Who are typical candidates for bone anchored systems, including the new Ponto system from Oticon Medical?
Audiological indications for Ponto Pro and Ponto sound processors include patients with cnductive or mixed hearing loss, where the bone conduction pure tone average (PTA) in the better ear is better than 45 dB HL. Studies indicate that patients with an air-bone gap of more than 30 dB (PTA) will benefit significantly from a bone anchored sound processor as compared to a traditional air conduction hearing aid (Mylanus, van der Pouw,& Cremers, 1998). In addition, patients with a profound sensorineural hearing loss in one ear and normal hearing in the opposite ear (also known as Single Sided Deafness, or SSD) may be suitable candidates for a bone anchored sound processor. In this case, the sound processor is placed on the poorer ear, and transfers sound to the functioning cochlea. The air conduction PTA for the hearing ear should be better than 20 dB HL.
An additional recommended criterion includes a maximum speech discrimination score better than 60%, however, an individual evaluation must always be made based on the patient's specific needs.
Who are the patients presenting with these audiological criteria? They may be those with chronically draining ears (external otitis, draining otitis media and radically operated ears) where conventional hearing aids aggravate infection or cause feedback problems, poor wearing comfort or poor sound quality. They may be patients with skin allergies where an earmold aggravates problems, or patients with congenital malformations where ear canals are absent and cannot be restored through conventional surgery. Other medical conditions that may present with audiological criteria described above include patients with: ear canal stenosis or previous ear surgery which makes an ear mold unsuitable;conductive hearing loss due to ossicular disease that cannot be satisfactorily rectified by surgical correction or conventional hearing aids;unilateral sensorineural deafness caused by acoustic neuroma surgery, infection or other factors.
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Mylanus EA, van der Pouw KC, Snik AF, Cremers CW. Intraindividual comparison of the bone-anchored hearing aid and aid-conduction hearing aids. Archives of Otolaryngology-Head & Neck Surgery 1998;(3):271-6.
Teri Sinopoli is an experienced professional in the hearing medical device field with 20 years of clinical, technical, sales and training support. Her background includes cochlear implants and tinnitus rehabilitation, but her greatest fulfillment has been her work in the field of auditory osseointegrated implants. She is now happily engaged as Oticon Medical's Western Clinical Manager where she provides clinical, training, and technical support for the Ponto System as well as management of U.S. clinical studies.