14 / 264
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.