Systematic and audiological indication criteria for bone conduction devices and active middle ear implants

Area of Science:

• Audiology and Otolaryngology
• Biomedical Engineering
• Hearing Device Technology

Background:

• Conductive or mixed hearing loss can be managed with bone-conduction hearing devices (BCHD) or active middle ear implants (AMEI).
• Existing BCHD and AMEI technologies vary in coupling methods, energy transfer, and actuator types (active vs. passive).

Purpose of the Study:

• To review currently available implantable and conventional bone-conduction hearing devices and active middle ear implants.
• To compare these devices based on technical features, market availability, and expected effective output dynamic range.

Main Methods:

• Systematic review of available bone-conduction hearing devices and active middle ear implants.
• Analysis of technical specifications including maximum power output, noise floor, and coupling efficiency.
• Evaluation of audiological benefit based on effective dynamic range (target 30-35 dB).

Main Results:

• Device selection is a complex trade-off involving audiological requirements, technical parameters, surgical considerations, and patient-specific factors.
• Key performance indicators include maximum stable power output, noise floor, and coupling efficiency.
• The effective dynamic range is crucial for audiological benefit, with a target of 30-35 dB.

Conclusions:

• Optimal patient outcomes depend on carefully matching device capabilities with individual hearing loss profiles and patient needs.
• Understanding the technical specifications and limitations of each device is essential for informed clinical decision-making.
• This review provides a comprehensive overview to aid in selecting the most appropriate BCHD or AMEI.