Background:
The ASIST is a novel, non-invasive device that measures implant stability by analyzing the vibration response of the implant system. Clinically, infections, bone resorption, and bone defects may occur around BAHS implants. Previous studies found that ASIST is sensitive to changes in the density of material around the implant and changes in bone volume in the direction of measurement for dental applications. Objectives of the study were to (i) evaluate ASIST in BAHS and assess its sensitivity to variations in polyurethane foam defects around the implants, and (ii) evaluate the primary stability of several clinically used BAHS implants in polyurethane foam of varying densities and defect levels.

Methods:
Four types of BAHS implants (Ponto BHX 3mm & 4mm, Acorn C4.0, and COH BI300 4mm) were implanted, using their respective surgical protocols, into three densities of polyurethane foam blocks. The primary stabilities of each implantation were measured through insertion torque, Implant Stability Quotient), ASIST Stability Coefficient (ASC), and max pull-out force. Implants were installed in two types of defects (unilateral and circumferential) with different depths (0.3, 0.6, and 0.9 mm) and ISQ and ASC were determined in each quadrant.

Results:
Detailed primary stability data, as well as significance and correlation results, were obtained and will be presented.
Conclusions: This study was the first to evaluate the sensitivity of ASIST to bone defects. It also evaluated the effect of different geometries of BAHS implants on primary stabilities.

Background:
Limited Usable Hearing Unilaterally (LUHU) significantly impacts patients’ auditory perception, communication, and overall quality of life. Implantable hearing devices, such as Cochlear Implants (CI) and Bonebridge (BB), are emerging interventions for restoring auditory functionality. However, their specific roles, benefits, and clinical applications require further investigation to guide effective decision-making.
Methods:
LUHU cases received CI or BB implantation by our team were enrolled. Comprehensive evaluations were conducted pre- and postoperatively, including pure-tone audiometry, sound-field audiometry, word recognition tests, binaural effect assessments, and subjective benefit questionnaires.
Results:
A total of 8 cases were recruited. Of the 7 CI patients, 2 had temporal bone trauma, 2 had cochlear nerve deficiency (CND), 2 had congenital SSD, and 1 had sudden hearing loss. The BB case had microtia. All cases showed much better sound-field performance and word recognition score compared to their results with hearing aids. Those with trauma-induced injuries demonstrated the best word recognition performance, while CND cases had the poorest outcomes. The BB recipient also performed better compared to performance with bone-conduction hearing aids. All cases obtained significant subjective benefit improvement after surgery.
Conclusion:
Clinical approaches to managing LUHU remain diverse and debated. However, for cases of SNHL, if the auditory deprivation period is short, hearing aids benefits are insufficient, CI is recommended. For cases of conductive hearing loss that cannot be resolved through surgery, where BCHA is effective, BB is considered as a viable solution, especially for single-sided microtia.

Background: Bone-conduction hearing aids can be chosen for single-sided deafness (SSD) patients as a method of auditory rehabilitation. Some SSD patients suffer from tinnitus. In this study, the effectiveness of the bone-conduction implant in tinnitus reduction was investigated.
Methods: This investigation was part of a prospective multicenter study involving 15 institutions. The Bonebridge® BCI 602 was implanted in 30 recruited participants. Of these, 19 reported tinnitus distress preoperatively. Subjects underwent audiologic evaluation and tinnitogram, and completed the Abbreviated Profile of Hearing Aid Benefit (APHAB), Bern Benefit in Single-Sided Deafness (BBSS), and Tinnitus Handicap Inventory (THI) questionnaires before and three months after device activation.
Results:The average age of 19 subjects with tinnitus was 47.6±14.8 years. In 13 of 19 subjects with tinnitus, tinnitus could be matched in tinnitogram. Among these 13 subjects, 11 (84.6%) showed the decrease in the loudness level. Significant changes were identified in the THI; it decreased from 47.4±30.1 to 31.1±27.0 (P<0.001). However, in three subjects, the THI scores increased rather than decreased, and all three subjects showed no residual hearing at 250, 2000, and 4000 Hz. THI scores significantly decreased after device activation in subjects with residual hearing (p = 0.011), whereas the reduction was not statistically significant in those with total deafness (p = 0.271). Nineteen patients with tinnitus showed significantly lower scores, particularly in the 'reverberation', 'background noise', and 'aversiveness' subscales at 3 months.
Conclusion: Active bone-conduction implant improves hearing and subjective satisfaction, and may reduce tinnitus in SSD patients, especially those with residual hearing.

Background:
Sensorineural hearing loss (SNHL) is a common sensory disorder with a significant Mendelian genetic component. Despite comprehensive genetic testing like exome sequencing, about 50% of SNHL cases remain genetically unresolved. The role of whole-genome sequencing (WGS) in diagnosing these unresolved cases is not well established. This study aims to assess the diagnostic and clinical value of WGS in SNHL.

Methods:
We investigated the genetic basis of SNHL in 394 families and 746 individuals, including probands (183, 46.2% male; median age 13, range 0-76) and their relatives. Initially, we achieved a complete genetic diagnosis in 220 families (55.86%) using standard genetic tests. For cases still undiagnosed, WGS was performed on 120 patients (both syndromic and a subset of nonsyndromic SNHL) selected through a stratified sampling approach.

Results:
WGS identified causal variants in 24 of the 120 families (20.0%). Notably, 14 of these (11.7%) included deep intronic variants, small structural variants, and complex genomic rearrangements that were not detectable with previous methods. WGS proved most beneficial for patients with specific features such as early onset, syndromic characteristics, and those analyzed through trio-based WGS.

Conclusion:
This study demonstrates that WGS can enhance the diagnostic yield for SNHL by approximately 12% beyond what is achieved with exome sequencing and other techniques. It confirms the clinical utility of WGS in diagnosing SNHL and highlights its potential in advancing precision medicine by providing a detailed genome-phenome landscape and uncovering genotype-phenotype correlations.

Background:
This purpose of this study is to assess the outcome of paediatric patients implanted with cochlear Osia as there is still a limited data available in the paediatric cohort, particularly in children with syndromes.

Methods:
A retrospective case review with ongoing prospective data collection between March 2022 to April 2024. Both surgical and audiological (by utilising CHILD Questionnaire) outcomes were reviewed.

Results:
14 patients were included and 18 OSIA inserted in total. The median age was 11.5 (7-15 years). Hearing loss cases included microtia, canal atresia/ stenosis, unknown cause conductive hearing loss, conductive hearing loss with background of Down’s syndrome and cholesteatoma and unilateral sensorineural hearing loss.
The outcomes from this study include both learning points for surgical considerations, surgical and audiological outcomes. In term of surgical considerations, consideration for patients with microtia, previous craniofacial surgery and variations in bone quality would allow appropriate placement for future reconstruction, anticipate possible complications (such as pre-existing drill holes from previous craniofacial surgery) and alteration of location to area with better bone quality. In term go audiological outcome, the pre-operative and post-operative CHILD questionnaire mean was 5 and 6.75 respectively. 1 patient had difficulty with wind noises and extra programmes were added (awaiting result at next review) and 1 microtia patient underwent removal of OSIA due to traumatic wound dehiscence.

Conclusion:
Current data suggests overall improvement in hearing and patient satisfaction. Surgical consideration learning points can be learnt as more OSIA is being inserted. Complications can happen in the form of surgical and audiological complications.

Background:

This study investigated hearing performance and overall satisfaction with Oticon Medical’s Ponto Sound Processors when used on a non-surgical softband in a pediatric population.

Methods:

An online survey was completed by the parents or primary caregivers of pediatric Ponto and softband users. Three questionnaires were utilized: The Parent's Evaluation of Aural Performance of Children (PEACH) to evaluate hearing performance in quiet and noisy listening situations; The Glasgow Children's Benefit Inventory (GCBI) to evaluate quality of life impacts across several life domains; and a softband-specific questionnaire to gather feedback in terms of usability, general comfort, and overall satisfaction.

Results:

Parents of 64 softband users, aged 4 months to 17 years, participated. Most respondents were highly satisfied with their child’s Ponto (77%) and with the softband (56%) overall.
Good hearing performance was reported, measured by the PEACH, with a mean total score of 76%, on a scale of 0-100% where higher scores indicate better performance. Likewise, parents reported positive quality of life impacts, measured by the GCBI, with a mean score of +38, on a scale of -100 to +100, where scores above 0 indicate positive benefit.

Conclusion:

The PEACH and GCBI revealed Ponto sound processors used on a non-surgical, softband solution had positive impacts on performance and quality of life, corroborating high satisfaction reports.

Taken together, these data from a wide age range of users can be taken as a representative picture of the perceived benefits of using Ponto sound processors on a softband solution in a pediatric population.