T.Keintzel,T.Rasse,T.Moser,A.Koller

Comparison of audiological results in pa3ents with SSD treated with Cochleaimplant versus Bone Bridge

Disclosure:

X Ihavenopoten<alconflictsofinterest

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

CIS0NAHCISSSDNAH

-1,45

-4,80

P0,008*

OLSAinnoiseCI

unaidedaided

+1,5

-2,68

unaidedaided

S

Results

CIS0NAHBBS0NAH

-1,45

-4,80

P0,008*

-2,1

-4,3

P0,048*

OLSAinnoise

unaidedaidedunaidedaided

S

N

S

HSM sentence test

0%

19%

33%

83%91%

96%

unaidedaided unaidedaided unaidedaided

CIad65dBSSSDNAH

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

Thankyouforyouraden<on