Bone Conduction
by Cochlear Guest Author

Science Spotlight: New Active Osseointegrated Steady-State Implant System

September 15, 2020
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Multicenter Clinical Investigation of a New Active Osseointegrated Steady-State Implant System

Emmanuel A. M. Mylanus,  Håkan Hua, Stina Wigren, Susan Arndt, Piotr Henryk Skarzynski, Steven A. Telian, and Robert J. S. Briggs

Note: Figures and tables are excerpted from the article.

Purpose

The aim of this international, multicenter study was to demonstrate clinical performance, safety and benefit of the Cochlear™ Osia® System, an active osseointegrated steady-state transcutaneous bone conduction hearing implant system that uses piezoelectric technology.

Key messages

The Osia® System provided excellent functional audiological gain, improved audibility for high frequencies and significant improvement in speech recognition in noise as compared to pre-operative aided testing with a Baha® Softband solution for recipients presenting with conductive-mixed hearing loss and single sided deafness.  Additionally, benefit with the Osia System was demonstrated in significantly positive patient-reported outcomes for hearing in real-life situations, wearing comfort and considerable daily use of the system. The surgery was straightforward with a low complication rate.

Methods3

This was a Cochlear sponsored, global, multicenter prospective within-subject clinical investigation of the first generation of the Cochlear Osia System (Cochlear Bone Anchored Solutions, Sweden). 

The first generation Osia System as shown in Figure 1 consists of an implant (OSI100 Implant) with a piezoelectric transducer and a receiver stimulator, receiving coil and retention magnet that is placed under the skin.  The OSI100 implant is fixed to the temporal bone with an osseointegrated implant (BI300 Implant, 3mm or 4mm).  The external sound processor houses a corresponding retention magnet, which keeps the sound processor magnetically retained on the skin in place, aligning the transmitting and receiving coils.  The signal captured by the sound processor is transmitted over a digital link along with power to the internal receiver stimulator package which then transfers the amplified signal to the internal piezoelectric transducer for sound stimulation.  

The implantable transducer of the Osia implant is designed for an under-the-skin application.  The piezoelectric material in the transducer bends when an electrical current is applied causing a vibration.  Attached to the piezoelectric material are counterweights which provide momentum to the vibrations to help amplify the signal.  The transducer (noted as “actuator” in the Figure 1 caption) is contained in a titanium housing in the OSI100 implant.  

Adult patients who 1) presented with either conductive hearing loss or mixed hearing loss with upper limit for bone conduction threshold of 55 dB HL or single-sided deafness with air conduction threshold pure tone average of 20 dB HL or better in the better ear, 2) trialed a bone conduction transducer on a soft band prior to surgical intervention and 3) chose to receive the Osia device were included in the study. 

The surgical outcome measures included soft tissue thickness, soft tissue thinning at the location of the sound processor, surgery time, bone polishing/removal at the actuator site, type/location of surgical incision and surgical complications.

Audiological outcome measures were conducted pre-operatively unaided and using a Cochlear Baha BP110 Power sound processor on a Baha Softband.  Post-operative assessments were performed with the implanted device at activation which was four weeks post-op as well as at six weeks post-op, three months post-op, six months post-op and 12 months post-op.  Pure tone average (0.5, 1, 2, and 4 kHz), speech recognition (monosyllabic words) in quiet, and speech recognition thresholds (SRT) in noise were analyzed for performance with the implanted device compared to pre-op scores. 

Patient-reported outcomes were measured on three validated questionnaires.  The first was the Health Utilities Index (HUI3) which evaluates eight health-related quality of life dimensions (vision, hearing, speech, walking/mobility, dexterity, self-care, emotion, cognition) and a comprehensive health state attribute.  The subject assigned a score to their health status in the various dimensions.

The second was the Abbreviated Profile of Hearing Aid Benefit (APHAB), which is a hearing-related instrument where subjects report the amount of trouble they are having with communication or noise in everyday situations.  The ratings are categorized into four subscales (ease of communication, reverberation, background noise, aversiveness) and a global score.  Benefit is calculated by comparing difficulty in the unaided condition with their amount of difficulty when using amplification. 

The third questionnaire was the Speech, Spatial and Qualities of Hearing Scale (SSQ12), a shorter version of the original 49-item SSQ questionnaire.  It measures ratings of hearing disability in the subject’s everyday life across three subdomains (speech, spatial and qualities of hearing).  In addition to the questionnaires, daily usage and a comfort rating were collected. 

Results3

Fifty-one adult subjects with mixed hearing loss (n=23), conductive hearing loss (n=14) and single-sided sensorineural deafness (n=14) were implanted with the Osia device.  Two were implanted bilaterally. 

The first generation Osia device was surgically implanted following the procedure described in the physician’s guide provided by the manufacturer.  The average length of surgery was 97.2 minutes.  Ten subjects had skin flap reduction at surgery, which was mandated if the skin flap was measured at greater than 6mm.  The majority of subjects (42) required bone polishing at the site of the BI300 and underneath the transducer.  The surgical incisions used were C-shaped (n=30), S-shaped (n=19), curvilinear C-shaped (n=1) and anterior slightly curved (n=1).  No unexpected problems arose in surgery, however there was one serious adverse event that occurred post-operatively.  A wound infection developed into skin necrosis and dehiscence leading to explantation at 55 days post-op despite medical and surgical treatment. 

Results were reported for 12 months post-op compared to pre-op unaided and aided testing with the BP110 on a Softband.  For all subjects, there was significant improvement of 30.4 dB from unaided and 7.8 dB from Softband for pure tone average.  High frequency thresholds were notably improved with the Osia device.  Results are shown in Figure 3.  Speech reception threshold (SRT) in noise (the signal-to-noise ratio at which 50% of the words in a sentence are correctly repeated) improved by 13.6 dB compared to unaided and 7.5 dB compared to softband.  For word recognition in quiet, there was no difference with the implanted device for subjects with single sided deafness (SSD), however performance was significantly improved for the subjects with mixed and conductive hearing loss (CHL/MHL).  At a soft speech level (50 dB), CHL/MHL subjects scored 26.7% better than with the Softband.  When tested at conversational levels (65 dB), CHL/MHL subjects had a 18.6% improvement over the Softband. Results are shown in Table 2.

Results on the three patient questionnaires were reported for all subjects and for the subgroups CHL/MHL and SSD.  All patient reported outcomes demonstrated statistically significant improvements post-operatively with the implanted device.  The HUI3 showed significant improvement in both the hearing and speech dimensions for all subjects and for the CHL/MHL subgroup.  However, the difference between pre- and post-op was not statistically significant in the SSD subgroup.  On the APHAB, the global score and all subscales except aversiveness demonstrated significant improvements for all subjects and for both subgroups.  Finally, all SSQ12 subdomains were significantly improved for all subjects and for both subgroups.  Results are shown in Table 3.

Daily use of the sound processor was also captured.  The average for all subjects was 11.3 hours per day.  There was a difference in daily wear when looking at the subgroups, with 12.2 average hours per day for CHL/MHL and 9.3 average hours per day for SSD.

Comfort was assessed using a visual analog scale (0% no comfort, 100% most comfortable).  The average comfort level was 80.9% for all subjects, 79.7% for CHL/MHL, and 83.9% for SSD.

Conclusion

The surgical analysis revealed no intraoperative surgical complications and while there was one serious post-operative complication (explantation following an infection shortly after surgery), overall, there was a low rate of post-operative complications.  The main surgical consideration by the authors was that a certain amount of bone polishing was performed in most subjects to create a flat bone surface underneath the actuator.  However, the amount of bone removal for the Osia implant’s piezoelectric transducer was less than the relatively large amount of bone removal needed to accommodate an electromagnetic transducer, which reduces surgical challenges and/or anatomical restrictions.  The Osia System can be implanted in patients with limited bone thickness and does not require significant volumes of bone to be removed.

Hearing performance improvements were statistically significant and clinically relevant demonstrating even greater outcomes over the unaided condition with the Osia, an active transcutaneous system implanted directly on the bone, than with a passive transcutaneous system that transmits sound vibrations across the skin from an externally housed actuator.  The difference in audibility with the Osia was greatest for the high frequencies in both subgroups.  In the SSD subgroup, the Osia was able to compensate for transcranial attenuation, especially in the high frequencies.  This improved access to high frequency sounds is important for speech discrimination, especially in noise as demonstrated in improved SRT signal-to-noise ratio for both subgroups. 

Additional benefits were found on quality of life questionnaires.  Real-life hearing situations were reported to be improved with use of the Osia and there was a significant decrease in hearing disability post-op. These betterments may positively impact social, emotional and communication dysfunctions caused by hearing impairment.  A further subjective benefit was seen for the SSD group on spatial hearing ability with acoustic information provided by the implanted device to the better hearing ear.  

Patient acceptance of the Osia device by all subjects was very good as suggested by the high average daily use and reported level of comfort.  The hours per day are higher than reports of passive transcutaneous systems.1-2 This increase in wear time is likely due to the improved cosmetics and comfort of wearing the device.  This is also shown in the lack of increase in aversiveness, which relates to discomfort with use or wearing, in the subjective reports on the APHAB. 

There are demonstrated benefits of the piezoelectric transducer in the first generation Osia System, representing technological advancement in bone conduction implants.  The piezoelectric transducer has high power output, especially in the high frequencies, to provide optimal speech perception and high levels of patient satisfaction.  The safety analyses up to and including 12 months of follow-up suggest that the system is safe and performs as intended.

To learn more about the Osia System, subscribe to Cochlear ProNews or watch this webinar series.

References:

  1. den Besten CA, Monksfield P, Bosman A, et al. Audiological and clinical outcomes of a transcutaneous bone conduction hearing implant: six-month results from a multicentre study. Clin Otolaryngol 2019;44:144–57.
  • Briggs R, Van Hasselt A, Luntz M, et al. Clinical performance of a new magnetic bone conduction hearing implant system: results from a prospective, multicenter, clinical investigation. Otol Neurotol 2015;36:834–41.

Citation:

  • Mylanus, Emmanuel A. M.; Hua, Håkan; Wigren, Stina; Arndt, Susan; Skarzynski, Piotr Henryk; Telian, Steven A.; Briggs, Robert J. S. Multicenter Clinical Investigation of a New Active Osseointegrated Steady-State Implant System, Otology & Neurotology: August 17, 2020 – Volume Publish Ahead of Print – Issue -doi: 10.1097/MAO.0000000000002794

Authors & Affiliations:

Emmanuel A. M. Mylanus – Department of Otorhinolaryngology, Donders Center for Neurosciences, Radboud university medical center, Nijmegen, The Netherlands

Håkan Hua; Stina Wigren  – Cochlear Bone Anchored Solutions AB, Mölnlycke, Sweden

Susan Arndt – Department of Oto-Rhino-Laryngology and Implant Center, Medical Center – University of Freiburg, Germany

Piotr Henryk Skarzynski – Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Poland

Steven A. Telian – John L. Kemink Professor of Neurotology, University of Michigan, Ann Arbor, Michigan

Robert J. S. Briggs -The University of Melbourne Department of Surgery, Otolaryngology, The Royal Victorian Eye and Ear Hospital, Australia

This blog is intended to serve as a resource for clinicians to help keep up to date with current clinical literature and is intended for professionals only. Clinical literature is based on research, which may include the experimental use of new or currently available products and technologies. Therefore, literature presented on Cochlear ProNews may represent use of Cochlear products that does not align with the intended use or indications approved by regulatory bodies, also known as off-label use. Cochlear does not condone any off-label use of its products, and it is not Cochlear’s intent to promote off-label use by providing this blog as a resource to clinicians.

This content is meant for professional use. If you are a consumer, please seek advice from your health professional about treatments for hearing loss. Outcomes may vary, and your health professional will advise you about the factors which could affect your outcome. Always read the instructions for use. Not all products are available in all countries. Please contact your local Cochlear representative for product information. Views expressed are those of the individual. Consult your health professional to determine if you are a candidate for Cochlear technology.

In the United States, the Osia 2 System is cleared for children 12 and older. In the United States and Canada, the placement of a bone conduction implant is contraindicated in Children under the age of 5.

Author

Cochlear Guest Author

In an effort to keep our content fresh and reflective of a diverse industry, Cochlear Americas features a mix of employees and professional partners to contribute to Cochlear ProNews as Guest Authors.

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cochlear osia system piezoelectric stimulation

What is Piezoelectric Stimulation and why does it matter?

January 27, 2020

By George Cire, Principal Clinical Project Manager at Cochlear

The heart of any bone conduction system is the vibrator or actuator that functions as a mechanism to convert amplified sound to mechanical vibration, which can in turn drive the bones in the skull to access the bone conduction pathway to the cochlea or inner ear. The Cochlear™ Osia® System applies a new and innovative way to create a bone conduction transducer that will produce high frequencies and thus positively impact speech understanding. 

Evolution of Bone Conduction Technology  

Historically, the actuator is an electromagnetic device that contains a magnet, coil and counterweight.   By application of an alternating polarity signal from the sound processor to the actuator, an electromagnetic field is produced that excites the magnet element and counterweight. This produces movement or vibration within the actuator to change the electrical signal to vibration that can move through the bone conduction pathway to stimulate the cochlea, thus facilitating hearing. 

It’s easy to visualize the complex design of springs, magnets, coils and a counterweight that form a “moving mass” system that facilitates a mechanical interaction between parts.  The electromagnetic actuator can be placed against the skull externally where the vibration must traverse soft tissue before stimulating the bone conduction pathway, providing a transcutaneous bone conduction system. This method advantageously provides a non-surgical option for candidates that need or require a bone conduction amplification system.

Innovations with the Baha® System

The Baha Connect system was developed to provide a direct drive access system where a surgically implanted titanium fixture can be placed in the bone where it will osseointergrate.  Attached to this implanted fixture is a titanium abutment that protrudes through the skin and provides a snap coupling that accepts the Baha Sound Processor, referred to as a percutaneous system.

Later, the Baha Attract system allowed an implant magnet to attach to the implant fixture, positioning the tissue flap to be in place over the implant fixture and implant magnet.  Then the sound processor can be attached to an external magnet that is held in place with the magnetic attraction between a “sandwich of tissue” and the internal implant magnet to hold the entire system in place.   Vibration from the actuator in the sound processor then passes though the system to the internal components to excite the same bone conduction pathway described above in the Baha Connect system. 

It forms an alternative transcutaneous system that offers candidates for bone conduction hearing treatment with a more cosmetic system that does not require the same hygiene regimen as the Baha Connect system.  The direct drive Baha Connect system provides the most effective transfer of vibrational energy with out the damping effect of the skin between the vibrating actuator and the bone conduction pathway.1,2

The Osia System and Piezoelectric Technology

As a natural evolution of bone conduction technology, the Osia System was created to combine the best of the direct drive, Baha Connect system and the hygiene and cosmetic advantages of the Baha Attract system. The Osia System is a new approach to an active transcutaneous system. Like other bone conduction systems, the actuator is the “heart” of the process. Designers and engineers looked toward the use of piezoelectric technology to create a smaller and most robust actuator that had clear advantages over traditional electromagnetic technology. 1,2  

In piezoelectric technology, a crystalline material can be formed into compact wafers that are laminated or bonded together.  When an electrical current is applied to this crystalline material, contraction and expansion is created that follows the electrical signal.  Because these wafers are laminated, the design allows for carefully controlled vibration to occur with out the need for a complex mechanical design containing moving parts and springs.  The actual size of the piezoelectric actuator can be formed into a package for optimal temporal bone placement where it can be mated with an osseointegrated fixture to apply vibration to excite the bone conduction pathway.  Application of this approach can be accomplished with modifications to the existing knowledge base of traditional Baha surgery.

The remaining components of the Osia Implant System include the magnet/coil assembly and a demodulator. The external Osia sound processor contains a battery-operated circuit that acts to pick up the acoustic signals of interest and then to amplify them.  Additionally, this circuit creates a digitally encoded radio frequency link that permits the combination of the amplified acoustic signal to the digital RF carrier to supply power to the implant via an inductive link between two coils (one in the external processor and one in the implanted package).  These two coils are held in place with magnets that only serve to provide a secure coupling and alignment.  This elegant design allows for the critical power supply to be maintained in the externally worn device.

Through the design and efficiency of power in this system, the Osia device provides the ability for clinicians to treat up to a 55dB HL sensorineural hearing level. 1,2  It has the advantage of hearing performance seen in our direct drive Baha Connect system combined with the non-skin penetrating transcutaneous system that provides a more cosmetic approach to the application of bone conduction amplification. 1,2

Overall the Osia System, an active transcutaneous osseointergrated implant system, combines the hearing performance seen in the Baha Connect system and the convenience and attractiveness of the Baha Attract system.

To learn more subscribe to our ProNews Blog using the panel to the left to ensure you receive new blog post notifications and check out this webinar.

References:

  1. Dotevall M. Technical Report: Available gain in Osia vs Baha 5 Power. D1664198. Cochlear Bone Anchored Solutions AB, Sweden 2019
  2. D1478473 CIR final report 12 month Data, Cochlear Bone Anchored Solutions AB. Sweden October 2019
Doctor putting head wrap on girl

Key Considerations for use of Bone Conduction solutions in pediatric patients – An audiologist’s perspective

February 26, 2020

By Guest Author: Lisa Christensen, AuD

Lisa Christensen, AuD, is the Audiology Program Manager at Cook Children’s Medical Center in Fort Worth, Texas and currently serves as President of the American Academy of Audiology (AAA).  We recently connected for a discussion on her use of bone conduction solutions as part of her clinical practice.

Q: Describe your process for fitting and using bone conduction technology in cases of atresia or microtia?

A: If the baby has atresia/microtia and traditional amplification is not an option, we follow the Joint Commission on Infant Hearing (JCIH) 1-3-6 Guidelines.  These babies are the easiest and most straight-forward cases, especially with bilateral atresia/microtia.  The cause of the hearing loss is visible, which helps with family motivation, and we fit the bone conduction scores instead of a potential fluctuating air conduction score.  These babies are also easy to obtain the JCIH new suggestions of 1-2-3 Guidelines.  In cases of bilateral losses, bilateral fittings should be fit bilaterally.

Q: How about for cases of unilateral hearing loss?

A: In cases of unilateral atresia/microtia or SSD, when-to-fit is a little more complex.  In order to put a Baha® processor behind and/or near the affected ear to obtain the best microphone placement, it creates a bit of an issue with babies and head control.  My recommendation with these patients is to obtain good, reliable diagnostic results and proceed with the Baha Softband order.  Wear-time may be limited until the baby has established good head control, and full-time wear-time may therefore be delayed.  However, parents can use tummy time and other times when the baby is upright to begin using the Baha on a Softband.  For most families, although a proper wear-time goal might not be obtained until 7-9 months of age when the baby spends a majority of their day sitting up, earlier use can still be beneficial.

Q: How do you choose between treatments using traditional air conduction, such as hearing aids, and treatments using bone conduction?

A: When choosing between traditional air conduction aids and bone conduction, first and foremost anatomy plays the biggest part.  If the ear can support an earmold and hearing aid, then it should at least be discussed with the family.  I often list out the advantages of each solution in the initial diagnosis or fitting appointment.  Some of the important things to discuss are if there is fluctuating air conduction due to middle ear status, such as in many patients with Down syndrome. Another notable thought is sound quality, do we overdrive an ear with a conductive loss and a traditional hearing aid? Or do we use the good bone conduction with a Baha for a better sound quality?

Q: What about deciding between a traditional CROS and Baha solution?

A: When comparing traditional CROS to Baha for SSD, age is a very important factor.  Fitting children with unilateral losses with a CROS should be given great consideration. As the AAA Pediatric Amplification Guidelines point out, attention to the child’s age and the ability to control their environment must be considered.  There is currently a very limited set of data to inform audiologists about this decision. As the Baha doesn’t ‘amplify’ by air conduction, I feel this is a safer option for young children with SSD.

Q: What is the earliest age you would fit a child with a Softband and are there any special considerations or tips for fitting Softband on very small children?

A: I have fit a two-week old with bilateral atresia with a Softband.  The mother of the baby had Treacher Collins and was a Baha user so when Treacher Collins with atresia was noted at birth we did a diagnostic ABR bedside in the NICU at one week of age and fit as soon as insurance was approved and the Bahas and Softband arrived in the clinic a week later.  As for tips or special considerations, bilateral loss equals bilateral Baha Softband.  Much like unilateral/SSD losses, you will most likely not get full-time wear with both Bahas for a period of time but that does not mean just order one and see what happens.  Get a bilateral Softband. Start with one Baha and as head control gets better start to add the second Baha during tummy time or times where the baby is sitting up.  I do recommend that parents switch out the Baha sound processors every few days to ensure both sides get wear time.  I also recommend not programming a right versus left until the time when the family is ready to start to use two at a time.  This will allow proper directional microphone usage. Lastly, I recommend for infants that the parents switch sides or places on the head every few hours to decrease chances of irritation and therefore lack of use.

Q: How do you test and verify a Softband fitting for a young child (baby or toddler)? 

A: Testing young children is the ‘easy’ part in this process when utilizing ABR tonebursts and bone conduction.  The harder part for most audiologists is verifying, especially for those who do not routinely see babies and toddlers.  Like most days working with kids, some of the following will be easily obtained….and the others will take some repeat visits. To start the verification process, I like to utilize BC Direct in the Cochlear™ Baha software.  This can be done just like behavior testing and will be based on developmental status of the patient.  You can use behavioral observation audiometry and/or visual reinforcement audiometry for BC Direct.  Some clinics will mount a video VRA screen on the wall or you can create a box with traditional VRA reinforcers that can be used to train these patients where VRA is most appropriate.  For BOA, it is like standard BOA testing so make sure you families bring in the infant hungry so that you can look for sucking responses.  Once BC Direct is completed you can take this show to the sound booth for verification using the same developmentally appropriate testing techniques to obtain aided thresholds and speech perception testing for verification of the device.

Q: How about an older child (pre-school or school age)?

A: For testing an older children, as always it starts with an accurate hearing evaluation that is done at the developmental status of the child.  So even for a 4 year old if behavioral testing isn’t achievable, you should obtain a sedated ABR to make sure your starting point is at the correct place.  BC Direct can also easily be achieved for this population with the proper tools aka toys.  Performing conditioned play audiometry through BC direct is easy and requires little preparation.  Again once the processor is programmed appropriately, take your show on the road to the booth and repeat for aided thresholds and speech perception testing to verify the device.

Q: What topics do you cover when counselling a family of a child that is getting a Softband? Are there differences depending on the child’s age?

A: I start fairly early on depending on the family’s readiness to learn explaining the anatomy of their child’s ear.  Through my experiences, I think this is a vital piece of information for them.  I utilize a clipboard with the ear anatomy on it and a dry eraser or a pad of ear anatomy paper.  This really helps them understand where the issue lies and helps them to understand why a Softband is the best, and many times only, option for the child.  When families understand why the Softband is needed, they are much more compliant in wearing it. 

Also, fairly early in the process I ask about their thoughts for surgical repairs. This might seem early to many but the sooner we start to discuss it the better knowledge the family will seek to make the best decision for their child.

Q: Do you ever fit Softband on a temporary basis (i.e. for children with Down Syndrome who have fluctuating middle ear problems)?  If so, what has your experience been with this?

A: This is one of the things I enjoy most about the Softband.  So many children, especially with conditions such as Down Syndrome, can benefit from something to help with a fluctuating conductive hearing loss.  Using the Softband has been life changing for these patients when so many times it was very hard and unreliable to fit a traditional hearing aid. 

Q: When would you consider a SoundArc for a child?  Have you ever switched a child from a Softband to a SoundArc?  If so, why and what were the considerations?

A: I would consider a SoundArc for a child as soon as they are about 3 years old.  By that point they can typically handle using the SoundArc and have many times started in a preschool program.  In my experience when a child begins a regular school program, many families start to have concerns about how the Softband will be received by peers.  So this tends to be when families are seeking out other options for the child.  I have switched many children from a Softband to SoundArc.  Most of these switches were done purely for cosmetic reasons and mostly preschool aged boys were the ones that were traded.  I always let kids wear the device how they will/want to wear it.  Then I verify it in the booth.  If I need to make changes to help them hear better how they like wearing it, then I do that.  If you put a Softband or a SoundArc where you think it should be clinically in the beginning, sometimes that lasts until surgical intervention.  However, sometimes kids find a specific place or device that feels better to them.  When this happens, I always try to work with them so that they wear their device as much as possible.

Q: When do you start discussing a surgical bone conduction option with a family who is using a non-surgical option like Softband?  How do you decide when a child might be ready to transition to a surgical option?

A: I begin discussing surgical options very soon in the process many times prior to fitting the actual Softband.  With atresia and microtia, you can see the loss and the process always seems to move along faster than with sensorineural losses.  I know these families search on the internet and I want to be there to help them find the best and most accurate information for their child.

For the most part, I have worked with very traditional surgeons, so deciding on when the child might be ready to transition is mostly based on the surgeon’s preference and the FDA-approved product indications.  I bring up the topic early so the family can read and make informed decisions but at the end of the day the surgical decision is left to the surgeon.

Q: Are there any future technologies you feel might change the way you work with children who need bone conduction solutions?

A: I believe that direct Bluetooth® streaming has changed the way we utilize hearing devices.  I think that anything that helps these children feel that their device has something fun for them they will want to wear them more and that is what I want as an audiologist – for children to hear the very best they can.  And now with more power options, it is easier to fit every child that needs a bone conduction solution.

Also, new technologies like the Osia® System will need to be added into the counseling topics early on.  This surgical solution is currently on the market for children 12 and older in the US and it will be something we discuss as families consider a surgical option.

As a pediatric audiologist, I think that we are starting to change the way verification and programming happens.  We are a rule driven group of pediatric audiologists. When there is a widely accepted protocol based on best practice we all get excited. So I feel that as we adopt more specific protocols related to bone conduction, more audiologists will get comfortable with the process.  And when more audiologists feel comfortable, more devices are fit and more individuals hear better.  It’s really a great time to be an audiologist as we watch so many exciting technologies get better and better.

In the United States and Canada, the placement of a bone-anchored implant is contraindicated in children below the age of 5

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This material is intended for health professionals. If you are a consumer, please seek advice from your health professional about treatments for hearing loss. Outcomes may vary, and your health professional will advise you about the factors which could affect your outcome. Always read the instructions for use. Not all products are available in all countries. Please contact your local Cochlear representative for product information.

 

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