One-Year Follow-Up in Children with Conductive Hearing Loss Using ADHEAR

Abstract

<b><i>Background:</i></b> The ADHEAR™ system (MED-EL, Innsbruck, Austria) is a nonsurgical bone conduction device (BCD) to treat conductive hearing loss (CHL) and single-sided deafness. In contrast to the nonsurgical alternatives on headbands or spectacle frames, the audio processor of ADHEAR is placed retroauricularly on an adhesive adapter. The published evidence on the performance of this system is limited to studies with a trial period of 2–8 weeks. <b><i>Objective:</i></b> This study assesses audiological and subjective outcomes over a period of 12 months, on patients with congenital aural atresia (CAA) using the ADHEAR hearing system. <b><i>Method:</i></b> Fifteen children (mean age: 9.4 ± 4 years; range: 5–16 years) diagnosed with CAA (7 uni/8 bilateral) were included in this prospective, observational, repeated-measures study. Each subject used ADHEAR for 1 year, and the performance was evaluated after 1, 6, and 12 months. Free-field audiometry and speech discrimination tests were performed, and hearing-, general health- and device-specific questionnaires were used. <b><i>Results:</i></b> The unaided sound field threshold improved from an average PTA4 of 63.6 ± 3.4 dB HL to an aided average PTA4 of 29.3 ± 3.0 dB HL after 1 month of device use. The word recognition score (WRS) improved from an average of 27.9 ± 15.9% unaided to an aided average WRS of 91.3 ± 4.4% (<i>p</i> = 0.0003) after 1 month, 92.0 ± 4.1% (<i>p</i> = 0.0002) after 6 months, and 92.7 ± 5.3% (<i>p</i> < 0.0001) after 12 months using the ADHEAR system compared to the unaided condition for all 3 time points. The improvements in the speech in noise at 1, 6, and 12 months were as well consistent over time. The average improvement at the signal to noise ratio (SNR) of +5 dB was 58% and 53% at the SNR of +0 dB. No complications were reported, and all patients continued to use the ADHEAR after the study end. The questionnaire results revealed high user satisfaction and an average wearing time of 12 h per day. <b><i>Conclusion:</i></b> This 12-month trial of the nonsurgical adhesive BCD in CAA patients showed sufficient and reliable audiological and subjective outcomes, long wearing time, and high acceptance. The ADHEAR can be considered a suitable option to treat children with CAA for the given indication, without the drawbacks of nonsurgical devices that use pressure for retention of the audio processor or the costs and possible complications involved with a surgical alternative.

Improvement in quality of life comparing noninvasive versus invasive hearing rehabilitation in children

“…The literature also reported an average hearing threshold benefit of roughly 20 dB HL and a mean word recognition score of 75%. Studies reporting on children aged 12 years or younger also showed an average improvement in WRS of 65% with the ADH system 21,31,32,41 . Recently, one case of a bilateral implanted 2 year old subject was published, reporting significant audiological benefit and high patient satisfaction 42 .…”

“…Studies reporting on children aged 12 years or younger also showed an average improvement in WRS of 65% with the ADH system. 21 , 31 , 32 , 41 Recently, one case of a bilateral implanted 2 year old subject was published, reporting significant audiological benefit and high patient satisfaction. 42 Those reported that better speech intelligibility scores are also associated with better adjustment and social competence, 43 , 44 probably because of the general behavior after the age of 4, children tend to move away from dyadic interactions to larger groups, which generates higher levels of speech in‐noise (SIN).…”

Hearing Outcomes of a New Cartilage Conduction Device vs Bone Conduction Devices

“…There is no study to date that compares the CCD with the ADHEAR device (MED-EL), another nonsurgical alternative to the osseointegrated BCD that works by adhesive applied to a postauricular processor. 14,15 When audiologic outcomes were compared between CCDs and BCDs, PTA demonstrated a trend toward improved gain with the BCD vs CCD, which met significance at 1000 Hz. The difference in functional gain between devices was on average 5 to 12 dB, with greater difference in the high frequencies.…”

An objective bone conduction verification tool using a piezoelectric thin-film force transducer

“…Currently available percutaneous BCDs include the Baha five and Baha six connect systems (Cochlear Ltd., Sydney, Australia) ( Kim et al, 2017 ; Kruyt et al, 2020 ) and the Ponto three and Ponto four systems (Oticon A/S, Smorum, Denmark) ( Lagerkvist et al, 2020 ); the available passive transcutaneous BCDs include the Baha five Attract (Cochlear Ltd., Sydney, Australia) ( Oberlies et al, 2020 ) and Sophono Alpha2 (Medtronic, Dublin, Ireland) ( Kajosaari et al, 2017 ; Willenborg et al, 2022 ); and the available active transcutaneous BCDs include the BONEBRIDGE (MED-EL, Innsbruck, Austria) ( Sprinzl et al, 2021 ; Seiwerth et al, 2022 ) and the Osia (Cochlear Ltd., Sydney, Australia) ( Goldstein et al, 2021 ; Willenborg et al, 2022 ). The conventional BCDs are coupled to the skin either by an adhesive ADHEAR (MED-EL, Innsbruck, Austria) ( Dobrev et al, 2019 ; Zernotti et al, 2021 ) or by simple pressure [softband (Oticon A/S, Smorum, Denmark, Cochlear Ltd., Sydney, Australia) or Baha SoundArc (Cochlear Ltd., Sydney, Australia)] ( Rahne and Plontke, 2022 ).…”