Bonebridge – nový aktivní implantabilní systém pro přímé kostní vedení.
|Title in English||Bonebridge – The New Active Direct-drive Bone Conduction Hearing Implant.|
|Year of publication||2018|
|Type||Article in Periodical|
|Magazine / Source||Otorhinolaryngologie a foniatrie|
|MU Faculty or unit|
|Keywords||bone conduction hearing; conductive hearing loss; mixed hearing loss; single sided deafness; Bonebridge; bone conduction implants|
|Description||Objective Implantable systems for direct bone conduction have been designed for patients with conductive or mixed hearing loss for whom other treatments (e.g. conventional airway hearing aids) do not bring a sufficient benefit or are contraindicated. The aim of the work is to present the first experience with a new active implantable system for direct bone conduction – BonebridgeTM. Material and methodology Bonebridge is the first system for direct bone conduction using an active implant through which vibrations are felt inside the temporal bone. The system consists of an external audioprocessor and internal bone implant. The implanted part is composed of a receiving coil, a demodulator and source of vibrations (a transducer). The transducer is implanted into the bone bed and fixed by two cortical screws. It is a 15.8mm-diameter cylinder with a height of 8.7mm. Preoperatively, HRCT of the temporal bone is typically performed and special software is used to create a 3D model of the operating field. The operator is thus able to accurately determine the safe placement of the implant with respect to surrounding anatomical structures. The basic surgical approach is transmastoid implantation. A retrosigmoid approach is alternatively chosen in the case of unfavourable anatomical conditions. Results At our site, this active implant for direct bone conduction, Bonebridge, was used in four patients from 2014 to 2017. The first implantation of the BB system in the Czech Republic was performed in August 2014, in a patient with congenital complete atresia of the auditory canals due to Treacher-Collins syndrome. Other cases included a patient with acquired atresia of the auditory canals, a patient after repeated reconstructions of the inner ear system, and a patient with chronic mesotympal otitis and recurrent otorrhoea, for whom all options of remedial surgical treatment had been exhausted. The transmastoid and retrosigmoid approach was used in three patients and one patient, respectively. No complications occurred in any of the presented patients. All of them report a very good result in daily communication and use an external audioprocessor throughout the day. In all cases, patients show very good subjective satisfaction with the outcomes of their treatments and significant improvement in their audiological parameters compared to their states before implantation. Conclusion The direct bone conduction with an active implant system, Bonebridge, is a modern, patient-friendly, audiologically effective, and safe treatment method that eliminates some of the shortcomings of previous BAHDs.|