Amplification options for patients with mixed hearing loss.

Area of Science:

• Audiology
• Otolaryngology
• Biomedical Engineering

Background:

• Mixed hearing loss requires effective amplification strategies.
• Various bone conduction devices (BCDs) and middle ear implants (MEIs) exist.
• Understanding maximum output is crucial for patient benefit.

Purpose of the Study:

• To compare the amplification capabilities of different bone conduction devices and middle ear implants.
• To evaluate devices for patients with mixed hearing loss.

Main Methods:

• Evaluated percutaneous and transcutaneous bone conductors (BCDs) and middle ear implants (Vibrant Soundbridge [VSB], Cochlear Direct Acoustic Cochlear Stimulator [Codacs]).
• Maximum output measured using simulators and in patients for MEIs.
• Main outcome: maximum output in dB HL at 0.5, 1, and 2 kHz.

Main Results:

• Codacs demonstrated the highest maximum output, exceeding patient comfort levels.
• VSB output varied (65-85 dB HL); percutaneous BCD output ranged from 68-80 dB HL.
• Transcutaneous BCD (Sophono) exhibited the lowest maximum output.

Conclusions:

• Codacs allows full utilization of the dynamic range for mixed hearing loss.
• Percutaneous BCDs are suitable for sensorineural hearing loss up to 50 dB HL, independent of middle ear status.
• Transcutaneous Sophono BCD is appropriate for mild sensorineural hearing loss (≤20 dB HL).