T.Keintzel, T.Rasse, T.Moser, A.Koller Comparison of audiological results in pa3ents with SSD treated with Cochleaimplant versus Bone Bridge
T.Keintzel,T.Rasse,T.Moser,A.Koller
Comparison of audiological results in pa3ents with SSD treated with Cochleaimplant versus Bone Bridge
Single Sided Deafness
func<onaldeafness
normalhearing
×Asymmetrics<mula<onoftheauditorysystem
Defini<on:
Single Sided Deafness
Consequenceisadeficitincommunica<onespeciallyinnoisysurroundings
• impairmentindirec<onalhearing
• poorwordrecep<oninnoisysurroundings• restrectedspa<alorienta<on• occupa<onaldisadvantage• workfeelsmorestrenuous
• moreconcentra<onbydoingatelephonecall
Single Sided Deafness
Theeffectontheauditorysystemisquitedifferentifasinglesideddeafnessoccuresinchild-(beforematura<onoftheauditorypathway)orinadulthood.Pa<entswithaquiredsinglesidedeafnessinadulthoodpreservetheabilityofspa<allocalisa<onevenwhenhearingisrestoredwithanCochleaimplantaNermanyyearsofdeafness.Senkowskietal2014,Lazardetal2012,Tavora-Vieiraetal.2013
Single Sided Deafness
binaural
monaural
squelcheffect
+
−
binauralesumma<on
+
−
headshadoweffect
+
−
Beneficialeffectofbinauralhearing:
centralprocessing
binauralhearing
Twoacous<ccues:interaural<medifference(ITD)interauralleveldifference(ILD)
Single Sided Deafness
• Improvementofhearinginnoisysurroundings
• Improvementindirec4onalhearing
• Improvementinspa4alhearing
Aim
Single Sided Deafness
Whichpossibili<esoftreatmentofsinglesideddeafnessdowehave?• CROS/Bi-CROS-cabel/wirelessCROS-boneanchoredhearingimplantspercutaneortranscutanesystems• Cochleaimplanta<on
SSD-study CI vs. Bone Bridge
Implantexperience:CI1year–6yearsBB4month–3years
26pa<entswithSSD15pa<ents11pa<ents
MedElConcerto/Synchronystandardelectrode
Ac<vetranscutaneBoneanchoredhearingimplantBoneBridge
SSD-study CI vs. Bone Bridge
26pa<entswithSSD15CIpa<ents11BoneBridgepa<ents
OLSAS0NAH/SSSDNAHHSM65dBSSSDNAH0,5,10dBSNRSSQBBSS
OLSAS0NAH
SSQBBSS
Direc<nonalhearing:ISVR5–SpeakerLocalisa<onstest
CI - pa3ents
AgeatDura<onofSideofPTA0.5,1,2,4KHzPTAPat.NosurgerySexCauseunilateralDeafnessimpairedearbederear(dBHL)poorerear
123456789101112131415
533058352137464342456352513833
mwwmwmwwmwwmwmm
SuddenhearinglossScullbasefractureSuddenhearinglossSuddenhearinglossO<<smediaProgredienthearinglossScullbasefractureScullbasefractureScullbasefractureScullbasefractureScullbasefractureSuddenhearinglossSuddenhearinglossSuddenhearinglossSuddenhearingloss
6133219323211242012411
RightRightLeNRightLeNRightLeNRightRightLeNLeNRightRightRightRight
10105221044161511211188
>120>12083110>120>120>120>120>120>1201188810811096
Bone Bridge - pa3ents
AgeatDura<onofSideofPTA0.5,1,2,4KHzPTAPat.NosurgerySexCauseunilateralDeafnessimpairedearbederear(dBHL)poorerear
1234567891011
1643544430606247545747
mwwmwmmwmmm
SuddenhearinglossMeninigitsinchildhoodAcus<cneuromaAcus<cneuromaKongenitaldeafnessMeningi<sinchildhoodKongenitaldeafnessAcus<cneuromaMeningi<sinchildhoodScullbasefracturePneumokokkeno<<s
164244305962453101
RightRightLeNRightLeNRightleNLeNLeNLeNRight
41610207201021171223
>120>120>120>120>120>120>120>120>120>12093
Results
CIS0NAHBBS0NAH
-1,45
-4,80
P0,008*
-2,1
-4,3
P0,048*
OLSAinnoise
unaidedaidedunaidedaided
S
N
S
SSQ for CI pa3ents
unaidedaided
forall3quali<es
unaidedaidedunaidedaidedunaidedaided
speechrecep<onspa<alhearingsoundquality
Bern Benefit in SSD
SpeechinquietTVorradio
MusicDistantspeakerSpeechinnoise
Conversa<onincarReveberantroom
Groupconversa<on
Soundlocalisa<onOverall
CI BB
Direc3onal hearing
2x35measurementseachear
Sizeoftestroom:340x300x220cmRevebera<ons<me:0,173sec.Pinknoise,speech:60dB
-90° +90°
45°45°
0°
azimuth
ISVR 5 Localisa3ostest
33,40°
10,30°
21,20°
14,10°18,0°
22,15°
30,85° 32,50°
Meande
flec<on
indegree
unaidedaidedpinknoisespeech
unaidedaided unaidedaided unaidedaidedpinknoisespeech
Pinknoiseandspeech60dB2x35measurements
CI BB
Meande
flec<on
indegree
Conclusion
• Improvementofhearinginnoisysurroundings
• Improvementindirec4onalhearing
• Improvementinspa4alhearing
• Improvementinqualityoflife
BB
ü --ü
CI
ü
ü
ü
ü
• Thereissta<s<calsignificantbenefitinspeechrecep4oninnoisysurroundingswiththecochleaimplantaswellastheBoneBridge
• Cochleaimplantpa<entswereabletolocalizesoundsandregaiedaspa4alhearing• Allpa<entshadanimprovementinqualityoflife