More: Spielmann et al.2018, Neumann et al. 2019, Mertens et al. 2018, Osborne et al. 2019, Zarowski et al. 2011, Spielmann et al.2018

    Drawbacks

    Statement

    Literature


    Audiological aspect Limited gain (in general)

    "However, due to dampening of energy by skin and soft tissue, especially in the high frequencies, the application of these devices has limitations." (Dahm et al. 2018)

    "Since the vibrations produced by the skindrive device are transmitted through the soft skin to the bone, the vibrations are attenuated. This mainly affects frequencies above 1 kHz, which are important for speech reception." (Mertens et al. 2018)


    Audiological aspect Limited gain (in SSD cases)

    "Observation in clinical practice shows that, still, the majority of [bone conduction device] trial experiences in the general SSD population are negative." (Mertens et al. 2018)


    Medical aspect Skin issues (mostly valid for non-adhesive systems)

    "In conclusion, this new, adhesive bone conduction hearing aid has a high patient satisfaction rate while causing no skin irritation or pain." (Dahm et al. 2018)

    "Bone conduction hearing devices integrated in softbands (BCDSs) are frequently not well accepted by children with conductive hearing loss due to pressure on the head, sweating, or cosmetic stigma." (Neumann et al. 2019)

    More: Verhagen et al. 2008, Osborne et al. 2019, Canale et al.
    2019, Reinfeldt et al. 2015


    User's report Limited retention / non reliable attachment

    "Adapter adhesion was sufficient for most of the subjects in our study but varied between one and seven days among participants. Excessive handling of the adapter or rubbing against car seats, armrests, hats etc. as well as variations in mastoid shape, skin type, sweating, or a combination of these factors could cause the observed differences." (Neumann et al. 2019)

    "However, these skin-drive devices have some drawbacks. (…) the placement may be unreliable, since the transducer may move out of position " (Mertens et al. 2018)

    [multistep multistep-2 "https://www.hearring.com/hct-bc-at"]

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