There is a newer version of the record available.

Published October 16, 2021 | Version 1.0.0
Dataset Open

Audibility of the Bone Conduction Device Headband Trial in Single-sided Deaf Subjects.

Creators

  • 1. Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands

Description

Data and Code of the study

Objective
This study aims to evaluate if a transcutaneous Bone Conduction Device (BCD), attached to the headband, can adequately compensate for the head shadow effect, providing subjects with Single-Sided Deafness (SSD) with a balanced CROS-fitting.

Participants
Eighty-five adults with SSD, enrolled in a Randomized Controlled Trial, were fitted during a trial period with a transcutaneous Bone Conduction Device (BCD). 

Method
After loading the first-fit settings, the BCD output was measured on a skull-simulator. The sensation levels of the Bone-Conduction and Air-Conduction sound paths were compared, simulating three different spatial conditions with speech in quiet, with the signal in front of the subject, at BCD-side, and on the best-ear side respectively. We modeled the speech perception with aid of the Speech Intelligibility Index and the CVC-score for those conditions and, additionally, for seven conditions with speech in noise: 1. With signal and noise directly in front of the subject; 2. With the signal in front and the noise from the BCD-side; 3. With the signal in front and the noise from the best-ear-side; 4. With the signal from the BCD-side and the noise from the best-ear-side; 5. With the signal from the BCD-side and the noise in front; 6. With the signal from the best-ear-side and the noise from the BCD-side; 7. With the signal from the best-ear-side and the noise in front.

Results
We could retrieve data about 49 fittings with a CochlearTM BP110 and 36 fittings with a CochlearTM BAHA® 5 Power (BAHA5P) on a headband. Due to some missing BC-direct thresholds, we present complete data of 35 subjects fitted with a BP110 and 35 subjects fitted with a  BAHA5P.
The BAHA5P delivered higher output force levels in the high-frequency range compared to  the BP110. However, neither the BP110 nor the BAHA5P could provide the large majority of the subjects with SSD and (near) normal hearing in the best ear with a balanced CROS-effect. With first-fit settings, only 9% of individuals of our population achieved an audible  CROS-effect in the most favorable condition, with the signal at the BCD-side. In the condition with the signal in front of the subject, the number of fittings with an audible CROS-effect drops to 0. The transcutaneous BCD did not provide any substantial positive effect on the speech understanding, during the three simulated listening situations in quiet. In noise, we found a limited improvement in some specific conditions and a very small degradation in others. Analysis of the logbook showed a low daily usage of the transcutaneous BCD.

Conclusion
This study challenges the evidence-based fundamentals of a trial period with a transcutaneous BCD in subjects with SSD. Even with current “power” BCDs, it is not possible to achieve a satisfactory audibility of speech during the headband trial in the large majority of subjects with SSD and (near) normal hearing in the best ear. Further research has to highlight if a wireless (Bi)CROS-system can provide SSD-subjects with a reliable trial period to assess the possible benefits of head shadow effect compensation in daily life.

Notes

Related to: Peters, J. P., van Zon, A., Smit, A. L., van Zanten, G. A., de Wit, G. A., Stegeman, I., & Grolman, W. (2015). CINGLE-trial: cochlear implantation for siNGLE-sided deafness, a randomised controlled trial and economic evaluation. BMC Ear, Nose and Throat Disorders, 15(1), 3. https://doi.org/10.1186/s12901-015-0016-y

Files

Audibility_BCD_headband_in_SSD.zip

Files (49.5 MB)

Name Size Download all
md5:d9deefe98cf13f3dc5b5c954d5b6566c
49.5 MB Preview Download

Additional details

Related works

Cites
Journal article: 10.1186/s12901-015-0016-y (DOI)

References

  • Bentler, R. A., Pavlovic, C. V, & others. (1989). Transfer functions and correction factors used in hearing aid evaluation and research. Ear Hear, 10(1), 58–63.
  • Bosman, A. J., Kruyt, I. J., Mylanus, E. A. M., Hol, M. K. S., & Snik, A. F. M. (2018). On the evaluation of a superpower sound processor for bone-anchored hearing. Clinical Otolaryngology, 43(2), 450–455. https://doi.org/10.1111/coa.12989
  • Bosman, A.J. and G.F. Smoorenburg. (1992). Word lists for speech audiometry. [CD-ROM]. Dutch Association of Audiology (NVA).
  • Bosman, A. J., & Smoorenburg, G. F. (1995). Intelligibility of Dutch CVC syllables and sentences for listeners with normal hearing and with three types of hearing impairment. Audiology : Official Organ of the International Society of Audiology, 34(5), 260–284. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8837785
  • Carhart, R., & Jerger, J. F. (1959). Preferred Method For Clinical Determination Of Pure-Tone Thresholds. Journal of Speech and Hearing Disorders, 24(4), 330. https://doi.org/10.1044/jshd.2404.330
  • Carlsson, P., Håkansson, B., & Ringdahl, A. (1995). Force threshold for hearing by direct bone conduction. The Journal of the Acoustical Society of America, 97(2), 1124–1129. https://doi.org/10.1121/1.412225
  • Dillon, H. (2012). Hearing aids. Sydney : New York: Boomerang Press ; Thieme.
  • Faber, H. T., de Wolf, M. J. F., de Rooy, J. W. J., Hol, M. K. S., Cremers, C. W. R. J., & Mylanus, E. A. M. (2009). Bone-Anchored Hearing Aid Implant Location in Relation to Skin Reactions. Archives of Otolaryngology-Head & Neck Surgery, 135(8), 742. https://doi.org/10.1001/archoto.2009.99
  • Flynn, M. C., & Hillbratt, M. (2012). Improving the Accuracy of Baha® Fittings through Measures of Direct Bone Conduction. Clinical and Experimental Otorhinolaryngology, 5(Suppl 1), S43. https://doi.org/10.3342/ceo.2012.5.S1.S43
  • Gründer, I., Seidl, R. O., Ernst, A., & Todt, I. (2008). Wertigkeit der BAHA-Testung für das postoperative Hörergebnis. HNO, 56(10), 1020–1024. https://doi.org/10.1007/s00106-007-1608-7
  • Hol, M. K. S., Kunst, S. J. W., Snik, A. F. M., & Cremers, C. W. R. J. (2010). Pilot study on the effectiveness of the conventional CROS, the transcranial CROS and the BAHA transcranial CROS in adults with unilateral inner ear deafness. European Archives of Oto-Rhino-Laryngology, 267(6), 889–896. https://doi.org/10.1007/s00405-009-1147-9
  • Holube, I., Fredelake, S., Vlaming, M., & Kollmeier, B. (2010) Development and analysis of an International Speech Test Signal (ISTS). International Journal of Audiology, 49:12, 891-903. https://doi.org/10.3109/14992027.2010.506889
  • Kitterick, P. T., Smith, S. N., & Lucas, L. (2016). Hearing Instruments for Unilateral Severe-to-Profound Sensorineural Hearing Loss in Adults. Ear and Hearing, 37(5), 495–507. https://doi.org/10.1097/AUD.0000000000000313
  • Kompis, M., Pfiffner, F., Krebs, M., & Caversaccio, M.-D. (2011). Factors influencing the decision for Baha in unilateral deafness: the Bern benefit in single-sided deafness questionnaire. Advances in Oto-Rhino-Laryngology, 71, 103–111. https://doi.org/10.1159/000323591
  • Kurz, A., Flynn, M., Caversaccio, M., & Kompis, M. (2014). Speech Understanding with a New Implant Technology: A Comparative Study with a New Nonskin Penetrating Baha System. BioMed Research International, 2014, 1–9. https://doi.org/10.1155/2014/416205
  • Lucas, L., Katiri, R., & Kitterick, P. T. (2018). The psychological and social consequences of single-sided deafness in adulthood. International Journal of Audiology, 57(1), 21–30. https://doi.org/10.1080/14992027.2017.1398420
  • Mattingly, J. K., Greene, N. T., Jenkins, H. A., Tollin, D. J., Easter, J. R., & Cass, S. P. (2015). Effects of Skin Thickness on Cochlear Input Signal Using Transcutaneous Bone Conduction Implants. Otology & Neurotology, 36(8), 1403–1411. https://doi.org/10.1097/MAO.0000000000000814
  • Monini, S., Musy, I., Filippi, C., Atturo, F., & Barbara, M. (2015). Bone conductive implants in single-sided deafness. Acta Oto-Laryngologica, 135(4), 381–388. https://doi.org/10.3109/00016489.2014.990057
  • Pennings, R. J. E., Gulliver, M., & Morris, D. P. (2011). The importance of an extended preoperative trial of BAHA in unilateral sensorineural hearing loss: a prospective cohort study. Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 36(5), 442–449. https://doi.org/10.1111/j.1749-4486.2011.02388.x
  • Peters, J. P., van Zon, A., Smit, A. L., van Zanten, G. A., de Wit, G. A., Stegeman, I., & Grolman, W. (2015). CINGLE-trial: cochlear implantation for siNGLE-sided deafness, a randomised controlled trial and economic evaluation. BMC Ear, Nose and Throat Disorders, 15(1), 3. https://doi.org/10.1186/s12901-015-0016-y
  • Peters, J. P. M., van Heteren, J. A. A., Wendrich, A. W., van Zanten, G. A., Grolman, W., Stokroos, R. J., & Smit, A. L. (2020). Short-term Outcomes of Cochlear Implantation for Single-Sided Deafness compared to Bone Conduction Devices and Contralateral Routing of Sound hearing aids – Results of a Randomised Controlled Trial (CINGLE-trial). Manuscript submitted for publication. https://dspace.library.uu.nl/handle/1874/400352
  • Pfiffner, F., Kompis, M., Flynn, M., Asnes, K., Arnold, A., & Stieger, C. (2011). Benefits of low-frequency attenuation of baha® in single-sided sensorineural deafness. Ear and Hearing, 32(1), 40–45. https://doi.org/10.1097/AUD.0b013e3181ecd002
  • Snapp, H. A., Fabry, D. A., Telischi, F. F., Arheart, K. L., & Angeli, S. I. (2010). A clinical protocol for predicting outcomes with an implantable prosthetic device (baha) in patients with single-sided deafness. Journal of the American Academy of Audiology, 21(10), 654–662. https://doi.org/10.3766/jaaa.21.10.5
  • Snapp, H., Angeli, S., Telischi, F. F., & Fabry, D. (2012). Postoperative Validation of Bone-Anchored Implants in the Single-Sided Deafness Population. Otology & Neurotology, 34(4), 777–778. https://doi.org/10.1097/MAO.0b013e31828bb1cc
  • Snapp, H. A., Morgenstein, K. E., & Kuzbyt, B. (2019). Speech Perception Outcomes in Transcutaneous Versus Percutaneous Bone Conduction Stimulation in Individuals With Single-sided Deafness. Otology & Neurotology, 40(8), 1068-1075. https://doi.org /10.1097/MAO.0000000000002362
  • Snik, F. M., Mylanus, E. a M., Proops, D. W., Wolfaardt, J. F., Hodgetts, W. E., Somers, T., … Tjellström, A. (2005). Consensus Statements on the BAHA System: Where Do We Stand at Present? Annals of Otology, Rhinology & Laryngology, 114(12_suppl), 2–12. https://doi.org/10.1177/0003489405114S1201
  • Stenfelt, S. (2005). Bilateral fitting of BAHAs and BAHA® fitted in unilateral deaf persons: Acoustical aspects. International Journal of Audiology, 44(3), 178–189. https://doi.org/10.1080/14992020500031561
  • Stenfelt, S. (2012). Transcranial attenuation of bone-conducted sound when stimulation is at the mastoid and at the bone conduction hearing aid position. Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 33(2), 105–114. https://doi.org/10.1097/MAO.0b013e31823e28ab
  • Verstraeten, N., Zarowski, A. J., Somers, T., Riff, D., & Offeciers, E. F. (2009). Comparison of the Audiologic Results Obtained With the Bone-Anchored Hearing Aid Attached to the Headband, the Testband, and to the "Snap" Abutment. Otology & Neurotology, 30(1), 70–75. https://doi.org/10.1097/MAO.0b013e31818be97a
  • Wendrich, A. W., Kroese, T. E., Peters, J. P. M., Cattani, G., & Grolman, W. (2017). Systematic Review on the Trial Period for Bone Conduction Devices in Single-Sided Deafness: Rates and Reasons for Rejection. Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 38(5), 632–641. https://doi.org/10.1097/MAO.0000000000001405
  • Zwartenkot, J. W., Snik, A. F. M., Mylanus, E. A. M., & Mulder, J. J. S. (2014). Amplification Options for Patients With Mixed Hearing Loss. Otology & Neurotology, 35(2), 221–226. https://doi.org/10.1097/MAO.0000000000000258
  • American National Standards Institute. (1997). Methods For Calculation Of The Speech Intelligibility Index (ANSI/ASA Standard No. 3.5).
  • International Organization for Standardization. (1998). Acoustics — Reference zero for the calibration of audiometric equipment — Part 1: Reference equivalent threshold sound pressure levels for pure tones and supra-aural earphones (ISO Standard No. 389-1).