Clinical and Functional Results after Implantation of a Semi-implantable, Active, Transcutaneous Bone Conduction Hearing Device in Children and Adults

Introduction In 2012, the Bonebridge (BB), a semi-implantable, active, transcutaneous bone conduction hearing device was introduced by MED-EL (Innsbruck, Austria) followed by a widespread use of this implant in the treatment of conductive or mixed hearing loss or in single-sided deafness (SSD). The aim of this study is to evaluate the surgical, clinical and audiological outcome of 32 implantations in children and adults since 2012.

Methods A retrospective chart review was carried out with regard to medical history, indication, preoperative planning, surgery, short- and longtime clinical and audiological outcome in all implantations conducted in our hospital until May 2019.

Results 32 BB implantations were conducted in 31 patients, (mean 38 (SD 22) years; range 5-74 years), among them 7 younger then 16 years, with conductive or mixed hearing loss, malformations, after multiple ear surgery, or SSD. Four implantations were done as contralateral routing of signal (CROS). In five cases, a simultaneous surgery with ear episthesis anchors was performed, and 23 implantations (72%) were preoperatively planned through three dimensional (3D) “virtual surgery”. Audiological outcome significantly improved free field threshold (p < 0.0001), speech recognition in quiet (WRS, p <0.0001) and in noise (S0N0, p = 0,0018).

Conclusions Hearing rehabilitation with the BB leads to a clinically relevant audiological benefit. As the correct placement of the implant might be anatomically challenging, preoperative 3D planning is recommended in small and hypoplastic mastoids, in children, after multiple ear surgery, in ear malformation and in simultaneous implantation of anchors for ear prosthesis.

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Publication History

Article published online:
10 June 2020