Active Middle Ear Implant Patient Outcomes With Adaptive Feedback Canceller

Abstract

Objective: Evaluation of the audiological patient performance with an upgrade of the firmware from the fixed feedback canceller (FFC) to the adaptive feedback canceller (AFC) on an active middle ear implant. Study Design: Retrospective observational nonrandomized group study. Setting: Private hospital. Patients/Intervention(s): From March 2018 to September 2019, 15 patients implanted with an active middle ear implant, with 6 or more months of experience with a FFC system, were upgraded to an AFC algorithm. Main Outcome Measure(s): Functional gain, speech perception in silence and in noise, and sound localization capacities were examined. Feedback reduction was also analyzed. Results: Thirteen patients were analyzed. Pure tone audiometric evaluation with FFC (mean value of 48.02 dB) compared with AFC at 1 (mean value of 49.12 dB) and 6 months (mean value of 42.75 dB) revealed no statistically significant differences (p = 0.889 and p = 0.358 respectively). In speech discrimination in silence, clinically relevant improvements were observed with AFC at 1 and 6 months, with a mean value of 41.5 and 38.3 dB, respectively (p = 0.03 and p = 0.021 correspondingly). In speech discrimination in noisy environments, we observed an improvement of the different conditions tested. No differences were found in localization capacities between FFC and AFC at the two different moments of evaluation. Conclusions: AFC is more effective than FFC in cancelling feedback and improving sound quality, allowing for better speech understanding in silence and in noise.

Impact on Daily Life of an Active Middle Ear Implant

“…In background noise conditions as in a supermarket, with several people talking, in a crowd or with other environment noises, patients demonstrated with APHAB less difficulties with Carina. This is in line with what had been demonstrated in 2019 and 2021 by another's studies, in which there was an improvement in speech discrimination in noise in patients implanted with the Carina device [13,17].…”

“…All patients were assessed pre-and postoperatively with tonal and speech audiometry. The results of this evaluation have already been published and can be accessed in Peixoto., et al 2021 [13].…”

“…When analyzed the discomfort conditioned by ambient noises, such as a car alarm (3), traffic (8), running water in a kitchen sink or in a bathroom (13), construction sounds (17), a siren (20) or a car break (22), it was found that in all these conditions a greater discomfort was reported by the patients with AMEI (Figure 4).…”