How Can I Complete a Pre-op Evaluation to Assess Benefit with Ponto?

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When first identifying potential candidates, we have our pre-op evaluation. Let's talk about a couple of things that we can as audiologists include in our assessment for the patient trial, and then we'll talk about some objective and subjective measures.

Having access to a pre-op trial helps facilitate informed decisions and engage the patient in a lifetime decision. Just like we demo in trial hearing aids, we want to make sure someone who's undergoing surgery has access to that opportunity as well. For our single-sided patients, it is essential to have a trial on a softband or a headband in their daily situation for at least a week. These are the patients that are unsure of what kind of expected benefits they're going to get. We want to ensure that they have this lived experience of bone-anchored, and there are a couple of ways to do that if they don't want to wear a softband. We also have a hard headband that they could wear. The test band would most likely be used in the office and looks just like your bone conduction headband when we're talking about testing pre-operatively in our booth. We know that we're going to have some skin attenuation. They haven't had surgery yet, so it may be more beneficial for you to use a SuperPower processor during your eval, even if that's not what they're going to be fit with and show them the size of the Ponto 4, or test both.

For a bone-anchored system, there are just a few steps before you go to your fine-tuning:

• The first step is performing a feedback calibration and running our bone conduction in situ measurements through the processor.  
• Then we'll recalculate and use that fitted prescription to do some aided word recognition in quiet and noise.
• Aided sound field measurements, maybe not as practical for the patient, but to see that effective and functional gain. Just keep in mind that your booth set up, what you're using as your test signal, how the sound processor is set, patient's seating can affect those aided sound field measurements.
• Then we have questionnaires, whatever you're using for your hearing aid patients, just some way to assess benefit and satisfaction pre and post-fitting, so that the patient see that they are having a significant benefit when they're using the device and where they are so we know how to counsel. 

This Ask the Expert is an excerpt from The Ponto System: Assessing Candidacy & Completing Pre-operative Evaluation of Bone Anchored Hearing Systems. For more information, visit oticonmedical.com/us or visit Oticon Medical's Partner Page on AudiologyOnline.