First clinical experiences with a direct acoustic cochlear stimulator in comparison to preoperative fitted conventional hearing aids.
OBJECTIVE
Patients with moderate-to-severe mixed hearing losses (MHLs) are hard to provide sufficient benefit with currently available conventional hearing aids. Here, the long-term safety of a direct acoustic cochlear stimulator (DACS) and the effectiveness compared with conventional "high-performance" hearing aids were investigated.


METHODS
Prospective, within patient reference, nonrandomized, interventional multicenter clinical study performed at these 3 centers: Medical University Hannover, University of Heidelberg, and Helios Hospital Krefeld.


METHODS
Ten otosclerosis patients with severe-to-profound MHL were preoperatively fitted with state-of-the-art conventional hearing aids (HA). After 2 months of testing conventional HA, 9 of the patients decided to be implanted with a DACS.


METHODS
Air conduction (AC) and bone conduction (BC) aided and unaided thresholds, speech discrimination before and after implantation and at 3, 6, and 12 months after activation. The subjective benefit was assessed by the Abbreviated Profile of Hearing Aid Benefit (APHAB).


RESULTS
Preoperative hearing thresholds were preserved over the 12 month observation time after activation. Average functional gain (0.5-4 kHz) achieved with conventional HA was 47 dB compared with 56 dB with the DACS. Speech-in-noise tests revealed a lower SNR for DACS (3.1 dB) than for the HA (6.6 dB) and patients were more satisfied with the DACS.


CONCLUSIONS
The DACS significantly improved hearing, speech intelligibility, and satisfaction in patients with a severe-to-profound mixed hearing loss and can be considered a safe and useful alternative to conventional hearing aids.
*Department of Otolaryngology, and †Cluster of Excellence Hearing4all, Medical University Hannover, Hannover; ‡Department of Oto-Rhino-Laryngology, HELIOS Hospital Krefeld, Krefeld; and §Department of Otolaryngology, Head and Neck Surgery, University of Heidelberg, Heidelberg, Germany.
Susan
S
Busch
Stefanie
S
Kruck
Dirk
D
Spickers
Rudolf
R
Leuwer
Sebastian
S
Hoth
Mark
M
Praetorius
Peter K
PK
Plinkert
Hamidreza
H
Mojallal
Burkard
B
Schwab
Hannes
H
Maier
Thomas
T
Lenarz
D000161:Acoustic Stimulation; D000328:Adult; D000368:Aged; D001309:Auditory Threshold / Q000502:physiology*; D001844:Bone Conduction / Q000502:physiology; D005260:Female; D006310:Hearing Aids; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013067:Speech Perception / Q000502:physiology*