HSC Section 8_April 2017

III.

Hearing Loss A. Sensorineural hearing loss

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(5):834-841. EBM level 2b.................................118-125 Summary : Twenty-seven patients with mixed, conductive, and single-sided hearing loss who received the Baha Attract System were studied for 9 months. Patient benefit, soft-tissue status, device retention, and safety were monitored. Results demonstrated significant improvement in audibility and speech understanding in noise and quiet when compared to preoperative unaided hearing. Roland JT Jr, Gantz BJ, Waltzman SB, et al. United States multicenter clinical trial of the cochlear nucleus hybrid implant system. Laryngoscope . 2016; 126(1):175-181. EBM level 2b................................................................................................................................126-132 Summary : This article discusses U.S. trials for the Cochlear Nucleus Hybrid L24 implant at ten investigational sites. The study included 50 patients with low-frequency hearing intact. Mean improvements in consonant-nucleus-consonant and AzBio were seen in nearly all patients. Hearing preservation rate (as defined as any measurable hearing) at 6 months was 66%. B. Conductive and mixed hearing loss Marino R, Lampacher P, Dittrich G, et al. Does coupling and positioning in vibroplasty matter? A prospective cohort study. Otol Neurotol . 2015; 36(7):1223-1230. EBM level 2..................................................................................................................................133-140 Summary : This is a prospective cohort study evaluating the audiological outcomes in patients with conductive/mixed hearing loss who underwent vibroplasty surgery using three different coupling techniques (direct to round window [RW], soft-tissue RW coupling, and stapes/incus coupling). Patients with soft tissue interposed between the floating mass transducer and RW showed the poorest coupling efficiency. Direct RW coupling was significantly better than with soft-tissue RW coupling. Vibroplasty directly to the ossicular chain provided the best coupling efficiency outcomes. Wegner I, van Waes AMA, Bittermann AJ, et al. A systematic review of the diagnostic value of CT imaging in diagnosing otosclerosis. Otol Neurotol . 2016; 37(1):9-15. EBM level 3..................................................................................................................................141-147 Summary : This article is a systematic review of the utility of CT in the diagnosis of otosclerosis in patients with conductive hearing loss. In patients with a strong clinical suspicion of otosclerosis, the positive and negative predictive value of CT is relatively high. In patients with a low suspicion for otosclerosis, positive and negative predictive values of CT were much lower. CT imaging for conductive hearing loss is only recommended for suspected pathology other than otosclerosis when preparing for middle ear surgery.