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Laryngorhinootologie 2016; 95(05): 352-363
DOI: 10.1055/s-0042-104946
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© Georg Thieme Verlag KG Stuttgart · New York

Implantierbare Knochenleitungs- und aktive Mittelohr-Hörsysteme

Bone Conduction and Active Middle Ear Implants
S. Volkenstein
1   Klinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie der Ruhr-Universität Bochum am St. Elisabeth-Hospital Bochum (Direktor: Univ.-Prof. Dr. med. S. Dazert)
,
J. P. Thomas
1   Klinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie der Ruhr-Universität Bochum am St. Elisabeth-Hospital Bochum (Direktor: Univ.-Prof. Dr. med. S. Dazert)
,
S. Dazert
1   Klinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie der Ruhr-Universität Bochum am St. Elisabeth-Hospital Bochum (Direktor: Univ.-Prof. Dr. med. S. Dazert)
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Publication History

Publication Date:
02 May 2016 (online)

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Zusammenfassung

Ein Großteil der schwerhörigen Patienten kann mit konventionellen Hörgeräten abhängig von Schweregrad und Ursache der Hörstörung gut und zufriedenstellend versorgt werden. Für manche Patienten ist eine Hörgeräteversorgung trotz audiologisch eindeutig vorliegender Kriterien aus unterschiedlichen Gründen (anatomisch, entzündlich, u. a.) nicht möglich oder führt nicht zu einem zufriedenstellenden Hörergebnis. Für diese Patientengruppe stehen verschiedene teil- und vollimplantierbare Hörsysteme zur Verfügung. Das gemeinsame Wirkprinzip der im Folgenden abgehandelten Systeme ist die mechanische Stimulation der Gehörknöchelchenkette (aktive Mittelohrimplantate), des Schädelknochens (knochenverankerte Hörsysteme) oder der Cochlea selbst (direkte akustische Stimulation). Unter strenger Beachtung der jeweiligen audiologischen Indikationskriterien und der anatomischen Gegebenheiten kann so geeigneten Patienten, die mittels einer hörverbessernden Operation oder einem konventionellen Hörgerät nicht ausreichend zu versorgen sind, eine Verbesserung des Sprachverständnisses und ein deutlicher Gewinn an Lebensqualität in Aussicht gestellt werden.

Abstract

The majority of patients with moderate to severe hearing loss can be supplied with conventional hearing aids depending on severity and cause for hearing loss in a satisfying way. However, some patients either do not benefit enough from conventional hearing aids or cannot wear them due to inflammatory reactions and chronic infections of the external auditory canal or due to anatomical reasons. For these patients there are fully- and semi-implantable middle ear and bone conduction implants available. These devices either directly stimulate the skull (bone conduction devices), middle ear structures (active middle ear implants) or the cochlea itself (direct acoustic stimulation). Patients who failed surgical hearing rehabilitation or do not benefit from conventional hearing aids may achieve a significant better speech understanding and tremendous improvement in quality of life by implantable hearing devices with careful attention to the audiological and anatomical indication criteria.

Schlüsselwörter

implantierbare Hörsysteme - aktive Mittelohr-Hörsysteme - Knochenleitungs-Hörsysteme - Innenohrschwerhörigkeit - kombinierte Schwerhörigkeit

Key words

implantable hearing device - active middle ear implant - bone conduction hearing device - sensorineural hearing loss - mixed hearing loss
 

  • Literatur

  • 1 Hesse G. Hörgeräte im Alter. HNO 2004; 52: 321-328
    CrossrefPubMedGoogle Scholar
  • 2 Gates GA, Mills JH. Presbycusis. The Lancet 2005; 366: 1111-1120
    CrossrefPubMedGoogle Scholar
  • 3 Strawbridge WJ, Wallhagen MI, Shema SJ, Kaplan GA. Negative Consequences of Hearing Impairment in Old Age A Longitudinal Analysis. The Gerontologist 2000; 40: 320-326
    CrossrefPubMedGoogle Scholar
  • 4 Dawes P, Emsley R, Cruickshanks KJ, Moore DR, Fortnum H, Edmondson-Jones M, McCormack A, Munro KJ. Hearing loss and cognition: the role of hearing AIDS, social isolation and depression. PLoS One 2015; 10: e0119616
    CrossrefPubMedGoogle Scholar
  • 5 Bittencourt AG, Burke PR, de Souza Jardim I, de Brito R, Tsuji RK, de Oliveria Fonseca AC, Bento RF. Implantable and Semi-Implantable Hearing Aids: A Review of History. Indications, and Surgery. Int Arch Otorhinolaryngol 2014; 18: 303-310
    PubMedGoogle Scholar
  • 6 Dun CA, Faber HT, de Wolf MJ, Cremers CW, Hol MK. An overview of different systems: the bone-anchored hearing system. Adv Otorhinolaryngol 2011; 71: 22-31
    PubMedGoogle Scholar
  • 7 Jacob R, Stelzig Y, Nopp P, Schleich P. Audiologische Ergebnisse mit Cochleaimplantat bei einseitiger Taubheit. HNO 2011; 59: 453-460
    CrossrefPubMedGoogle Scholar
  • 8 Berger KW. Early bone conduction hearing aid devices. Arch Otolaryngol 1976; 102: 315-318
    CrossrefPubMedGoogle Scholar
  • 9 Dazert S, Thomas JP, Volkenstein S. Surgical and technical modalities for hearing restoration in ear malformations. Facial Plast Surg 2015; 31: 581-586
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Siegert R. Magnetic coupling of partially implantable bone conduction hearing aids without open implants. Laryngorhinootologie 2010; 89: 346-351
    Article in Thieme ConnectPubMedGoogle Scholar
  • 11 Siegert R, Kanderske J. A new semi-implantable transcutaneous bone conduction device: clinical, surgical, and audiologic outcomes in patients with congenital ear canal atresia. Otol Neurotol 2013; 34: 927-934
    CrossrefPubMedGoogle Scholar
  • 12 Reinfeldt S, Hakansson B, Taghavi H, Eeg-Olofsson M. New developments in bone-conduction hearing implants: a review. Medical Devices: Evidence and Research 2015; 8: 79-93
    PubMedGoogle Scholar
  • 13 Badran K, Arya AK, Bunstone D, Mackinnon N. Long-term complications of bone-anchored hearing aids: a 14 years experience. J Laryngol Otol 2009; 123: 170-176
    CrossrefPubMedGoogle Scholar
  • 14 Dun CA, Faber HT, de Wolf MJ, Mylanus EA, Cremers CW, Hol MK. Assessment of more than 1000 implanted percutaneous bone conduction devices: skin reactions and implant survival. Otol Neurotol 2012; 33: 192-198
    CrossrefPubMedGoogle Scholar
  • 15 Hultcrantz M, Lanis A. A five-year follow-up on the osseointegration of bone-anchored hearing device implantation without tissue reduction. Otol Neurotol 2014; 35: 1480-1485
    CrossrefPubMedGoogle Scholar
  • 16 Mohamad S, Khan I, Hey SY, Hussain SSM. A systematic review on skin complications of bone-anchored hearing aids in relation to surgical techniques. Eur Arch Otorhinolaryngol 2016; 273: 559-565
    CrossrefPubMedGoogle Scholar
  • 17 Verstraeten N, Zarowski AJ, Somers T, Riff D, Offeciers EF. Comparison of the audiologic results obtained with the bone-anchored hearing aid attached to the headband, the testband, and to the “snap” abutment. Otol Neurotol 2009; 30: 70-75
    CrossrefPubMedGoogle Scholar
  • 18 Todt I, Seidl RO, Gross M, Ernst A. Comparison of different Vibrant Soundbridge audioprocessors with conventional hearing AIDS. Otol Neurotol 2002; 23: 669-673
    CrossrefPubMedGoogle Scholar
  • 19 Beutner D, Hüttenbrink KB. Passive and active middle ear implants. GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery. 2009; 8 Doc09 (20110310)
    PubMedGoogle Scholar
  • 20 Colletti V, Soli SD, Carner M, Colletti L. Treatment of mixed hearing losses via implantation of a vibratory transducer on the round window. Int J Audiol 2006; 45: 600-608
    CrossrefPubMedGoogle Scholar
  • 21 Dazert S, Shehata-Dieler WE, Dieler R, Helms J. “Vibrant Soundbridge” middle ear implant for auditory rehabilitation in sensory hearing loss. I. Clinical aspects, indications and initial results. Laryngorhinootologie 2000; 79: 459-464
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Marino R, Lampacher P, Dittrich G, Tavora-Vieira D, Kuthubutheen J, Rajan GP. Does Coupling and Positioning in Vibroplasty Matter? A Prospective Cohort Study. Otol Neurotol 2015; 36: 1223-1230
    CrossrefPubMedGoogle Scholar
  • 23 Jenkins HA, Uhler K. Otologics active middle ear implants. Otolaryngol Clin N Am 2014; 47: 967-978
    CrossrefPubMedGoogle Scholar
  • 24 Braun K, Zenner HP, Friese N, Tropitzsch A. Differenzialindikation aktiver Mittelohrimplantate. HNO 2015; 63: 402-418
    CrossrefPubMedGoogle Scholar
  • 25 Kraus EM, Shohet JA, Catalano PJ. Envoy Esteem Totally Implantable Hearing System: phase 2 trial, 1-year hearing results. Otolaryngol Head Neck Surg 2011; 145: 100-109
    CrossrefPubMedGoogle Scholar
  • 26 Lenarz T, Schwab B, Maier H, Kludt E. Direct acoustic cochlear stimulation for therapy of severe to profound mixed hearing loss: Codacs™ Direct Acoustic Cochlear Implant System. HNO 2014; 62: 481-489
    CrossrefPubMedGoogle Scholar
  • 27 Wagner F, Todt I, Wagner J, Ernst A. Indications and Candidacy for Active Middle Ear Implants. In: Böheim K. (Hrsg.) Active Middle Ear Implants. Basel: Karger; 2010: 20-26
    CrossrefGoogle Scholar
  • 28 Zwartenkot JW, Snik AFM, Mylanus EAM, Mulder JJS. Amplification Options for Patients With Mixed Hearing Loss. Otol Neurotol 2014; 35: 221-226
    CrossrefPubMedGoogle Scholar
  • 29 Edfeldt N, Stromback K, Grendin J, bunne M, Harder H, Peebo M, Eeg-Olofsson M, Petersson CM, Konradsson K. Evaluation of cost-utility in middle ear implantation in the ’Nordic School’: a multicenter study in Sweden and Norway. Acta Otolaryngol 2014; 134: 19-25
    CrossrefPubMedGoogle Scholar
  • 30 Debeaupte M, Decullier E, Tringali S, Deveze A, Mom T, Darrouzet V, Truy E. Evolution of the Reliability of the Fully Implantable Middle Ear Transducer Over Successive Generations. Otol Neurotol 2015; 36: 625-630
    CrossrefPubMedGoogle Scholar