For the long-term use of a bone-anchored hearing device for single-sided deafness or profound unilateral sensorineural hearing loss (SNHL), what are the perceived benefits, complications and device malfunction rate?
Explore this issue:February 2011
Background: For the condition of single-sided deafness or profound unilateral SNHL, there are limited rehabilitation options. These options include a CROS (contralateral routing of signals) hearing aid system, a conventional bone-conduction hearing aid or a bone-anchored hearing device. The bone-anchored hearing device requires a surgical procedure for placement of a titanium screw and a transcutaneous abutment pedestal. The transcutaneous abutment requires regular skin care. The hearing device attached to the abutment is subject to mechanical or electrical wear.
Study design: Prospective, non-randomized, case-control study.
Setting: Tertiary referral center.
Synopsis: Fifty-six patients with profound unilateral SNHL were evaluated as candidates for a bone-anchored hearing device and were administered two study questionnaires. Twenty-one patients underwent placement of a bone-anchored hearing device and were administered three study questionnaires at intervals to a total of three years after fitting of the sound processor. Twenty-two of the non-implanted patients served as controls and were administered two study questionnaires at an average duration of 2.5 years after the initial assessment.
Fourteen of the 21 implanted patients completed all questionnaires for long-term follow-up, and 16 completed the short-term follow-up. Results demonstrated statistical improvement in measures of the Abbreviated Profile of Hearing Aid Benefit and Glasgow Hearing Aid Benefit Profile. No change in these measures was noted in the control group.
Local skin reactions around the implant site occurred in 38 percent of patients. The implant loss rate was 5 percent. Two-thirds of implant patients required a repair of the external sound processor. By 3.5 years, 19 percent stopped wearing the external device.
Bottom line: The use of a bone-anchored hearing device for profound unilateral SNHL or single-sided deafness has demonstrated long-term perceptual benefits for users. Pre-operative counseling should also emphasize the need for regular skin maintenance, and potential users should be aware that management of device complications can be time consuming and frustrating.
Citation: Gluth MB, Eager KM, Eikelboom RH, et al. Long-term benefit perception, complications and device malfunction rate of bone-anchored hearing aid implantation for profound unilateral sensorineural hearing loss. Otol Neurotol. 2010;31(9):1427-1434.
—Reviewed by George T. Hashisaki, MD