Retrospective audiological analysis of bone conduction versus round window vibratory stimulation in patients with mixed hearing loss.
OBJECTIVE
To compare audiological outcomes in mild-to-moderate mixed hearing loss patients treated with a bone-anchored hearing aid or an active middle-ear implant. Analysis aimed to refine criteria used in preoperative selection of implant type.


METHODS
Retrospective comparative analysis of audiological data. Follow-up time ranged between 0.55 and 8.8 years.


METHODS
For detailed comparative analysis, 12 patients (six in each group) with comparable bone conduction thresholds and similar clinical characteristics were selected. A larger cohort of 48 patient files were used to evaluate overall audiological indication criteria (24 per group).


RESULTS
In free-field tone audiometry, Baha patients showed mean aided thresholds between 40-48 dB, whereas hearing thresholds for VSB patients were 25-43 dB. Baha and VSB users had mean WRS of 56% and 82%, respectively, at 65 dB. Better speech understanding in noise was seen with the VSB.


CONCLUSIONS
Analysis of the main cohort (n = 48) showed that treatment with round window vibroplasty leads to better hearing performance than treatment with a bone-anchored hearing device, if the bone conduction pure-tone average (0.5 to 4 kHz) is poorer than 35 dB HL. Audiological analysis in the smaller comparative analysis showed similar findings.
Department of Otolaryngology, Medical University of Hannover , Germany.
Hamidreza
H
Mojallal
Burkard
B
Schwab
Anna-Lena
AL
Hinze
Thomas
T
Giere
Thomas
T
Lenarz
D000161:Acoustic Stimulation / Q000295:instrumentation / Q000379:methods*; D000328:Adult; D000368:Aged; D001299:Audiometry; D001309:Auditory Threshold; D001844:Bone Conduction / Q000502:physiology; D012048:Correction of Hearing Impairment / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006310:Hearing Aids; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009622:Noise; D009998:Ossicular Prosthesis; D012189:Retrospective Studies; D012405:Round Window, Ear / Q000503:physiopathology; D013067:Speech Perception; D055815:Young Adult
Bone-anchored hearing aids; Vibrant Soundbridge; active middle-ear implants; bone conduction; mixed hearing loss; round window vibroplasty