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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
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