ORIGINAL ARTICLE
GAIN AND MAXIMUM OUTPUT OF IMPLANTABLE HEARING DEVICES IN PATIENTS WITH MODERATE TO SEVERE SENSORINEURAL HEARING LOSS
 
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1
Department of Otorhinolaryngology & Head and Neck Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
 
2
Centre for Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
 
3
Department of ENT, Head and Neck Surgery, Inselspital, University of Bern, Bern, Switzerland
 
4
ARTORG Center for biomedical engineering research, University of Bern, Bern, Switzerland
 
 
Publication date: 2012-09-30
 
 
Corresponding author
Joost W. Zwartenkot   

Joost W. Zwartenkot, Department of Otorhinolaryngology, Head and Neck Surgery, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands, e-mail: j.zwartenkot@kno.umcn.nl
 
 
J Hear Sci 2012;2(3):35-40
 
KEYWORDS
ABSTRACT
Background:
To determine the dynamic range and the maximum output of three current middle ear implants and to discuss optimal candidacy for middle ear implantation.

Study Design:
Clinical study

Material and Methods:
Gain and output measurements were compared for three types of middle ear implants: the Otologics middle ear transducer (MET), the Vibrant Soundbridge (VSB), and the Direct Acoustic Cochlear Stimulator (DACS). The performance of these selected implants in users with severe, predominantly sensorineural, hearing loss (50–65 dB HL) was studied. Patients with chronic external otitis and sensorineural hearing loss used either a MET (n=9) or a VSB (n=9) implant. Patients with a predominantly sensorineural hearing loss after surgically treated otosclerosis used a DACS (n=4). Patients were selected from two different implant teams but evaluated with the same protocol. The relative gain at threshold level was determined, viz. the bone-conduction threshold minus the aided soundfield threshold, divided by the bone-conduction threshold. Input–output measurements were performed with the devices in linear amplification mode and with unlimited output. In this latter data set, the maximum output and the input dynamic range of the devices were determined.

Results:
The relative gain for each of the three implants was comparable; however, the values were slightly lower than the generally accepted target values. The input dynamic range of the devices varied, with the widest range for the DACS and Otologics devices.

Conclusion:
The results from this study indicate that the first generation DACS device is a good option for patients with moderate/severe sensorineural hearing loss and surgically treated otosclerosis who require a hearing implant.

 
REFERENCES (19)
1.
Dietz TG, Ball GR, Katz BH: Partial implantable vibrating ossicular prosthesis IEEE Electron Device Society. Chicago, 1997: 433–36.
 
2.
Labassi S, Beliaeff M: Retrospective of 1000 patients implanted with a vibrant Soundbridge middle-ear implant. Cochlear Implants Int, 2005; 6(Suppl.1): 74–77.
 
3.
Verhaegen VJ, Mylanus EA, Cremers CW, Snik AF: Audiological application criteria for implantable hearing aid devices: a clinical experience at the Nijmegen ORL clinic. Laryngoscope, 2008; 118: 1645–49.
 
4.
Jenkins HA, Niparko JK, Slattery WH et al: Otologics Middle Ear Transducer Ossicular Stimulator: performance results with varying degrees of sensorineural hearing loss. Acta Otolaryngol, 2004; 124: 391–94.
 
5.
Kasic JF, Fredrickson JM: The Otologics MET ossicular stimulator. Otolaryngol.Clin.North Am, 2001; 34: 501–13.
 
6.
Venail F, Lavieille JP, Meller R et al: New perspectives for middle ear implants: first results in otosclerosis with mixed hearing loss. Laryngoscope, 2007; 117: 552–55.
 
7.
Beltrame AM, Martini A, Prosser S et al: Coupling the Vibrant Soundbridge to cochlea round window: auditory results in patients with mixed hearing loss. Otol Neurotol, 2009; 30: 194–201.
 
8.
Dumon T, Gratacap B, Firmin F et al: Vibrant Soundbridge middle ear implant in mixed hearing loss. Indications, techniques, results. Rev Laryngol Otol Rhinol (Bord), 2009; 130: 75–81.
 
9.
Kontorinis G, Lenarz T, Mojallal H et al: Power stapes: an alternative method for treating hearing loss in osteogenesis imperfecta? Otol Neurotol, 2011; 32: 589–95.
 
10.
Bernhard H, Stieger C, Perriard Y: New implantable hearing device based on a micro-actuator that is directly coupled to the inner ear fluid. Conf Proc IEEE Eng Med Biol Soc, 2006; 1: 3162–65.
 
11.
Hausler R, Stieger C, Bernhard H, Kompis M: A novel implantable hearing system with direct acoustic cochlear stimulation. Audiol Neurootol, 2008; 13: 247–56.
 
12.
Snik AF, Cremers CW: Vibrant semi-implantable hearing device with digital sound processing: effective gain and speech perception. Arch Otolaryngol Head Neck Surg, 2001; 127: 1433–37.
 
13.
Snik AF, Noten J, Cremers C: Gain and maximum output of two electromagnetic middle ear implants: are real ear measurements helpful? J Am Acad Audiol, 2004; 15: 249–57.
 
14.
Dillon H: Hearing Aids. New York: Thieme Verlag, 2001.
 
15.
Byrne D, Dillon H, Ching T et al: NAL-NL1 procedure for fitting nonlinear hearing aids: characteristics and comparisons with other procedures. J Am Acad Audiol, 2001; 12: 37–51.
 
16.
Morgan DE, Dirks DD, Bower DR: Suggested threshold sound pressure levels for frequency-modulated (warble) tones in the sound field. J Speech Hear Disord, 1979; 44: 37–54.
 
17.
Gatehouse S, Browning GG: The output characteristics of an implanted bone conduction prosthesis. Clin Otolaryngol Allied Sci, 1990; 15: 503–13.
 
18.
Ohno T, Kajiya T: Performance of the middle ear implants. Adv Audiol, 1998; 4: 85–96.
 
19.
Dillon H, Storey L: The National Acoustic Laboratories’ procedure for selecting the saturation sound pressure level of hearing aids: theoretical derivation. Ear Hear, 1998; 19: 255–66.
 
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