Guadagno protesico della protesi Adhear: confronto con i risultati ottenuti con le protesi impiantabili Bonebridge

In the study there are 30 patients with a Bonebridge, the first active bone conduction implant system since 2011. It can be an effective solution for individuals with lasting hearing loss following a middle ear operation, malformations, or generally for conductive hearing loss and mixed hearing loss for example in Franceschetti syndrome, Charge syndrome or chronic otitis. It is also an option for individuals with singlesided deafness. In conductive or mixed hearing loss, sound cannot take the natural path through the outer and middle ear to the inner ear. With the bonebridge, the sound waves are transmitted via bone conduction directly to the inner ear, where they are processed as natural sound. It ensures optimal daily hearing performance while remaining discreet and unobtrusive. All patients in the study have deafness caused by different pathologies, such as Treacher Collins syndrome, chronic otitis, Atresia Auris, Charge syndrome who have bilateral or unilateral implants. The first examination is performed by an ENT Specialist or Audiologist for the surgical aspects, while the audiometric technician takes care of acoustic measures. In the study all patients underwent pure tone audiometry without their devices on. Then they had to do speech audiometry in free field but with speech noise in background. Three different types of speech audiometry were carried out: the first with no devices on, the second with a bonebridge on and the third with Adhear on. Adhear is a novel and revolutionary bone conduction system it is an effortless treatment option for people with conductive hearing loss or single sided deafness. The system is non-surgical and offers great performance, simple handling and high wearing comfort. There are two aims in the study: the first one is to evaluate audiologic performance with a Bonebridge implant, which focused on speech audiometry results, patients satisfaction and the impact on their everyday life using a questionnaire. The second aim of the study is to compare speech audiometry gain with two different types of devices, in particular, we focused on the perception and intelligibility threshold.

La protesizzazione acustica in pazienti affetti da ipoacusia trasmissiva o mista di entità lieve e moderata rappresenta una sfida terapeutica, in quanto non è sempre possibile riuscire ad ottenere buone performance uditive e un buon grado di soddisfazione da parte del paziente. Condizioni cliniche, quali esiti di otiti croniche, sia colesteatomatose che semplici, o malformazioni congenite (atresia auris, quadri sindromici es. Francescehtti, Charge, Binder), rappresentano le cause più comuni tra quelle che comportano l’impossibilità di utilizzare protesi acustiche classiche per via aerea (es. atresia auris) o non rappresentano le condizioni ideale per l’utilizzo di tali ausili (es. otiti croniche). D’altro canto, le protesi acustiche per via ossea esterne classiche non consentono nella maggioranza dei casi di avere delle performance uditive soddisfacenti. Il Bonebridge rappresenta una strategia terapeutica relativamente recente (2011) ed è costituito da una protesi impiantabile attiva a conduzione ossea composta da un audioprocessore esterno, indossato dietro l’orecchio, e da un impianto, con posizionamento chirurgico sottocutaneo. La protesi viene normalmente posizionata in regione mastoidea o, eventualmente, a livello retrosigmoideo (in particolare nei pazienti con alterazioni anatomiche o iatrogene della regione mastoidea). Per poter posizionare l’impianto il paziente deve essere sottoposto ad un intevervento otochirurgico in anestesia generale. Circa 2-4 settimane dopo l’intervento l’impianto viene attivato adattando l’audioprocessore alle esigenze del paziente.