[ADHEAR Performance in Cases with Maximal Conductive Hearing Loss in Otosclerosis]

ADHEAR is a non-invasive, passive bone conduction hearing aid. It is a pressure-free device, which overcomes the skin problems and irritations of conventional devices. Patients with otosclerosis and stapes fixation with normal inner ear represent an audiological homogenous group. We tested the ADHEAR benefit for this group.Thirty-one patients with maximal conductive hearing loss were tested preoperatively with and without ADHEAR. Pure tone and speech recognition tests, Freiburger mono- and multisyllables, were performed. The performance was evaluated at four sound pressure levels (35, 50, 65, and 80 dB). Intraoperative findings confirmed otosclerosis in 28 cases.The free-field PTA4 (pure tone average at 500 Hz, 1, 2, 4 kHz) in patients with otosclerosis improved with ADHEAR by 8.1 (±7.14) dB. Multisyllable understanding without ADHEAR at 65 dB was 69.6%, and 87.3% with ADHEAR (p = 0.002). Monosyllable understanding without ADHEAR at 65 dB was 37.9%, and 61.2% with ADHEAR (p = 0.00008).ADHEAR in patients with otosclerosis improved their speech understanding significantly in most testsituations. Because of its size at the speech-relevant sound pressure levels of 50 and 65 dB, the gain is clinically relevant. In difficult and easy situations we observed ceiling and floor effects. Thus, ADHEAR appears to be at least temporarily a good rehabilitation alternative.