Individualised headband simulation test for predicting outcome after percutaneous bone conductive implantation

Area of Science:

• Audiology
• Biomedical Engineering
• Neurosurgery

Background:

• Trans-cutaneous bone conduction (BC) stimulators (BC-HB) are used to predict outcomes of bone conductive implant (BCI) surgery.
• BC-HB performance is often considered inferior to definitive percutaneous systems.
• Accurate prediction of BCI outcomes is crucial for patient selection and surgical planning.

Purpose of the Study:

• To compare the performance of BC-HB and BCI systems of the same type.
• To evaluate the predictive accuracy of BC-HB when fitted to individual auditory needs.
• To assess the efficacy of BC-HB as a pre-surgical evaluation tool for BCI candidates.

Main Methods:

• Twenty-two patients undergoing BCI surgery were evaluated using a standardized audiological protocol.
• BC-HB was fitted based on individual hearing loss and auditory targets.
• Audiometric tests included pure tone average (PTA), word recognition scores (WRS) in quiet and noise, and subjective sound quality (VAS).

Main Results:

• Mean PTA differences between BCI and BC-HB ranged from 1.27 to 8.27 decibels across patient groups.
• BCI demonstrated superior WRS compared to BC-HB in both conductive/mixed hearing loss (CMHL) and single-sided deafness (SSD) groups.
• Significant correlations were found between BC-HB and BCI outcomes, and between audiological measures and subjective VAS scores.

Conclusions:

• The headband bone conduction test (BC-HB), when personalized, provides highly predictive data for bone conductive implant (BCI) surgery outcomes.
• This simulation tool can reliably guide the selection of candidates and set expectations for BCI surgery.
• Personalized fitting of the BC-HB sound processor is key to its predictive accuracy.