Decision making in bone conduction and active middle ear implants – hearing outcomes and experiences over a 10-year period

Abstract

Objectives

To review the decision-making paradigm in the recommendations of BCI and aMEI overlapping candidacy for patients with conductive or mixed HL, and to determine if there are differences in hearing and quality of life outcomes between these implantable hearing devices.

Methods

Retrospective data from patients receiving BCI or aMEI in the past decade were analysed. Patients were grouped into: 1. BCI candidates, 2. BCI or aMEI candidates, and 3. aMEI candidates. We compared outcomes and examined the impact of BC threshold, age at implantation, and duration of hearing loss on candidacy.

Results

89 participants were included: 30 BCI, 37 aMEI, and 22 BCI or aMEI candidates. All groups performed similarly in aided sound field threshold testing. BCI group had lower speech scores in quiet compared to 'BCI or aMEI.' No significant differences were found in APHAB global scores. BC threshold, duration of hearing loss, and age at implantation had no significant effects.

Discussion

Outcomes were generally similar across groups, except for higher effective gain in the aMEI group.

Conclusion

Our proposed patient pathway and decision-making approach facilitate candidate selection for aMEI and BCI, aiming to optimise outcomes.

KEYWORDS:

• Bone conduction implant
• Middle ear implant
• Candidacy overlap
• Hearing outcomes

Acknowledgments

Special thanks to Thomas Dejaco for his help with this manuscript.

Disclaimer statements

Contributors: None.

Funding: Dayse Távora-Vieira holds a research fellowship grant from Rayne Medical Research Foundation.

Conflict of interests: No potential conflict of interest was reported by the author(s).

Ethics approval: Ethics approval was obtained from the South Metropolitan Health Ethics Committee (reference number: 2101).

Additional information

Notes on contributors

Dayse Távora-Vieira

Associate Professor Dayse Tavora-Vieira is the Head of the State-Wide Audiology Services in Western Australia and a faculty member at the University of Western Australia and Curtin University. Her main research interest is focused on cortical activity, binaural hearing pathway and brain plasticity after hearing implantation.

Roberta Marino

Dr Roberta Marino is a senior audiologist at Fiona Stanley Hospital and a faculty member at the University of Western Australia. She is well published on middle ear implants and bone conduction implants.

Jafri Kuthubutheen

Dr. Kuthubutheen is an ENT surgeon who graduated with honours from the University of Western Australia in 2002. He completed his Fellowship in Otolaryngology Head and Neck Surgery in 2010, followed by specialised training in Otology and Skull Base Surgery at Sunnybrook Health Sciences Centre in Canada. Currently, he serves as a full-time sub-specialist Otology and Skull Base Surgeon at Fiona Stanley Hospital, Perth Children's Hospital, Sir Charles Gairdner Hospital, and in private practice at Western ENT.

Christopher Broadbent

Dr Christopher Broadbent is a senior audiologist at Fiona Stanley Hospital with vast experience in hearing rehabilitation.

Aanand Acharya

Dr Aanand Acharya, trained at the University of Cambridge and Imperial College School of Medicine (UK), is an experienced ENT surgeon specialising in otology, implant surgery, and auditory rehabilitation. He holds a consultant position at two major teaching hospitals in Perth, Australia, and leads the Telethon Speech & Hearing Chevron Ear Health Program. Dr. Acharya is also involved in surgical training and research with numerous publications and textbook contributions to his name.