Background:
Subjecting hearing implants to magnetic resonance imaging (MRI) scanning poses several potential challenges, such as torque, demagnetisation and heating. The aim of this preclinical study was to investigate the compatibility of the Sentio Ti Implant (Oticon Medical AB, Sweden) to 1.5T MRI.

Materials:
The implant consists of an electromagnetic transducer and antenna with a retention magnet. The retention magnet is enclosed in a titanium casing which is welded to the transducer casing via a titanium reinforcement wire. The assembly is then encapsulated by a hardened silicone overmould. The system was evaluated according to standards to determine the effect of the static and gradient fields on torque, magnet dislocation, demagnetisation and heat generation. In addition, experimental tests with artificial skin and a calibrated Mooney-Rivlin computational model were used to determine the antenna deformation, skin deformation, and skin pressure distribution during 1.5 T MRI.

Results:
The maximum worst-case pressure from the antenna deformation was 36 kPa. In comparison, the in vivo pressure pain threshold (PPT) is minimum 282 kPa. However, the sensation of pressure is highly directional and data shows that the sensors for pressure detection reduce their sensitivity when the pressure direction is reversed, thereby doubling the in vivo PPTs for pressure from the inside, resulting in a pressure pain perception safety factor of 16x.
Conclusion:

This preclinical study demonstrated that the Sentio Ti implant is 1.5T MR conditional without need for bandaging. In conclusion, a preclinical study demonstrated that the Sentio Ti implant is 1.5T MR conditional without need for bandaging.

Background:
Serious complications in BAHA surgery are rare. This is a case report of a patient who developed an intraparenchymal cerebral haemorrhage.
A female patient aged 78, with a history of bilateral CSOM (cholesteatoma), for which she had undergone multiple mastoid and middle ear operations, continued with recurrent ear infections and hearing loss, was found to be a suitable candidate for a left BAHA, scoring 76% @ 50dB, on bone conduction speech discrimination.

Methods:
BAHA surgery without soft tissue reduction was performed. The bone structure was different (harder to drill, needing 50Ncm). The sigmoid sinus was breached and was sealed with a 4mm fixture and 9mm abutment. Immediate post-operative period was uneventful and patient discharged in a couple of hours from DSU.
The following day, the patient started to notice mild confusion and was unable to express herself clearly, which got progressively worse and presented to the Stroke clinic, with expressive and nominal dysphasia. A CT Head showed an Intraparenchymal parietal lobe bleed (2.4 by 2.1 cms), adjacent to the BAHA fixture. Neurosurgeons advised conservative treatment.

Results:
The patient made steady recovery, with the dysphasia resolving completely in ten days. She was extremely pleased when fitted with the BAHA at 6 weeks.

Conclusion:
This rare complication following BAHA surgery, is hard to explain. The multiple previous mastoid operation with altered anatomy could be a warning sign and an indicator to be extra vigilant and cautious during surgery.

Background: Active transcutaneous bone conduction implants (aTBCI) are indicated for individuals with conductive/mixed hearing loss or single sided deafness. In contrast to percutaneous devices they are allow the skin to remain intact and the internally implanted component actively trasmits the vibrations conferring an advantage over transcutaneous passive devices. In the UK three devices are available; BonebridgeTM (Med-El, Innsbruck, Austria), the Osia® (Cochlear BAS, Gothenburg, Sweden) and Sentio Ti (Oticon Medical).  Data from systematic reviews of two devices has demonstrated high patient satisfaction and good safety profiles however there is a paucity of data directly comparing these three devices.(1,2)

Methods: Retrospective patient notes assessment was undertaken from patients with an aTBCI at the Queen Elizabeth Hospital in Birmingham between the dates of 2013 and 2025.

Results: We present data for a series of 52 patients implanted with BonebridgeTM (n=9), Osia® (n=33) and Sentio Ti (n=10) between the dates of 2013 and 2025. We present data for device usage and patient reported outcomes including Glasow benefit inventory scale as well as the safety profile of the devices.

Conclusion: There is a paucity of data for the direct comparison between active transcutaneous bone conduction implants. This is a single centre series highlighting outcomes from each of these devices.

Background: Bone conduction implants are essential devices for enhancing auditory perception in patients with conductive or mixed hearing loss, particularly when conventional hearing aids fail to meet their needs. The advancement of bone conduction technology has led to improved patient outcomes and quality of life.
Methods: This case series presents two case reports detailing the transition from unilateral BAHA Attract® and bilateral BAHA Connect® systems to bilateral Osia® implants. These transitions address the significant limitations of traditional BAHA systems, such as skin complications and sound attenuation. The transition involved careful planning and assessment, ensuring that the new Osia® implants were suitable for their individual auditory profiles.
Results: Case 1 (unilateral attract to simultaneous bilateral Osia®) showed an aided average 4PTA thresholds of 48 dB and 44 dB for the right and left ears respectively. For case 2 (bilateral BAHA connect to sequential bilateral Osia®), the aided average 4PTA is 26 dB and 25 dB for the right and left ears respectively. Both cases post-implantation evaluations indicated a marked improvement in auditory performance and overall satisfaction.
Conclusions: The transition from unilateral Baha devices to bilateral Osia® implants represents a promising therapeutic option for individuals with conductive hearing loss. The case studies presented herein highlight the potential benefits of this approach, including improved hearing outcomes and enhanced quality of life. As technology continues to evolve, it is anticipated that Osia® implants will play an increasingly important role in the management of hearing loss.

BACKGROUND: This study aimed to evaluate patient satisfaction and usage patterns of bone conduction devices (BCDs) for hearing rehabilita-
tion, focusing on both users and non-users. Specific objectives included assessing reasons for non-use, exploring patient perceptions of BCD
efficacy, and examining complications associated with BCD implantation.
METHODS: A monocentric investigation was conducted at the Department of Ear, Nose, and Throat Diseases, Head and Neck Surgery at XXX.
Patients who underwent BCD implantation between 2009 and 2020 were included. A questionnaire based on the International Outcome
Inventory for Hearing Aids (IOI-HA) was administered to assess patient satisfaction. Additional questions were added to explore reasons for non-
use and interest in alternative devices. Data analysis included descriptive statistics and chi-square tests to compare outcomes between groups.
RESULTS: Among 76 respondents, the majority expressed high satisfaction with their BCDs, reporting significant improvements in daily life and
quality of hearing. The non-user rate was 8.9%, primarily attributed to perceived lack of benefit or skin problems. Complications requiring explan-
tation were rare (3.4%). Single-sided deafness (SSD) and non-SSD patients exhibited similar satisfaction levels, but SSD patients reported higher
non-use due to insufficient hearing benefits. Patients expressed interest (29.6%) in more advanced BCDs.
CONCLUSION: This study highlights the overall positive impact of BCDs on patient satisfaction and quality of life. Personalized care, informed
decision-making, and rigorous preoperative evaluation are crucial in achieving favorable outcomes. Technological advancements offer promising
opportunities for further enhancing BCD efficacy, underscoring the importance of ongoing research and innovation in hearing rehabilitation.