Implantable Bone Conduction Hearing Aids

Description

Three decades after the introduction of the first bone-anchored hearing aids, the available systems have improved significantly and the field is expanding faster than ever. New technologies such as digital signal processing have opened new avenues unique to bone conduction hearing aids. Better insights into the physiology of bone-conducted hearing have not only changed the field but also provided ideas for new areas of application.In this volume of Advances in Oto-Rhino-Laryngology, renowned researchers and experienced clinicians from all over the world present the latest findings and practices. Reviews on the theoretical background of bone conduction hearing, presentation of currently available hearing aid systems, chapters on monaural and binaural hearing with implantable bone conduction hearing aids, a comparison with conventional hearing aids and a glimpse into the future of implantable bone conduction hearing aids render this volume an invaluable reference book to ENT surgeons, audiologists, hearing aid acousticians and researchers alike.

Advances in Oto-Rhino-Laryngology 4
Implantable BoneConduction Hearing Aids 5
Contents 7
Preface 9
Introduction and Basics 11
- Historical Background of Bone ConductionHearing Devices and Bone ConductionHearing Aids 11
  - Abstract 11
  - Antiquity to Mid- 19th Century 12
  - Teeth Stimulators 13
  - Mastoid Bone External Stimulators 15
  - Bone- Anchored Hearing Aid 16
  - Conclusion 18
  - References 18

Advances in Oto-Rhino-Laryngology 4
Implantable BoneConduction Hearing Aids 5
Contents 7
Preface 9
Introduction and Basics 11
- Historical Background of Bone ConductionHearing Devices and Bone ConductionHearing Aids 11
  - Abstract 11
  - Antiquity to Mid- 19th Century 12
  - Teeth Stimulators 13
  - Mastoid Bone External Stimulators 15
  - Bone- Anchored Hearing Aid 16
  - Conclusion 18
  - References 18
- Acoustic and Physiologic Aspects of BoneConduction Hearing 20
  - Abstract 20
  - Clinical Measurements using BoneConduction 20
  - Basilar Membrane Stimulation 21
  - Pathways for Bone- Conducted Sound 22
  - Bone Conduction Sound Transmission in theSkull 25
  - Transcranial Transmission 27
  - Binaural Bone Conduction Hearing 28
  - Own Voice 28
  - References 29
  - Bone Conduction in Relation to HearingProtection 29
  - Implications for Bone Conduction Hearing AidUsage 29
- Overview over Different Systems 32
  - An Overview of Different Systems:The Bone- Anchored Hearing Aid 32
    - Abstract 32
    - Introduction 32
    - Description of the Baha System 33
    - Physiology of Bone Conduction 33
    - Indications 34
    - Baha Surgery 36
    - Development of Different Generations of theBaha Sound Processors 36
    - References 39
  - The Ponto Bone- Anchored Hearing System 42
    - Abstract 42
    - Audiograms and Preoperative Trial 44
    - Patient Candidates 44
    - Technology 45
    - Discussion and Conclusion 49
    - References 50
  - Partially Implantable Bone Conduction HearingAids without a Percutaneous Abutment (Otomag):Technique and Preliminary Clinical Re 51
    - Abstract 51
    - Material and Methods 52
    - Discussion 53
    - Results 53
    - References 56
    - Disclosure Statement 56
  - Surgical Aspects 57
    - Surgery for the Bone- Anchored Hearing Aid 57
      - Abstract 57
      - Indications 57
      - Setting and Anesthesia 58
      - Preoperative Diagnostics 58
      - Alternatives in Skin and Soft TissueProcedures 59
      - Skin and Soft Tissue Work 59
      - Drilling and Insertion of the Titanium Screw 61
      - Wound Closure 62
      - Alternative: Two- Stage Procedure 63
      - Postoperative Care and Follow- Up 63
      - Conclusion 63
      - Acknowledgements 64
      - References 64
    - Paediatric Baha 66
      - Abstract 66
      - When Is the Best Time to Implant Children? 67
      - Evolving Indications for Baha in Children 67
      - Complications 69
      - References 70
      - Conclusions 70
    - Complications of Bone- Anchored Hearing Devices 73
      - Abstract 73
      - Bone Complications 73
      - Intraoperative Complications 75
      - Postoperative Complications 75
      - Soft Tissue Complications 75
      - Pediatric Patients and Soft TissueComplications 78
      - Reasons for Soft Tissue Complications 79
      - Conclusion 80
      - Avoiding Soft Tissue Complications 80
      - References 81
    - Audiological Aspects 83
      - Audiological Results with Baha® in Conductive andMixed Hearing Loss 83
        
        Abstract 83
        
        Materials and Methods 84
        
        Results 86
        
        Discussion 90
        
        Conclusions 92
        
        Acknowledgements 92
        
        References 92
      - Conductive Hearing Loss and Bone ConductionDevices: Restored Binaural Hearing? 94
        
        Abstract 94
        
        Measurements and Methods 95
        
        Results 97
        
        Discussion 98
        
        Conclusions 100
        
        References 100
      - Bone- Anchored Devices in Single- Sided Deafness 102
        
        Abstract 102
        
        Sound on the Side of Impairment/HeadShadow 103
        
        Conventional Solutions 103
        
        Role of Baha 105
        
        Literature Overview 109
        
        Conclusions 110
        
        References 111
      - Factors Influencing the Decision for Baha inUnilateral Deafness: The Bern Benefitin Single- Sided Deafness Questionnaire 113
        
        Abstract 113
        
        Materials and Methods 114
        
        Results 114
        
        Discussion 117
        
        Appendix 118
        
        Acknowledgements 120
        
        References 120
      - Challenges and Recent Developments in SoundProcessing for Baha® 122
        
        Abstract 122
        
        Cleaning the Signal 123
        
        Dedicated Amplification for Bone Conduction 126
        
        Direct Bone Conduction 130
        
        References 131
        
        Discussion and Conclusions 131
      - Implantable and Nonimplantable Devices 134
        
        Headbands, Testbands and Softbands inPreoperative Testing and Application ofBone- Anchored Devices in Adults and Children 134
        
        Abstract 134
        
        Importance of Preoperative Evaluation ofBone- Anchored Devices 134
        
        Test Rod, Headband, Testband and Softband 136
        
        Skin Damping 137
        
        Differences in the Results of Pure Tone andSpeech Audiometry Obtained with theTestband, the Headband and the ImplantedFixture/Ab 138
        
        Discussion and Conclusions 140
        
        References 141
        
        Bone- Anchored Hearing Aids versusConventional Hearing Aids 142
        
        Abstract 142
        
        Conventional Air Conduction Devices 143
        
        Conventional Bone Conduction Devices 143
        
        Bone- Anchored Hearing Aids 144
        
        Advantages of Baha versus Bone Conductionand Air Conduction Hearing Aids 144
        
        Disadvantages of Bone- Anchored Hearing Aids 147
        
        Conclusions 148
        
        References 148
        
        Outlook 150
        
        The Future of Bone Conduction Hearing Devices 150
        
        Abstract 150
        
        Past, Present and Future Bone ConductionHearing Systems 151
        
        The Bone Conduction Implant 156
        
        Discussion 160
        
        References 161
        
        Conclusions 161
        
        Acknowledgement 161
        
        Author Index 163
        
        Subject Index 164

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