119 4.2 Longitudinal study of use of ADHEAR 1. Introduction The application of the adhesive bone conducting hearing aid device (ADHEAR MED-EL, Austria) has grown in popularity since its intro- duction in 2015. Multiple centres now demonstrate audiological and quality of life indicator improvements as compared to conventional alternative hearing aid options including functional gain in word recognition score by up to 30% [1]. In paediatric studies, statistically significant gains in speech audiometry with babble noise and hearing thresholds were improved as compared to unaided thresholds. This was demonstrated in children with both sensorineural (6.34 dB HL p = 0.027) and conductive hearing loss (13.29 dB HL P = 0.008) [2]. When compared to conventional softband hearing aids, the adhesive device demonstrated a 7.3 dB HL advantage in free field thresholds [3j as well as functional gains of 5.7 dB [4]. Speech understanding in noise and in multiple streams, sound localization and sound quality were rated significantly better with the adhesive device as compared to softband [5]. In the adult population audiological comparisons to implanted passive bone conducting devices (Baha® Attract) [6] demonstrated comparable hearing benefits with the adhesive hearing system where the mean aided thresholds and speech understanding in quiet, and noise were similar. In patients with single sided deafness, a randomized crossover study comparing the application of a contralateral routing of signals (CROS) hearing aids, 70% of included subjects reported that the adhesive hearing system was partially useful or better [7]. Non-surgical transcutaneous hearing systems provide a simple and effective solution for both a unilateral and bilateral CHL. Although audiologically effective, subjective patient feedback particularly in children highlights poorer compliance with headbands due to concerns about the aesthetics. This can be a significant deterrent for older children with self-perception issues and concerns about integrating with their peers. Additionally, the retention pressure by headbands may produce some complications, more discomfort and limitations in daily usage [8]. With the bone conduction headband options, migration of the sound processor from its optimal position reduces its audiological efficacy [9]. It also increases artifacts by movement over the patient’s own hair. Often the position of the processor can ‘slip’ and be far from the mastoid process and therefore the cochlea. This becomes more pronounced for those children requiring glasses or those with an unusual shaped skull as seen with some craniofacial conditions. The development and application of an adhesive bone conducting aid overcomes many of these issues in the paediatric population due to its lightweight construction, optimal positioning and adhesive “nonpressure” retention. The removal of an obvious headband improves selfconfidence which ultimately improves compliance with the device demonstrated by a 53% increase in median daily wearing times from 4.3hrs to 8.1hrs [10].
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