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Bonebridge – The New Active Direct-drive Bone Conduction Hearing Implant


Authors: B. Gál;  T. Talach;  M. Veselý;  J. Rottenberg;  P. Urbánková;  P. Smilek;  R. Kostřica;  J. Hložek
Authors‘ workplace: Klinika otorinolaryngologie a chirurgie hlavy a krku, Lékařská fakulta Masarykovy univerzity a Fakultní nemocnice u sv. Anny v Brně
Published in: Otorinolaryngol Foniatr, 67, 2018, No. 2, pp. 50-55.
Category: Original Article

Overview

Objective:

Implantable systems for direct bone conduction have been designed for patients with conductive or mixed hearing loss for whom other treatments do not bring a sufficient benefit or are contraindicated. The objective of this article 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 by which vibrations are generated 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. Preoperatively, HRCT of the temporal bone is typically performed and special software is used to create a 3D model of the operating field. The surgeon is thus able to ensure a safe placement of the implant with preservation surrounding anatomical structures. The first-choice surgical approach is transmastoid implantation. A retrosigmoid approach is alternatively chosen in case of difficult anatomy.  

Results:

Bonebridge, was used in four patients between 2014 and 2017. The first implantation of the Bonebridge system in the Czech Republic was performed in August 2014, in a patient with Treacher-Collins syndrome. Other cases included a patient with acquired atresia of the auditory canals, a patient after repeated middle ear reconstructions, and a patient with chronic mesotympanic otitis and recurrent otorrhoea, for whom there were no other surgical options. The transmastoid approach was used in three whereas the retrosigmoid in one patient. No complications occurred in any of the patients. All patients report very good effect in everyday communication, as well as significant improvement in audiology results. 

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 other passive implantable systems.

Keywords:

bone conduction hearing, conductive hearing loss, mixed hearing loss, single sided deafness, Bonebridge, bone conduction implant


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Audiology Paediatric ENT ENT (Otorhinolaryngology)
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