Dura and sinus compression with a transcutaneous bone conduction device – hearing outcomes and safety in 38 patients

Vyskocil, Erich; Riss, Dominik; Arnoldner, Christoph; Hamzavi, Jafar; Liepins, Rudolfs; Kaider, Alexandra; Honeder, Clemens; Fumicz, Judith; Gstœttner, Wolfgang; Baumgartner, Wolf‐Dieter

doi:10.1111/coa.12793

Cited by 32 publications

(28 citation statements)

References 10 publications

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“…Patients who received additional, non-osseous stimulation via the dura or the sigmoid sinus, showed no statistically significant differences in SFT, WRS and SRT values, compared to the group with only bone conduction stimulation. Previous studies also found that direct stimulation of the soft tissue structures within the skull, by a transcutaneous bone conduction implant, provides satisfactory hearing outcomes [34]. Our further analysis found that different degrees of mastoid pneumatization did not interfere with hearing sensation.…”

Section: Discussionsupporting

confidence: 70%

The effect of anatomical variables and use of the Lifts system on hearing outcomes after implantation of an active transcutaneous bone conduction device in bilateral congenital conductive hearing loss

Yang

Zhao

Liu

et al. 2020

Journal of Otolaryngology - Head & Neck Surgery

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Background: Malformations of the temporal bone present different challenges to the implantation of a transcutaneous active bone conduction device, such as Bonebridge (Med-el, Innsbruck, Austria). This study aims to describe the benefits of high-resolution computed tomography (HRCT) in preoperative assessment and to analyze whether characteristics of the mastoid process, intraoperative compression of the dura or sigmoid sinus, and the use of the Lifts system, lead to differences in audiological performance after implantation. Methods: We examined 110 cases of congenital microtia. The structure of the temporal bone was examined using HRCT and a 3D simulation software program. The mean anteroposterior mastoid bone thickness from the external auditory canal to the sigmoid sinus was measured (a measurement referred to as "AP", hereafter). Sound field threshold (SFT), speech reception threshold (SRT) in noise, and word recognition score (WRS) in quiet, before and after implantation, were also measured. Independent variables were recorded in all patients: mastoid type (well pneumatized or poorly pneumatized), the presence of dural or sigmoid sinus compression, and the use of the Lifts system. Results: We found that the mean AP in the non-compression group was 16.2 ± 2.3 mm and in the compression group, 13.1 ± 2.9 mm (p < 0.001). We analyzed the hearing improvement of patients grouped by mastoid development, dural or sigmoid sinus compression, and use of the Lifts system, and found that these factors did not interact and that they had no influence on the hearing outcomes (p > 0.05).

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Section: Discussionsupporting

confidence: 70%

The effect of anatomical variables and use of the Lifts system on hearing outcomes after implantation of an active transcutaneous bone conduction device in bilateral congenital conductive hearing loss

Yang

Zhao

Liu

et al. 2020

Journal of Otolaryngology - Head & Neck Surgery

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“…The preoperative and postoperative results can be seen in the S2 Table. Speech understanding in quiet was assessed in 27 publications [16, 26, 27, 7, 28, 22, 29, 24, 30, 10, 31, 25, 32–34, 18, 12, 13, 35, 36, 20, 14, 37, 38, 21, 39], resulting in a mean unaided WRS score of 25.73±23.64% improving to 84.48±15.09% in the aided condition, resulting in an overall mean improvement of almost 60% (S2 Table).…”

Section: Resultsmentioning

confidence: 99%

Active transcutaneous bone conduction hearing implants: Systematic review and meta-analysis

et al. 2019

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BackgroundIn July 2018 the active transcutaneous bone conduction hearing implant received FDA approval in the US (for patients 12 years and older with conductive and/or mixed hearing loss or single-sided deafness), reflecting the current trend of moving away from percutaneous hearing solutions towards intact skin systems.ObjectivesTo critically assess the current literature on safety, efficacy and subjective benefit after implantation with an active transcutaneous bone conduction hearing device.Data sourcesLiterature investigation was performed by electronic database search including PubMed and Cochrane Central Register of Controlled Trials, and manual search of relevant journals and reference lists of included studies.Study eligibility criteriaRandomized controlled trials, clinical controlled trials and cohort studies, case series and case reports investigating subjective and objective outcomes.Study appraisal and synthesis methodsRetrieved literature was screened and extracted by two reviewers independently. Subgroup analysis of indications (conductive and/or mixed hearing loss, single-sided deafness) and participant ages (pediatric vs. adults) was conducted on patients with active transcutaneous bone conduction devices. Sensitivity analysis was performed to test the stability of the results in meta-analysis.Results39 citations reporting on pre- and postoperative audiological results, speech performance in quiet and in noise, localization testing as well as subjective outcomes were included in this systematic review. Functional gain as well as word recognition score outcomes could be further investigated via meta-analysis. All outcomes reported and summarized here reflect beneficial audiological performance and high patient satisfaction, accompanied with a low complications rate (minor event incidence rate: 9.9 person-years; major incidence rate: 148.9 person-years) for the indications of conductive and mixed hearing loss as well as in individuals suffering from single-sided deafness for all age groups of subjects who underwent active transcutaneous bone conduction hearing device implantation.LimitationsA limiting factor of this systematic review was the Level of Evidence of the reviewed literature, comprising 2a/3a studies (cohort studies and case-control studies). Furthermore, the reporting standards, especially in outcomes such as word recognition scores in quiet and in noise, vary across study cites from various countries, which impedes comparisons. Last but not least, no other comparable other device was retrieved as the active transcutaneous bone conduction hearing device is the only available at the moment.ConclusionThe device’s transcutaneous technology results in a minor event incidence rate of one in 9.9 person-years and a major incidence rate of one in 148.9 person-years. Based on the audiological outcomes, high patient satisfaction as well as the low complication rate, the authors recommend the active transcutaneous bone conduction hearing device as a safe and effective treatment for patients sufferi...

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“…The hearing outcome results were comparable to the sparsely available data found elsewhere in literature. A recently published study showed dura compression, which may occur during retrosigmoidal placement, may even have a positive effect on hearing outcome . In our patient collective, all be it in a small sample size, we could identify a possibility that soft tissue compression, which regularly becomes necessary in the retrosigmoidal approach, may potentially benefit hearing outcome (Figure ).…”

Section: Discussionmentioning

confidence: 77%

Direct comparison of mastoidal and retrosigmoidal placement of a transcutaneous bone conduction device after canal wall down tympanoplasty

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Sterrer

Reichmayr

et al. 2018

Clinical Otolaryngology

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Dura and sinus compression with a transcutaneous bone conduction device – hearing outcomes and safety in 38 patients

Cited by 32 publications

References 10 publications

The effect of anatomical variables and use of the Lifts system on hearing outcomes after implantation of an active transcutaneous bone conduction device in bilateral congenital conductive hearing loss

The effect of anatomical variables and use of the Lifts system on hearing outcomes after implantation of an active transcutaneous bone conduction device in bilateral congenital conductive hearing loss

Active transcutaneous bone conduction hearing implants: Systematic review and meta-analysis

Direct comparison of mastoidal and retrosigmoidal placement of a transcutaneous bone conduction device after canal wall down tympanoplasty

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