Introduction. The retrosigmoidal (RS) placement of the Bonebridge system (BB) has been advocated for cases of unfavourable anatomical or clinical conditions which contraindi-cate transmastoid-presigmoidal positioning. However, these disadvantageous conditions, combined with the considerable dimensions of the implant, may represent a challenge, especially for surgeons with no skull base experience. Moreover, the literature reports only limited experience concerning RS implantation of the BB system. Methods. A multicentre, retrospective study was conducted to analyse the surgical and functional outcomes of a wide population of patients undergoing RS placement of the BB system by means of a surgical technique specifically developed to overcome the intraopera-tive issues related to this surgery. Twenty patients with conductive or mixed hearing loss and single sided deafness were submitted to RS implantation of the BB system. Results. Audiological assessment concerning the measurement of the functional and effective gain by pure-tone audiometry (28 dB HL and-12.25 dB HL, respectively) and speech audiometry (24.7 dB HL and-21 dB HL, respectively) was conducted. A high overall sub-jective improvement of quality of life was recorded with the Glasgow Benefit Inventory questionnaire. No major complications, such as device extrusions or other conditions re-quiring revision surgery, were reported during the follow-up period (median: 42 months). Conclusions. In our study, which has one of the largest cohort of patients reported in the literature, RS placement of the BB system was safe and effective. Our functional results showed comparable hearing outcomes with presigmoidal placement. The effective gain, rarely investigated in this field, may be the object of further research to improve our under-standing of bone conduction mechanisms exploited by bone conduction hearing implants.

Retrosigmoidal placement of an active transcutaneous bone conduction implant: Surgical and audiological perspectives in a multicentre study

Canzi P.;Avato I.;Aprile F.;Malpede S.;Scribante A.;Manfrin M.;Benazzo M.
2021-01-01

Abstract

Introduction. The retrosigmoidal (RS) placement of the Bonebridge system (BB) has been advocated for cases of unfavourable anatomical or clinical conditions which contraindi-cate transmastoid-presigmoidal positioning. However, these disadvantageous conditions, combined with the considerable dimensions of the implant, may represent a challenge, especially for surgeons with no skull base experience. Moreover, the literature reports only limited experience concerning RS implantation of the BB system. Methods. A multicentre, retrospective study was conducted to analyse the surgical and functional outcomes of a wide population of patients undergoing RS placement of the BB system by means of a surgical technique specifically developed to overcome the intraopera-tive issues related to this surgery. Twenty patients with conductive or mixed hearing loss and single sided deafness were submitted to RS implantation of the BB system. Results. Audiological assessment concerning the measurement of the functional and effective gain by pure-tone audiometry (28 dB HL and-12.25 dB HL, respectively) and speech audiometry (24.7 dB HL and-21 dB HL, respectively) was conducted. A high overall sub-jective improvement of quality of life was recorded with the Glasgow Benefit Inventory questionnaire. No major complications, such as device extrusions or other conditions re-quiring revision surgery, were reported during the follow-up period (median: 42 months). Conclusions. In our study, which has one of the largest cohort of patients reported in the literature, RS placement of the BB system was safe and effective. Our functional results showed comparable hearing outcomes with presigmoidal placement. The effective gain, rarely investigated in this field, may be the object of further research to improve our under-standing of bone conduction mechanisms exploited by bone conduction hearing implants.
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11571/1469253
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 3
  • ???jsp.display-item.citation.isi??? 3
social impact