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Have you ever heard of bone-anchored hearing implants? These surgical implants have multiple benefits.

But how do we know that bone-anchored implants work?

How do we know that any of our treatment options work?

The answer: research.

Stay with us as we go over the history and science of bone-anchored implants.

Research and Hearing Treatment: Bone-anchored Implants

First, let’s talk about hearing treatments and research.

Like most advancements in science, successful hearing treatment started with research.

Similar to today, methods need to be proven.

It’s up to researchers needed to show that different treatments work. People agree to adopt new ways of doing things after there is sufficient evidence.

Studies like this are how medicine improves and new practices emerge.

The success of bone-anchored implants is no different.

Proving that bone-anchored hearing aids work

Next, we go over how researchers proved bone-anchored hearing aids worked.

Researchers needed to evaluate the effectiveness of bone-anchored hearing aid implants. They needed to prove that bone-anchored hearing aids worked. To do this, they compared the benefits of implants to the advantages of reconstructive surgery.

The scientists specifically focused on treatment benefits for children and adolescents.

Hearing Defects in Children and Speech

First, let’s talk about the importance of hearing in children. You may not know this, but hearing and language development are related to one another.

Some children are born with hearing defects. When children have hearing defects, it can impact their lives. This is part of why advancing science for this population is so important.

Children unable to hear early on in their lives can suffer speech delays.

Importantly, children with unidentified hearing loss receive less exposure to language at a critical time in their lives. Children may suffer delays with developmental milestones when hearing loss is not identified.

While there are many diseases causing hearing defects, we focus on aural atresia in this article.

Aural Atresia and Hearing Loss

Have you ever heard of Aural Atresia?

If you answered no, don’t worry. Many people haven’t.

We break it down for you in simple terms.

Defining Aural Atresia

Aural atresia is a congenital birth defect. It results in a deformed outer ear and middle ear.

Aural Atresia affects many children. On average, it affects one in 10,000-20,000 kids a year.  That’s a lot of kids!

Unfortunately, aural atresia can cause complications in speech development.

To advance science and hearing treatments, researchers examined the quality of life of children treated.

The study sought to determine whether congenital aural atresia is better addressed with ear canal surgery or by a bone-anchored hearing aid.

Treatment Options for The Hearing Impaired:

A Look at Hearing Treatment Over Time

Lastly, we get to the meat of things: treatment.

Treatment options for the hearing impaired have a long and windy scientific history. Like much of historical medicine, treatment options were limited. Doctors used what they knew at the time.

With less known in the past, treatment options were often unusual and ineffective. For example, you may remember how leeches were often used as a remedy for sickness in the past!

We would never allow such a thing today. It would be considered archaic!

Why would medical practitioners never turn to old treatments in a modern medical setting? Because there are better-proven options out there.

Similarly, hearing treatments of the past weren’t always the most practical.

Today, thanks to research and science, we have many effective hearing treatment options. That means you no longer have to worry about a doctor giving you leaches to cure your illness.

To understand the advancement in hearing treatment, we first have to look backward in time.

Reconstructive Surgery vs. Bone-anchored Hearing Aids

Let’s rewind history back to the 1800s.

Reconstructive Surgery in the 1800s

In 1883, reconstructive surgery for the disease was first attempted. That’s a long time ago!

As you might guess, thing’s didn’t go exactly as planned. Such is the way with many old experiments. Unfortunately, the results were less than promising.

Complications from Reconstructive Hearing Surgery

Patients suffered complications from reconstructive surgery. These complications included facial nerve paralysis and continuous bouts of hearing loss.

As you can imagine, this treatment option wasn’t widely accepted, given the risks. After all, facial nerve paralysis is a scary complication.

Can you imagine having surgery to address your hearing loss and ending up with some form of paralysis? It was a tough consequence to stomach for most. This was especially true for those who still had hearing loss following their surgeries.

The 1900s and Hearing Treatment Options

In 1977, almost 100 years later, Bone-anchored hearing aids were invented.

Bone-anchored hearing aids were considered a huge scientific advancement and success. They came with much fewer complications.

Treating Hearing Loss With Bone-Anchored Hearing Aids

So, how do Bone-anchored hearing aids work?

Don’t worry – we’ll keep things easy for you.

The process can be broken down into a few basic parts.

First, bone-anchored hearing aids involve anchoring a titanium screw into the mastoid process of the skull. You can see part of the mechanism. In fact, the external piece protrudes from the skin.

Additionally, a removable hearing aid is attached and detached from the external piece. There’s some flexibility with this. Some people appreciate the control it provides.

Bone-anchored hearing aid wearers can take the hearing aid in and out as they wish.

Of course, sound must communicate with the brain to work.

Sound and Bone-anchored Implants

So how does sound communicate with an implant?

Now you’re asking the right questions.

The bone-anchoring process relies on sound waves channeled from the hearing aid to the vestibulocochlear nerve. The nerve is essential. The hearing aid is embedded in the skull.

Then, the titanium screw acts as a medium. That’s right! A screw that goes into your skull!

This screw is special. It has an important job. It relays the external signal past the surface of the skull.

The entire process relies on osseointegration.

Understand Osseointegration in Bone-anchored Implants

Have you heard of osseointegration before?

For many people, the answer is no. It isn’t a word you use every day.

Like many medical terms, it might seem intimidating. Don’t be fooled though.

Osseointegration is a relatively simple concept.

It’s a term used to indicate that the implant is applied to the bone. The idea is to incorporate the implant into the regenerating bone tissue.

How cool is that?

Procedures and Complications with Bone-anchored Hearing Aids

At this point, you may be wondering: how did the children in the study fare?

Well, let’s first look at the test group composition itself.

The test group consisted of children diagnosed with aural atresia or stenosis. Both diagnoses were allowed in the study given their similar implications.

In total, nineteen children received a bone-anchored hearing aid. The remaining children – 49 in total – received external auditory canal reconstruction. More children received reconstruction treatment than the hearing aid implant.

Determining Whether Bone-anchored Hearing Aids Worked

Hearing examinations were administered to analyze treatment success. Children took the hearing tests at specific points in their post-treatment journey.

First, children received short-term hearing examinations less than six months after surgery.

Then, to test whether the treatment remained effective, children took hearing examinations again. Next, long-term hearing tests were completed more than a year after surgery.

That’s quite a bit of time!

Evaluating Quality of Life

As mentioned, researchers tested the quality of the patients’ post-op hearing experience. To do this, they used a questionnaire. Scientists wanted to understand if patients thought their lives were better after receiving treatment.

The hearing exams also looked at whether the procedures had adverse effects. If children were struggling, the questionnaire would identify that. If the children were doing well, the questionnaire would act as proof.

The Success of Bone-anchored Hearing Implants

In both the short-term and long-term examinations, the group with bone-anchored hearing aids performed marginally better. Their scores surpassed the group with external auditory canal reconstruction.

How’s that for a good outcome?

We’ll take it!

Overall, the study was a great victory for science! The researchers were elated.

Bone-anchored hearing aids were now a good option to treat hearing impairment. It was a remarkable time in history.

Quality of Life for Bone-anchored Implants and Surgical Treatment

Using the questionnaire, researchers concluded there wasn’t a significant difference in the quality of life for either group of patients.

Don’t get confused here. You’re right if you remember that the scores were higher for individuals with implants. That being said, the scores weren’t much better for those with implants.

The difference in scores between both groups wasn’t significant enough. They were too close overall! Therefore, the study did not prove one treatment option was better than the other when it comes to QOL.

The best part?

Neither group suffered severe complications during or after surgery. The patients were all okay. Of course, that’s an ideal outcome for any medical study.

Both treatments were considered a success!

To many, the results indicate that bone-anchored hearing aid appear a more suitable choice. The reason for this comes down to audiometric performance. Bone-anchored hearing implants boast superior audiometric performance.

by Aaron Rodriques: Updated in 2022 by Kim Smith