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Audiological results of a transcutaneous bone conduction hearing instrument for conductional and
mixed hearing loss
Gerdes T. , Schwab B. , Lenarz T. , Maier H.
MH Hannover, ENT, Hannover, Germany
Introduction: In conductional, mixed hearing losses and single-sided-deafness bone anchored hearing aids are
well established treatments. Patients with this type of hearing loss have little or no benefit in most cases of
conventional hearing aids. The transcutaneous transmission across the intact skin avoids the percutaneous
abutment of a bone anchored device with the usual risk of infections and requires less care.
In this clinical study the audiological results of the Bonebridge transcutaneous bone conduction instrument from
MED-EL are compared to a generally used percutaneous device.
Objective: Nine patients from the ENT department at the Medical University Hannover, implanted between Aug.
2011 and Dec. 2012 with a transcutaneous hearing instrument, were audiologically analyzed and compared with
the results of nine patients, implanted with a percutaneous device, between Oct. 2002 and Nov. 2011. All
patients fulfilled the audiological criteria for both devices (BC ≤ 45 dB HL at 0.5, 1.0, 2.0, 4.0 kHz) and had at
least 8 weeks of experience with the respective device. Patients with single-sided-deafness were excluded from
the study. Tests included AC and BC thresholds with headphones and unaided and aided thresholds in sound
field. The speech intelligibility was determined with speech from the front (S 0) using the Freiburg monosyllable
test and hearing in noise with the Oldenburg sentence test (OLSA) in sound field. All sound field measurements
were performed with the contra-lateral ear plugged and muffled. The subjective benefit was assessed with the
Results: In comparison to unaided condition there was a significant improvement of aided threshold, word
recognition score and speech reception threshold in noise, measured in free field, for both devices. The
comparison of the two devices revealed a minor but not significant difference in aided threshold (Bonebridge
PTA=36.7 dB; BAHA PTA=39.4 dB). In terms of speech intelligibility no significances between the devices could
be found. The assessment of the subjectively perceived benefit with the APHAB showed a significant
improvement in the aided situation with both devices. Otherwise results were similar between both devices
without significances or pronounced trends.
Conclusion: Our data shows that the transcutaneous bone conduction hearing instrument is an attractive
alternative to bone anchored devices in conductional hearing loss with a minor sensorineural hearing loss