Bone Conduction
by Cochlear Guest Author

Hearing loss related to chronic otitis media can directly impact patient quality of life

November 2, 2021
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By Natasha McDougald, Director, Acoustics Product Management and Marketing

Chronic otitis media (COM) affects up to 330 million people across the globe and an estimated 200 million of these have a disabling hearing loss* that requires treatment.¹ The World Health Organization estimates that chronic otitis media may contribute to more than half of the global burden of hearing impairment.2 It’s clear that COM and related hearing loss are global issues. Patients here in North America are also directly impacted and can suffer degradation to their comfort and quality of life as a result.

Bone conduction systems can provide COM patients with effective and stable hearing improvement during standard disease treatment, making the case that bone conduction solutions may be the ideal supplement to treat hearing loss.3,4,5

“Given the need to provide adequate treatment options that address the hearing loss component of chronic otitis media, Cochlear™ bone conduction solutions offer treating clinicians and patients suffering from COM a hearing loss treatment option that has potential for good outcomes and patient satisfaction especially in cases of hearing loss where there is a 30dB or greater air-bone gap.”

 – George Cire, Au.D Clinical Technical Project Manager at Cochlear

Treating chronic otitis media disease and hearing loss together

It’s important to focus on treating the disease to give your patients a safe, dry and healthy ear. It’s also crucial to consider that COM-related hearing loss can also impact a patient’s quality of life. Hearing rehabilitation can be accomplished through multiple means, including reconstructive middle ear surgeries; however, multiple factors influence the final postoperative hearing result, and the most important determinant of long-term hearing outcomes is the environment of the middle ear.6 We know that 29% of patients can have a conductive hearing loss of > 20 dB after tympanoplasty7 and these patients may require an additional hearing intervention as part of their treatment. Additionally, during the treatment pathway for COM, many patients may not have access to reliable hearing while waiting for an upcoming surgery or treatment.

Cochlear bone conduction solutions can improve your patients’ quality of life

Bone conduction systems are a safe, reliable and effective treatment for COM-related hearing loss.3 Patients with COM that require additional hearing intervention or amplification to obtain reliable hearing can experience a significant improvement in their quality of life after bone conduction solution.5In addition to improving hearing, the Cochlear™ Osia® System and Cochlear Baha® Systemkeep the ear canal open, unlike hearing aids, which can reduce the frequency of chronic ear infections.8,9

“Patients who have chronic otitis media tend to benefit [from bone conduction solutions] rather than wearing a traditional hearing aid.”

– Kristan Alfonso, MD Children’s Healthcare of Atlanta

You can also consider bone conduction as a hearing intervention earlier in the treatment pathway with the non-surgical Baha Start, which gives patients access to reliable hearing during the treatment pathway between surgeries.

Click here to find out more about Cochlear Bone Conduction Solutions.

References:

  1. World Health Organization. Chronic suppurative otitis media: burden of illness and management options. 2004; https://apps.who.int/iris/handle/10665/42941. Accessed January 16 2020.
  2. Acuin J and the Department of Child and Adolescent Health and Development, and the Team for Prevention of Blindness and Deafness of the World Health Organization. World Health Organization, Geneva; 2004.
  3. Gillett D, Fairley JW, Chandrashaker TS, Bean A, Gonzalez J. Bone-anchored hearing aids: results of the first eight years of a programme in a district general hospital, assessed by the Glasgow benefit inventory. J Laryngol Otol. 2006;120(7):537-542.
  4. Watson GJ, Silva S, Lawless T, Harling JL, Sheehan PZ. Bone anchored hearing aids: a preliminary assessment of the impact on outpatients and cost when rehabilitating hearing in chronic suppurative otitis media. Clin otolaryngol. 2008;33(4):338-342.
  5. McLarnon CM, Davison T, Johnson IJ. Bone-anchored hearing aid: comparison of benefit by patient subgroups. The Laryngoscope. 2004;114(5):942-944.
  6. Dornhoffer J and Walker D. Ossicular reconstruction. ENT & Audiology News2020;29(1).
  7. Lewis A, . Vanaelst, B. Hua, H. Choi, B. Hol, M. Jaramillo, R. Kong, K. Ray, J. Thakar, A. Järbrink, J. Success rates in restoring hearing loss in patients with chronic otitis media: a systematic review. Eur Arch Oto-Rhino-L. 2020:Submitted manuscript. Funded by Cochlear Bone Anchored Solutions AB.
  8. Medical Advisory Secretariat (2002). Bone anchored hearing aid: an evidence-based analysis. Ontario health technology assessment series, 2(3), 1–47.
  9. Macnamara M, Phillips D, Proops DW. The bone anchored hearing aid (BAHA) in chronic suppurative otitis media (CSOM). J Laryngol Otol Suppl. 1996;21:38-40. doi: 10.1017/s0022215100136254. PMID: 9015447.

*Disabling hearing loss refers to hearing loss greater than 40 dB in the better hearing ear in adults (15 years or older) and greater than 30 dB in the better hearing ear in children (0 to 14 years).

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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Finding Cochlear™ Baha® upgrade patients in Noah® 4

March 29, 2021

By Danielle Clark, Product Marketing Manager, Recipient Services

Our newest technology is designed to help your patients hear their best. Although you know there are patients that could benefit from upgrading to new technology, it may initially seem like a complicated process to identify them in order to start these discussions. However, Noah® 4 can serve as a helpful resource to quickly get a list of your upgrade eligible patients. The patient search function in Noah 4 can be used to identify patients who may be eligible for an upgrade.   

Baha patients

1. Click the Advanced search button in Noah 4 and ensure any prior search values are cleared, by using the ‘Clear’ button (see figure 1).

Fig. 1

2. Select a fitting end date that matches typical reimbursement requirements – typically five years is the time period for the “useful life” of a sound processor for many insurance providers. For example, to find patients with a sound processor that is five years old as of January 1, 2021, enter January 1, 2016 (01/01/2016) as the fitting end date to find all patients fitted before this date. (See figure 2).

Fig. 2

3. Leave the fitting start date blank, or enter a fitting start date to narrow down the search.

4. Select Cochlear as a manufacturer.

5. Click ‘Search.’

6. A list of Baha patients eligible for an upgrade will appear in the Noah patient browser.

To find more information about upgrading to share with your patients visit www.Cochlear.com/US/Upgrade.

“Noah” is a registered trademark of HIMSA II K/S in the USA. Outside the USA, “Noah” is a trademark of HIMSA II K/S.

man and woman looking in eyes

Baha Dermalock and Implant Stability

January 8, 2019

Baha

What is implant stability and why does it matter?

By Shawn Enter

Dating back to the 1950s, Swedish Professor P-I Branemark pioneered the study of titanium and its osseointegration qualities.  His research was advanced by Dr. Anders Tjellstrom’s work on bone conduction hearing implants.  Throughout the decades, titanium has served as the metal of choice for hearing implants.  Today, Cochlear offers the most advanced titanium implant in the Baha® 300 Series implant.  The BI300 implant boasts the TiOblast™ surface for faster/stronger osseointegration and secondary stability when compared to previous implants. It has small sized threads for optimal load distribution and a wider profile of 4.5mm to optimize strength of the system.  These attributes allow clinically proven long-term stability.1, 2 The chart below shows 5-year follow up data of primary and long-term strength of osseointegration with the Baha 300 Series implant. Baha implant stability

Whether a sound processor is actively loaded on a Baha Connect system or passively loaded on a Baha Attract system, your patients will benefit from the most advanced titanium bone conduction implant available; the Baha 300 Series implant.

The Importance of DermaLock™

By Kelly Crettol

Kelly Crettol

 

The Cochlear® Baha® Connect System is a well-proven percutaneous bone conduction implant system allowing direct, single-point sound transmission via a minimally invasive skin-penetrating abutment.

Conventional titanium abutments have been used for 40 years, but despite titanium’s well established ability to osseointegrate with bone, it does not integrate with the surrounding tissue. As a result, bone conduction implant surgery previously involved substantial soft tissue reduction to facilitate successful outcomes. Consequently, viable structures of the soft tissue were permanently removed affecting the healing capacity of the local immune system. The Cochlear® Baha® BA400 Abutment with DermaLock™ technology features a plasma-sprayed hydroxyapatite (HA) coating and concave design that promotes soft tissue adherence and stability.3 

Hydroxyapatite (HA) has been shown to provide enhanced dermal adhesion, diminishing epidermal downgrowth and pocket formation, and thus allowing for preservation of the soft tissue during surgery. This technology helps preserve the hair and skin around the abutment which not only leads to improved aesthetics and reduced numbness, but also dramatically reduces surgery time and benefits healing through increased vascularization of soft tissue.4

Dermalock microscopic comparison

Download our Baha Connect and Attract Systems 2-pager to learn more about Baha Systems.

About our guest authors:

Shawn Enter, Regional Surgical Training Manager at Cochlear Americas

Shawn is responsible for training surgeons and OR staff in the Cochlear Implant, Baha and Vistafix product lines.  He also supports complicated surgical scenarios and assists in new product launches.  Shawn joined Cochlear as an Area Business Manager and has worked in the Surgical Specialist role over the last five years.  Prior to joining Cochlear in January of 2010, Shawn provided surgical training and support in the Orthopedic industry for DePuy Mitek and Stryker.

Kelly Crettol, Surgical Education Manager at Cochlear Americas

Previously, she was a RSTM for the West Region and has been with Cochlear since February 2016. In her new role, Kelly is responsible for the development and execution of Cochlear’s surgical and fellowship education programs which includes development of educational content, implementation, promotion and assessment of surgical education programs.  She is also responsible for the coordination and collaboration with both internal colleagues and professional partners, including KOLs.

Kelly has over twelve years of experience in pharmaceutical and medical devices sales from prior organizations. Kelly graduated from Pennsylvania State University with a B.S. in Psychology.

 

References:
  1. den Besten CA, Stalfors J, Wigren S, Blechert JI, Flynn M, Eeg-Olofsson M, Aggarwal R, Green K, Nelissen RC, Mylanus EA, Hol MK. Stability, Survival, and Tolerability of an Auditory Osseointegrated Implant for Bone Conduction Hearing: Long-Term Follow-Up of a Randomized Controlled Trial. Otol Neurotol. 2016;37(8):1077-1083.
  2. Sennerby L, Gottlow J, Rosengren A, Flynn M. An experimental evaluation of a new craniofacial implant using the rabbit tibia model: Part II. Biomechanical findings. Otol Neurotol. 2010;31(5):840-845.
  3. van Hoof M, Wigren S, Duimel H, Savelkoul PH, Flynn M, Stokroos RJ. Can the Hydroxyapatite-Coated Skin-Penetrating Abutment for Bone Conduction Hearing Implants Integrate with the Surrounding Skin? Front Surg. 2015;2:45.
  4. Iseri M, Orhan KS, Yariktas MH, Kara A, Durgut M, Ceylan DS, Guldiken Y, Keskin IG, Deger K. Surgical and audiological evaluation of the Baha BA400. J Laryngol Otol. 2015;129(1):32-37.
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