Profound Mixed Hearing Loss: Bone-Anchored Hearing Aid System or Cochlear Implant?

• Published in: Annals of otology, rhinology & laryngology Vol. 118; no. 10; pp. 693 - 697
• Main Authors: Verhaegen, Veronique J. O., Mulder, Jef J. S., Mylanus, Emmanuel A. M., Cremers, W. R. J., Snik, Ad F. M.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.10.2009; Annals Publishing Compagny; SAGE PUBLICATIONS, INC
• Subjects: Aged; Audiometry, Pure-Tone; Biological and medical sciences; Bone Conduction - physiology; Cochlear Implants; Disease Progression; Diseases of the ear; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Ent and stomatology; Hearing Aids; Hearing Loss, Mixed Conductive-Sensorineural - surgery; Hearing Loss, Mixed Conductive-Sensorineural - therapy; Humans; Male; Medical sciences; Middle Aged; Non tumoral diseases; Otorhinolaryngology. Stomatology; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Speech Perception - physiology; Speech Reception Threshold Test; Suture Anchors; profound mixed hearing loss; indication criterion; cochlear implant; bone-anchored hearing aid; Mixed hearing loss; Indication; Auditory disorder; Instrumentation therapy; ENT; Auditive prosthesis; Hearing; Criterion; Cochlear implant; ENT disease
• ISSN: 0003-4894; 1943-572X
• DOI: 10.1177/000348940911801002

Objectives: We evaluated 5 patients who were changed over from a Baha Cordelle to a cochlear implant (CI). Moreover, the level of phoneme score was determined at which a Baha Cordelle user was better helped with a CI. Methods: We offer descriptive case reports and a retrospective evaluation of speech recognition in Baha Cordelle users and CI users. Results: In the CI users with noncompromised cochleas, the 10th percentile of the aided phoneme score in quiet at 65 dB sound pressure level (PS65) was 42%. We consider this PS65 as the cutoff level for switching from a Baha Cordelle to a CI. When patients with mixed hearing loss were using the Baha Cordelle, the PS65 of 42% was obtained at a mean sensorineural hearing loss component of about 70 dB hearing level (HL). This 70–dB HL component was used to consider Baha Cordelle users for cochlear implantation. The results of the 5 patients support these transition criteria. Conclusions: A CI is a valuable option in patients with mixed hearing loss when the sensorineural hearing loss component exceeds 70 dB HL or when the PS65 with a Baha Cordelle is less than about 40%. In such patients, the implantation procedure should be individualized on the basis of the clinical findings in the middle ear and mastoid cavity.