Implantierbare Hörsysteme

Zusammenfassung

In den letzten Jahren hat sich die kombinierte Schwerhörigkeit als wesentliche Indikation für implantierbare Hörsysteme herauskristallisiert. In Abhängig von der Knochenleitungshörschwelle stehen verschiedene Optionen zur Verfügung: Patienten mit geringgradiger sensorineuraler Schwerhörigkeit profitieren in der Regel von transkutanen BCI, während die perkutanen BCI-Systeme ihre Vorteile im Übergangsbereich zu mittelgradigem Hörverlust ausspielen. Für kombinierte Hörverluste mit ausgeprägtem mittelgradigem und hochgradigem cochleärem Hörverlust schließlich bietet sich die Versorgung mit aktiven Mittelohrimplantaten an. Bei der Sekundärversorgung von Patienten mit Unverträglichkeiten oder Operationen des Mittelohrs sind diese Implantate eine wertvolle und bewährte Ergänzung des therapeutischen Arsenals.

Abstract

Combined hearing loss is an essential indication for implantable hearing systems. Depending on the bone conduction threshold, various options are available: Patients with mild sensorineural deafness usually benefit from transcutaneous BCI, while percutaneous BCI systems are recommended also for moderate hearing loss. For combined hearing loss with moderate and high-grade cochlear hearing loss, active middle ear implants are recommended. For patients with incompatibilities or middle ear surgery, implants are a valuable and proven addition to the therapeutic options.

Schlüsselwörter

Hörminderung, - Hörstörung, - Mittelohrimplantat, - Aktive Mittelohrimplantate, - Vollimplantierbare Systeme, - Teilimplantierbare Systeme, - Knochenleitungsimplantate, - Passive Systeme, - Aktive perkutane Systeme, - Aktive transkutane Systeme

Key words

Hearing loss, - Hearing disorder, - Middle ear implant - Active middle ear implant, - Fully implantable systems, - Partially implantable systems, - Bone conduction implants, - Passive systems, - Active percutaneous systems - Active transcutaneous systems

• Literatur

• 1 http://de.statista.com/statistik/daten/studie/71443/umfrage/hoergeminderte-und-hoergeraete-versorgung-in-deutschland/Abgerufen am 9. September 2016
• 2 Löhler J, Akcicek B, Wollenberg B. et al. Umsetzung der neuen Qualitätssicherungsvereinbarung zur Hörgeräteversorgung im Praxisalltag. HNO 2014; 62: 605-612
• 3 AWMF-Leitlinie: Aktive, implantierbare Hörsysteme bei Hörstörungen; Registernummer: 17/073; Klasse: S1; Version: 04/2010. Abgerufen am 9. September 2016
• 4 Zenner HP. Innenohrschwerhörigkeit: Elektronische Hörimplantate zur operativen Behandlung. Dtsch Ärztebl 2001; 98: A169-A174
• 5 Colletti V, Soli S, Carner M. et al. Treatment of mixed hearing losses via implantation of a vibratory transducer on the round window. Int J Audiol 2006; 45: 600-608
• 6 Huber A, Ball G, Veraguth D. et al. A new implantable middle ear hearing device for mixed hearing loss: A feasibility study in human temporal. Otol Neurotol 2006; 27: 1104-1109
• 7 Wollenberg B, Beltrame M, Schönweiler R. et al. Integration des aktiven Mittelohrimplantates in die plastische Ohrmuschelrekonstruktion. HNO 2007; 55: 349-356
• 8 Krause E. Implantierbare Hörsysteme – Wegweiser für die richtige Auswahl. HNO-Nachrichten 2014; 44: 15-18
• 9 Wilska A. Eine Methode zur Bestimmung der Hörschwellenamplituden des Trommelfells bei verschiedenen Frequenzen. Skand Arch Physiol 1935; 72: 161-165
• 10 Rutschmann J. Magnetic audition – auditory stimulation by means of alternating magnetic fields acting on a permanent magnet fixed to the eardrum. IRE Trans Med Electron 1959; 6: 22-23
• 11 Fredrickson JM, Tomlinson D, Davis E. Evaluation of an electromagnetic implantable hearing aid. Can J Otolaryngol 1973; 2: 53-62
• 12 Goode RL, Glattke TJ. Audition via electromagnetic induction. Arch Otolaryngol 1973; 98: 23-26
• 13 Heide H, Tatge G, Sander T. et al. Development of a semi-implantable hearing device. In: Suzuki I, Hoke M. (editors) Middle Ear Implant: Implantable Hearing Aids. Basel: Karger; 1988: 32-43
• 14 Maniglia AJ, Ko WH, Rosenbaum M. et al. Contactless semi-implantable electromagnetic middle ear device for the treatment of sensorineural hearing loss. Short-term and long-term animal experiments. Otolaryngol Clin North Am 1995; 28: 121-140
• 15 Maniglia AJ, Ko WH, Garverick SL. et al. Semi-implantable middle ear electromagnetic hearing device for sensorineural hearing loss. Ear Nose Throat J 1997; 76: 333-341
• 16 McGee TM, Kartush JM, Heide JC. et al. Electromagnetic semi-implantable hearing device: phase I. Clinical trials. Laryngoscope 1991; 101: 355-360
• 17 Caye-Thomasen P, Jensen JH, Bonding P. et al. Long-term results and experience with the first-generation semi-implantable electromagnetic hearing aid with ossicular replacement device for mixed hearing loss. Otol Neurotol 2002; 23: 904-911
• 18 Dumon T, Zennaro O, Aran JM. et al. Piezoelectric middle ear implant preserving the ossicular chain. Otolaryngol Clin North Am 1995; 28: 173-187
• 19 Hüttenbrink KB, Zahnert TH, Bornitz M. et al. Biomechanical aspects in implantable microphones and hearing aids and development of a concept with a hydroacoustical transmission. Acta Otolaryngol 2001; 121: 185-189
• 20 Goll E, Dalhoff E, Gummer AW. et al. Concept and evaluation of an endaurally insertable middle-ear implant. Med Eng Phys 2013; 35: 532-536
• 21 Perkins R. Earlens tympanic contact transducer: a new method of sound transduction to the human ear. Otolaryngol Head Neck Surg 1996; 114: 720-728
• 22 Perkins R, Fay JP, Rucker P. et al. The EarLens system: new sound transduction methods. Hear Res 2010; 263: 104-113
• 23 Ball GR. The Vibrant Soundbridge: design and development. Adv Otorhinolaryngol 2010; 69: 1-13
• 24 Branemark PI, Breine U, Adell R. et al. Intraosseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg 1969; 3: 81-100
• 25 Magnan J, Manrique M, Dillier N. et al. International consensus on middle ear implants. Acta Otolaryngol 2005; 125: 920-921
• 26 Zenner HP. Implantierbare Hörgeräte ̶ aktueller Stand. In: Jahnke K. (ed.) Middle Ear Surgery. Stuttgart: Thieme; 2000: 141-161
• 27 Hüttenbrink KB. Current status and critical reflections on implantable hearing aids. Am J Otol 1999; 20: 409-415
• 28 Stieger C, Wackerlin D, Bernhard H. et al. Computer assisted optimization of an electromagnetic transducer design for implantable hearing aids. Comput Biol Med 2004; 34: 141-152
• 29 Javel E, Grant IL, Kroll K. In vivo characterization of piezoelectric transducers for implantable hearing AIDS. Otol Neurotol 2003; 24: 784-795
• 30 Zenner HP, Leysieffer H, Maassen M. et al. Human studies of a piezoelectric transducer and a microphone for a totally implantable electronic hearing device. Am J Otol 2000; 21: 196-204
• 31 Beutner D, Hüttenbrink KB. Passive und aktive Mittelohrimplantate. Laryngol Rhinol Otol 2009; 88 (Suppl. 01) S32-S47
• 32 Maurer J. Vollimplantierbare Hörsysteme. HNO 2009; 57: 199-207
• 33 Bruschini L, Forli F, Passetti S. et al. Fully implantable Otologics MET Carina device for the treatment of sensorineural and mixed hearing loss: Audio-otological results. Acta Otolaryngol 2010; 130: 1147-1153
• 34 Martin C, Deveze A, Richard C. et al. European results with totally implantable carina placed on the round window: 2-year follow-up. Otol Neurotol 2009; 30: 1196-1203
• 35 Jenkins HA, Atkins JS, Horlbeck D. et al. Otologics fully implantable hearing system: Phase I trial 1-year results. Otol Neurotol 2008; 29: 534-541
• 36 Jenkins HA, Niparko JK, Slattery WH. et al. Otologics middle ear transducer ossicular stimulator: performance results with varying degrees of sensorineural hearing loss. Acta Otolaryngol 2004; 124: 391-394
• 37 Tringali S, Pergola N, Berger P. et al. Fully implantable hearing device with transducer on the round window as a treatment of mixed hearing loss. Auris Nasus Larynx 2009; 36: 353-358
• 38 Bruschini L, Forli F, Santoro A. et al. Fully implantable Otologics MET Carina device for the treatment of sensorineural hearing loss. Preliminary surgical and clinical results. Acta Otorhinolaryngol Ital 2009; 29: 79-85
• 39 Lefebvre PP, Martin C, Dubreuil C. et al. A pilot study of the safety and performance of the Otologics fully implantable hearing device: transducing sounds via the round window membrane to the inner ear. Audiol Neurotol 2009; 14: 172-180
• 40 Pulcherio JOB, Bittencourt AG, Burke PR. et al. Carina and Esteem: a systematic review of fully implantable hearing devices. PLoS One 2014; 9: e110636
• 41 Kam AC, Sung JK, Yu JK. et al. Clinical evaluation of a fully implantable hearing device in six patients with mixed and sensorineural hearing loss: our experience. Clin Otolaryngol 2012; 37: 240-244
• 42 Zenner HP, Rodriguez JJ. Totally implantable active middle ear implants: ten years’ experience at the University of Tübingen. Adv Otorhinolaryngol 2010; 69: 72-84
• 43 Deveze A, Rameh C, Sanjuan M. et al. A middle ear implant with a titanium canal wall prosthesis for a case of an open mastoid cavity. Auris Nasus Larynx 2010; 37: 631-635
• 44 Rodriguez JJ, Pfister M, Zenner HP. et al. In vitro model for intraoperative adjustments in an implantable hearing aid (MET). Laryngoscope 2006; 116: 473-481
• 45 Sweeney A. et al. The Envoy Esteem Hearing Implant. In: Makekar G. (ed.) Implantable Hearing Devices other than Cochlear Implants. Springer; 2014: 85-95
• 46 FDA – Esteem Implantable Hearing System. http://www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials/medicaldevices/medicaldevicesadvisorycommittee/earnoseandthroatdevicespanel/ucm194431.pdf.Abgerufen 24. September 2016
• 47 Chen DA, Backous DD, Arriaga MA. et al. Phase 1 clinical trial results of the Envoy System: a totally implantable middle ear device for sensorineural hearing loss. Otolaryngol Head Neck Surg 2004; 131: 904-916
• 48 Kraus EM, Shohet JA, Catalano PJ. Envoy Esteem Totally Implantable Hearing System: phase 2 trial, 1-year hearing results. Otolaryngol Head Neck Surg 2011; 145: 100-109
• 49 Monini S, Biagini M, Atturo F, Barbara M. et al. Esteem middle ear device versus conventional hearing aids for rehabilitation of bilateral sensorineural hearing loss. Eur Arch Otorhinolaryngol 2013; 270: 2027-2033
• 50 Barbara M, Biagini M, Monini S. The totally implantable middle ear device “Esteem” for rehabilitation of severe sensorineuralhearing loss. Acta Otolaryngol 2011; 131: 399-404
• 51 Gerard JM, Thill MP, Chantrain G. et al. Esteem 2 middle ear implant: our experience. Audiol Neurotol 2012; 17: 267-274
• 52 Pelosi S, Carlson ML, Glasscock ME. Implantable Hearing Devices: The Ototronix MAXUM System. Otolaryngol Clin North Am 2014; 47: 953-965
• 53 Dyer Jr. RK, Dormer KJ, Hough JV. et al. Biomechanical influences of magnetic resonance imaging on the SOUNDTEC Direct System implant. Otolaryngol Head Neck Surg 2002; 127: 520-530
• 54 Hough JV, Dyer RK, Glasscock ME. Surgeon’s manual, Maxum system. Houston; Ototronix, LLC 2012
• 55 Hough JV, Matthews P, Wood MW. et al. Middle ear electromagnetic semiimplantable hearing device: results of the phase II SOUNDTEC direct system clinical trial. Otol Neurotol 2002; 23: 895-903
• 56 Roland PS, Shoup AG, Shea MC. et al. Verification of improved patient outcomes with a partially implantable hearing aid, the SOUNDTEC direct hearing system. Laryngoscope 2001; 111: 1682-1686
• 57 Silverstein H, Atkins J, Thompson Jr JH. et al. Experience with the SOUNDTEC implantable hearing aid. Otol Neurotol 2005; 26: 211-217
• 58 Braun K, Zenner HP, Friese N. et al. Differenzialindikation aktiver Mittelohrimplantate. HNO 2015; 63: 402-418
• 59 Siegert R, Mattheis S, Kasic J. Fully implantable hearing aids in patients with congenital auricular atresia. Laryngoscope 2007; 117: 336-340
• 60 Venail F, Lavieille JP, Meller R. et al. New perspectives for middle ear implants: first results in otosclerosis with mixed hearing loss. Laryngoscope 2007; 117: 552-555
• 61 Kontorinis G, Lenarz T, Schwab B. Anatomic limitations in implantation of middle ear transducer and carina middle ear implants. Laryngoscope 2010; 120: 2289-2293
• 62 Jenkins HA, Niparko JK, Slattery WH. et al. Otologics Middle Ear Transducer Ossicular Stimulator: Performance results with varying degrees of sensorineural hearing loss. Acta Oto-Laryngologica 2004; 124: 391-394
• 63 Jenkins HA, Atkins JS, Horlbeck D. et al. U.S. Phase I preliminary results of use of the Otologics MET Fully Implantable Ossicular Stimulator. Otolaryngol – Head Neck Surg 2007; 137: 206-212
• 64 Jenkins HA, Uhler K. Otologics active middle earimplants. Otolaryngol Clin N Am 2014; 47: 967-978
• 65 Verhaegen VJO, Mylanus EAM, Cremers CWRJ. et al. Audiological application criteria for implantable hearing aid devices: a clinical experience at the Nijmegen ORL Clinic. Laryngoscope 2008; 118: 1645-1649
• 66 Lenarz T, Schwab B, Maier H. et al. Direct acoustic cochlear stimulation for therapy of severe to profound mixed hearing loss: Codacs Direct Acoustic Cochlear Implant System. HNO 2014; 62: 481-489
• 67 Häusler R, Stieger C, Bernhard H. et al. A novel implantable hearing system with direct acoustic cochlear stimulation. Audiol Neuro-Otol 2008; 13: 247-256
• 68 Lenarz T, Verhaert N, Desloovere C. et al. A comparative study on speech in noise understanding with a direct acoustic cochlear implant in subjects with severe to profound mixed hearing loss. Audiol Neuro-Otol 2014; 19: 164-174
• 69 Yanagihara N, Gyo K, Hinohira Y. Partially implantable hearing aid using piezoelectric ceramic ossicular vibrator. Results of the implant operation and assessment of the hearing afforded by the device. Otolaryngol Clin North Am 1995; 28: 85-97
• 70 Yanagihara N, Hidemitu S, Hinohira Y. et al. Long-term results using a Piezoelectric semi-implantable middle ear hearing device. The Rion Device E-Type Otolaryngol Clin North Am 2001; 34: 389-400
• 71 Komori M, Yanagihara N, Hinohira Y. et al. Long-term results with the Rion E-type semi-implantable hearing aid. Otolaryngol – Head Neck Surg 2010; 143: 422-428
• 72 Komori M, Yanagihara N, Hinohira Y. et al. Re-implantation of the Rion E-type semi-implantable hearing aid: Status of long-term use and hearing outcomes in eight patients. Auris Nasus Larynx 2012; 39: 572-576
• 73 Zenner HP, Leysieffer H. Total implantation of the Implex TICA hearing amplifier implant for high frequency sensorineural hearing loss: the Tubingen University experience. Otolaryngol Clin North Am 2001; 34: 417-46
• 74 Carlson ML, Pelosi S, Haynes DS. Historical Development of Active Middle Ear Implants. Otolaryngol Clin North Am 2014; 47: 893-914
• 75 Leysieffer H, Baumann J, Mayer R. et al. Ein vollständig implantierbares Hörsystem für Innenohrschwerhörige TICA LZ 3001. HNO 1998; 46: 853-863
• 76 Zenner H, Maassen M, Plinkert P. et al. Erste Implantation eines völlig implantierbaren elektronischen Hörsystems bei Patienten mit Innenohrschwerhörigkeit. HNO 1998; 46: 844-852
• 77 Zenner HP, Limberger A, Baumann JW. et al. Phase III results with a totally implantable piezoelectric middle ear implant: speech audiometry, spatial hearing and psychosocial adjustment. Acta Otolaryngol 2004; 124: 155-164
• 78 Luers JC, Beutner D, Hüttenbrink KB. Implantierbare Hörgeräte. HNO 2011; 59: 980-987
• 79 Baumgartner WD, Boheim K, Hagen R. et al. The vibrant soundbridge for conductive and mixed hearing losses: European multicenter study results. Adv Otorhinolaryngol 2010; 69: 38-50
• 80 Labassi S, Beliaeff M. Retrospective of 1000 patients implanted with a vibrant Soundbridge middle-ear implant. Cochlear Implants Int 2005; 6 (Suppl. 01) 74-77
• 81 Ball GR. The Vibrant Soundbridge. Design and Development Adv Otorhinolaryngol 2010; 69: 1-13
• 82 Dumon T. Vibrant soundbridge middle ear implant in otosclerosis: technique – indication. Adv Otorhinolaryngol 2007; 65: 320-322
• 83 Huber AM, Ball GR, Veraguth D. et al. A new implantable middle ear hearing device for mixed hearing loss: A feasibility study in human temporal bones. Otol Neurotol 2006; 27: 1104-1109
• 84 Hüttenbrink KB, Zahnert T, Bornitz M. et al. TORP-vibroplasty: a new alternative for the chronically disabled middle ear. Otol Neurotol 2008; 29: 965-971
• 85 Beutner D, Hüttenbrink KB. Passive und aktive Mittelohrimplantate. Laryngol Rhinol Otol 2009; 88 (Suppl. 01) S32-S47
• 86 Kahue CN, Carlson ML, Daugherty JA. et al. Middle Ear Implants for Rehabilitation of Sensorineural Hearing Loss: A Systematic Review of FDA Approved Devices. Otol Neurotol 2014; 35: 1228-1237
• 87 Verhaert N, Desloovere C, Wouters J. Acoustic Hearing Implants for Mixed Hearing Loss: A Systematic Review. Otol Neurotol 2013; 34: 1201-1209
• 88 Klein K, Nardelli A, Stafinski T. A Systematic Review of the Safety and Effectiveness of the Vibrant Soundbridge. J Otol Rhinol 2013; 2: 1-6
• 89 Luetje CM, Brackman D, Balkany TJ. et al. Phase III clinical trial results with the Vibrant Soundbridge implantable middle ear hearing device: a prospective controlled multicenter study. Otolaryngol Head Neck Surg 2002; 126: 97-107
• 90 Cremers CW, O‘Connor AF, Helms J. et al. International consensus on Vibrant Soundbridge implantation in children and adolescents. Int J Pediatr Otorhinolaryngol 2010; 74: 1267-1269
• 91 Counter P. Implantable hearing aids. Proc Inst Mech Eng H 2008; 222: 837-852
• 92 Pok SM, Schlogel M, Boheim K. Clinical experience with the active middle ear implant Vibrant Soundbridge in sensorineural hearing loss. Adv Oto-Rhino-Laryngol 2010; 69: 51-58
• 93 Mosnier I, Sterkers O, Bouccara D. et al. Benefit of the Vibrant Soundbridge device in patients implanted for 5 to 8 years. Ear Hear 2008; 29: 281-284
• 94 Beltrame AM, Todt I, Sprinzl G. et al. Consensus Statement on Round Window Vibroplasty. Otol Rhinol Laryngol 2014;
• 95 Skarzynski H, Olszewski L, Skarzynski PH. et al. A Direct round window stimulation with the Med-El Vibrant Soundbridge: 5 years of experience using a technique without interposed fascia. Eur Arch Otorhinolaryngol 2014; 271: 477-482
• 96 Colletti L, Mandala M, Colletti V. Long-term outcome of round window vibrant soundbridge implantation in extensive ossicular chain defects. Otolaryngol Head Neck Surg 2013; 149: 134-141
• 97 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: 834-841
• 98 Mankekar G. Bone conducting implant devices. In: Mankekar G. Implantable Hearing Devices other than Cochlear Implants. Springer; 2014: 41-69
• 99 Reinfeldt S, Hakansson B, Taghavi H. et al. New developments in bone-conduction hearing implants: a review. Med Devices (Auckl) 2015; 8: 79-93
• 100 Iseri M, Orhan KS, Kara A. et al. A new transcutaneous bone anchored hearing device – the Baha Attract System: the first experience in Turkey. Kulak Burun Bogaz Ihtis Derg 2014; 24: 59-64
• 101 Kurz A, Flynn M, Caversaccio M. et al. Speech understanding with a new implant technology: a comparative study with a new nonskin penetrating baha system. Biomed Res Int 2014;
• 102 Gawęcki W, Stieler OM, Balcerowiak A. et al. Surgical, functional and audiological evaluation of new Baha Attract system implantations. Eur Arch Otorhinolaryngol 2016; 273: 3123-3130
• 103 Siegert R, Kanderske J. A new semi-implantable transcutaneous bone conduction device: clinical, surgical, and audiologic outcomes in patients with congenital ear canal atresia. Otol Neurotol 2013; 34: 927-934
• 104 Siegert R. Magnetic coupling of partially implantable bone conduction hearing aids without open implants. Laryngorhinootol 2010; 89: 346-351
• 105 Sylvester DC, Gardner R, Reilly PG. et al. Audiologic and surgical outcomes of a novel, nonpercutaneous, bone conducting hearing implant. Otol Neurotol 2013; 34: 922-926
• 106 Federspil PA, Koch U, Schneider MH. et al. Perkutane Titanimplantate für Knochenleitungshörgeräte. HNO 2014; 62: 490-497
• 107 Snik AF, Mylanus EA, Proops DW. et al. Consensus statements on the Baha system: where do we stand at present?. Ann Otol Rhinol Laryngol 2005; 114: 1-12
• 108 Hol MK, Snik AF, Mylanus EA. et al. Long-term results of bone-anchored hearing aid recipients who had previously used air-conduction hearing aids. Archives of Otolaryngol Head Neck Surg 2005; 131: 321-325
• 109 McDermott AL, Dutt SN, Reid AP. et al. An intra-individual comparison of the previous conventional hearing aid with the bone-anchored hearing aid: The Nijmegen group questionnaire. J Laryngol Otol 2002; 116 (Suppl. 28) 15-19
• 110 De Wolf MJ, Hedrix S, Cremers CW. et al. Better performance with bone anchored hearing aid than acoustic devices in patients with severe air-bone gap. Laryngoscope 2011; 121: 613-616
• 111 Flynn MC, Sammeth CA, Sadeghi A. et al. Baha for single-sided Sensorineural Deafness: Review and Recent Technological Innovations. Semin Hear 2010; 31: 326-349
• 112 Kunst SJW, Hol MKS, Snik AFM. et al. Baha in patients with acquired and congenital unilateral inner ear deafness (Baha CROS): clinical evaluation of 56 cases. Ann Otol Rhinol Laryngol 2010; 119: 447-454
• 113 Pai I, Kelleher C, Nunn T. et al. Outcome of bone anchored hearing aids for single-sided deafness: A prospective study. Acta Otolaryngol 2012; 132: 751-755
• 114 Tjellström A, Hakansson B. The bone-anchored hearing aid. Design principles, indications, and long-term clinical results. Otolaryngol Clin North Am 1995; 28: 53-72
• 115 Kurz A, Caversaccio M, Kompis M. Hearing performance with 2 different high-power sound processors for osseointegrated auditory implants. Otol Neurotol 2013; 34: 604-610
• 116 Desmet JBJ, Bosman AJ, Snik AFM. et al. Comparison of sound processing strategies for osseointegrated bone conduction implants in mixed hearing loss: multiple-channel nonlinear versus single-channel linear processing. Otol Neurotol 2013; 34: 598-603
• 117 Kompis M, Kurz A, Pfiffner F. et al. Is complex signal processing for bone conduction hearing aids useful?. Cochlear Implants Int 2014; 15 (Suppl. 01) 47-50
• 118 Iseri M, Orhan KS, Tuncer U. et al. Transcutaneous bone-anchored Hearing Aids Versus Percutaneous Ones: Multicenter Comparative Clinical Study. Otol Neurotol 2015; 36: 849-853
• 119 Dun CAJ, Faber HT, de Wolf MJF. et al. Assessment of more than 1 000 implanted percutaneous bone conduction devices: skin reactions and implant survival. Otol Neurotol 2012; 33: 192-198
• 120 Nelissen RC, Mylanus EAM, Cremers CWRJ. et al. Long-term compliance and satisfaction with percutaneous bone conduction Devices in Patients With Congenital Unilateral Conductive Hearing Loss. Otol Neurotol 2015; 36: 826-833
• 121 Smith TJ, Galm A, Chatterjee S. et al. Modulation of the soft tissue reactions to percutaneous orthopaedic implants. J Orthop Res 2006; 24: 1377-1383
• 122 Husseman J, Szudek J, Monksfield P. et al. Simplified bone-anchored hearing aid insertion using a linear incision without soft tissue reduction. J Laryngol Otol 2013; 127 (Suppl. 02) S33-S38
• 123 Lanis A, Hultcrantz M. Percutaneous osseointegrated implant surgery without skin thinning in children: a retrospective case review. Otol Neurotol 2013; 34: 715-722
• 124 Granström G. Osseointegrated implants in children. Acta Otolaryngol 2000; 543: 118-121
• 125 Zeitoun H, De R, Thompson S. et al. Osseointegrated implants in the management of childhood ear abnormalities: with particular emphasis on complications. J Laryngol Otol 2002; 116: 87-91
• 126 Westbrook JL.The Ponto System and benefits of percutaneous BAHS. Audiology. Online 2015; Article 15188. Retrieved from http://www.audiologyonline.com
• 127 Olsen SO, Glad H, Nielsen LH. Comparison of two bone anchored hearing instruments: BP100 and Ponto Pro. Int J Audiol 2011; 50: 920-928
• 128 Taghavi H, Hakansson B, Reinfeldt S. et al. Technical design of a new bone conduction implant (BCI) system. Int J Audiol 2015; 54: 736-744
• 129 Reinfeldt S, Hakansson B, Taghavi H. et al. The bone conduction implant: Clinical results of the first six patients. Int J Audiol 2015; 54: 408-416
• 130 Eeg-Olofsson M, Hakansson B, Reinfeldt S. et al. The bone conduction implant – first implantation, surgical and audiologic aspects. J. Otol Neurotol 2014; 35: 679-685
• 131 Zernotti ME, Sarasty AB. Active bone conduction prosthesis: bonebridge. Int Arch Otorhinolaryngol 2015; 19: 343-348
• 132 Sprinzl G, Lenarz T, Ernst A. et al. First European multicenter results with a new transcutaneous bone conduction hearing implant system: Short-term safety and efficacy. Otol Neurotol 2013; 34: 1076-1083
• 133 Barbara M, Perotti M, Gioia B. et al. Transcutaneous bone-conduction hearing device: audiological and surgical aspects in a first series of patients with mixed hearing loss. Acta Otolaryngol 2013; 133: 1058-1064
• 134 Manrique M, Sanhueza I, Manrique R. A new bone conduction implant: surgical technique and results. Neurotol 2014; 35: 216-220
• 135 Plontke SK, Radetzki F, Seiwerth I. et al. Individual computer-assisted 3d planning for surgical placement of a new bone conduction hearing device. Otol Neurotol 2014; 35: 1251-1257
• 136 Ihler F, Volbers L, Blum J. et al. Preliminary functional results and quality of life after implantation of a new bone conduction hearing device in patients with conductive and mixed hearing loss. Otol Neurotol 2014; 35: 211-215
• 137 Riss D, Arnoldner C, Baumgartner WD. et al. Indication criteria and outcomes with the Bonebridge transcutaneous bone-conduction implant. Laryngoscope 2014; 124: 2802-2806
• 138 Schmerber S, Deguine O, Marx M. et al. Safety and effectiveness of the Bonebridge transcutaneous active direct-drive bone-conduction hearing implant at 1-year device use. Europ Arch Oto-Rhino-Laryng 2016; 273: 1-17
• 139 Hobson JC, Roper AJ, Andrew R. et al. Complications of bone-anchored hearing aid implantation. J Laryngol Otol 2010; 124: 132-136