The Ponto Bone-Anchored Hearing System - Benefits Following Radical Mastoidectomy

BACKGROUND Chronic otitis media with cholesteatoma requires surgical treatment. One technique used is radical modified mastoidectomy. However, if there is subsequent hearing loss, the patient will often need to be provided with a hearing prosthesis, and one option is to use a bone-anchored hearing device. One of the percutaneous bone-anchored hearing aids available in clinical practice is the Ponto system (Oticon Medical). MATERIAL AND METHODS There were 27 patients enrolled in this study (13 females, 14 males), all of whom had previously undergone radical modified mastoidectomy. They were implanted with the Ponto bone-anchored hearing device from Oticon Medical. The mean age of the subjects at implantation was 59 years (36-75 years, SD=11). Five patients had moderate conductive hearing loss in the implanted ear, and 22 had moderate to very severe mixed hearing loss. Benefits of the Ponto system were assessed using tone and speech audiometry (free-field), as well as with APHAB (Abbreviated Profile of Hearing Aid Benefit) and SSQ (Speech, Spatial and Qualities of Hearing Scale) questionnaires. RESULTS The Ponto system resulted in a statistically significant improvement in hearing sensitivity and speech discrimination. The questionnaires confirmed the benefits of the Ponto system under various acoustic conditions. CONCLUSIONS Ponto was found to be a safe and effective tool in compensating for conductive or mixed hearing loss after radical modified mastoidectomy. The system can provide good support for auditory function in people who are at risk of recurrent otitis media with cholesteatoma and who may therefore require subsequent revision or further surgical intervention.