The Prediction of Speech Recognition in Noise With a Semi-Implantable Bone Conduction Hearing System by External Bone Conduction Stimulation With Headband

Abstract

Semi-implantable transcutaneous bone conduction devices are treatment options for conductive and mixed hearing loss (CHL/MHL). For counseling of patients, realistic simulation of the functional result is desirable. This study compared speech recognition in noise with a semi-implantable transcutaneous bone conduction device to external stimulation with a bone conduction device fixed by a headband. Eight German-language adult patients were enrolled after a semi-implantable transcutaneous bone conduction device (Bonebridge, Med-El) was implanted and fitted. Patients received a bone conduction device for external stimulation (Baha BP110, Cochlear) fixed by a headband for comparison. The main outcome measure was speech recognition in noise (Oldenburg Sentence Test). Pure-tone audiometry was performed and subjective benefit was assessed using the Glasgow Benefit Inventory and Abbreviated Profile of Hearing Aid Benefit questionnaires. Unaided, patients showed a mean signal-to-noise ratio threshold of 4.6 ± 4.2 dB S/N for speech recognition. The aided results were −3.3 ± 7.2 dB S/N by external bone conduction stimulation and −1.2 ± 4.0 dB S/N by the semi-implantable bone conduction device. The difference between the two devices was not statistically significant, while the difference was significant between unaided and aided situation for both devices. Both questionnaires for subjective benefit favored the semi-implantable device over external stimulation. We conclude that it is possible to simulate the result of speech recognition in noise with a semi-implantable transcutaneous bone conduction device by external stimulation. This should be part of preoperative counseling of patients with CHL/MHL before implantation of a bone conduction device.

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

“…Results for speech in noise tests could not be compared directly in a meta-analysis due to the individual test set-up and inconsistency in reporting for the different studies. However, an improvement in speech understanding in noise was observed with the atBCI in all studies for subjects with CHL or MHL (S2 Table) [23, 8, 13, 20, 38, 21].…”

“…Mean aided signal-to-noise ratio (SNR) values in a total of 54 individuals with CHL and MHL were found to range from +2.9 dB to -6.1 dB SNR, compared to + 11.5 to -3.8 SNR unaided [7, 40, 41, 33, 42, 43]. Studies that investigated a setting in which speech was presented from a loudspeaker in front of the patient reported an average improvement in SNR of 5.5 dB [7, 41, 33, 42, 43]. Looking at individual data, large variability was observed between individuals, but outcomes were always in favour of the atBCI-aided condition.…”

Patient-reported long-term benefit with an active transcutaneous bone-conduction device

“…Our audiological results are in line with previous studies [ 4 , 13 , 14 , 23 , 24 , 26 , 27 , 30 , 35 , 36 ]. The mean gain in speech understanding was very high compared to the results in other studies, which also used the German monosyllabic Freiburger test at 65 dB [ 23 – 25 , 29 , 35 , 36 ]. Bone conduction thresholds remained mainly stable (shifted less than 10 dB), but dropped in one patient directly after implantation (Pat.…”

Three-Year Follow-Up with the Bone Conduction Implant

“…Results from other similar studies are of interest, and especially comparisons with the commercially available active transcutaneous Bone Bridge (Med El). The selected comparative studies are chosen with the criteria that both tone and speech audiometry are performed in unaided and aided conditions and where at least 6 or more subjects are included [Ihler et al, 2014;Rahne and Ehelebe, 2014;Riss et al, 2014;Eberhard et al, 2016;Gerdes et al, 2016;Ihler et al, 2016;Schmerber et al, 2017]. Different methods have been applied concerning indication for the Bone Bridge, number of subjects, tone and speech audiometry, follow-up time, and the presentation of questionnaires.…”

“…There also seems to be an established benefit from the questionnaire results compared to the unaided situation. A few studies include comparison with the Bone Anchored Hearing Aid either on head band or as a percutaneous solution (different group of patients) [Gerdes et al, 2016;Ihler et al, 2016;Schmerber et al, 2017]. Also, in these aspects the comparisons with the BCI are similar.…”