New developments in bone-conduction hearing implants: a review

Area of Science:

• Audiology and Hearing Rehabilitation
• Biomedical Engineering
• Medical Devices

Background:

• The landscape of bone-conduction devices (BCDs) for hearing loss is rapidly evolving.
• Existing BCDs include skin-drive and direct-drive categories, with percutaneous bone-anchored hearing aids being dominant.
• Increasing development focuses on transcutaneous BCDs to address limitations of percutaneous implants.

Purpose of the Study:

• To categorize and describe all currently available or clinically trialed bone-conduction devices.
• To review the principles behind different BCD classifications.
• To discuss the challenges and future potential of emerging transcutaneous BCD technologies.

Main Methods:

• Systematic review and categorization of bone-conduction devices based on their operational principles.
• Classification into skin-drive (conventional, passive transcutaneous) and direct-drive (percutaneous, active transcutaneous) categories.
• Analysis of current market presence and developmental trends, particularly for transcutaneous solutions.

Main Results:

• Bone-conduction devices are classified into skin-drive and direct-drive types.
• Percutaneous direct-drive devices (bone-anchored hearing aids) currently dominate the market.
• Transcutaneous solutions, both skin-drive and direct-drive, are under development to overcome percutaneous implant issues, facing challenges in power, attachment, invasiveness, and MRI compatibility.

Conclusions:

• Percutaneous direct-drive BCDs will remain important, but transcutaneous BCDs are expected to gain market share, particularly for specific hearing loss levels.
• Active transcutaneous direct-drive BCDs are highly promising but require further clinical validation.
• More research is needed to define inclusion criteria and fully assess the benefits and drawbacks of new transcutaneous BCDs.