Hearing Aids in Otology
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Hearing Aids in Otology Dr. Jerry Halik FRCSC Assistant Professor University of Toronto
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Hearing Aids in Otology. Dr. Jerry Halik FRCSC Assistant Professor University of Toronto. “Only 5% of patients seen for hearing loss may benefit from surgery” John Shea MD. Surgeon Safe Eradicate Disease Dry Function. Patient Dry Function Safe - PowerPoint PPT Presentation
Transcript of Hearing Aids in Otology
Hearing Aids in Otology
Dr. Jerry Halik FRCSCAssistant Professor University of Toronto
“Only 5% of patients seen for hearing loss may benefit from surgery”
John Shea MD
Expectations of Ear Surgery
Surgeon Safe Eradicate Disease Dry Function
Patient Dry Function Safe Eradicate Disease
Result of Hearing gain in Ear Surgery
Tympanoplasty Long term result at 11 years
- 81% closed Perforations - 9% Atelectatic pocket Formation 74% Normal Healed TM (Halik, Smyth; 1988)
Result of Hearing gain in Ear Surgery
Mastoid Surgery - 25% Post op SRT <30 dB
Ossiculoplasty
Ossiculoplasty Results
TORP/ PORP- 25% SRT < 31 dB 4/12 patients
Assemblies – 57% SRT <31 Db 58/102 patients
Follow up – Up to 6 years (average 2 years)
Stapes Surgery Goals
1. No Aid2. No Aid Aid3. Large Aid Small Aid
Stapes Surgery
Stapes Surgery ResultN=135
Avg A-B gap closure (Post op air minus pre-op bone)
A-B gap 0.5,1,2 KHz 0.5,1,2,4 KHz
< 10dB 118/135(87.4%)
107/135(79.3%)
<20dB 13/135(9.6%)
24/135(17.7%)
>20dB 4/135(3%) 4/135(3%)
Stapes Surgery Result
Post-op SRT< 30dB=111
Pre-op possible SRT<30db=107
%Improvement=111/107 (103%)(Raut, Halik 2002)
Post Stapes Chronic Progressive SNHL
Large Fenestra – 9.5 dB / 10 Years
Small Fenestra- 3.2 dB / 10 Years (<0.4 mm)
(Smyth, Hassard; 1986)
Time to Hearing Aids Post Stapedectomy
(Aided at 40 dB Level) Large Fenestra – 13 Years
Small Fenestra – 21 Years
(Smyth, Hassard; 1986)
Demographics of Hearing Loss Year 2000 in USA
29 Million Hearing Impaired(10%)
5.6 Million Hearing Aid Users (1/5)
Over 6 Million Age 45-54 with significant hearing loss
Why Hearing Aids
Critical for Communication Development speech & Language Education Employment Quality of life
Impact of Auditory Deprivation
Problems fitting aids
Sometimes permanent effects
Hearing Aids
“ Offering a Solution no One Wants”
Otologist- Role of Educator
Conventional Hearing Aids
Analogue Vs Digital
“Noise Management”
Clarity
Implantable Hearing Aid
Magnet (Implantable)& Electromagnetic Driver
Piezo-electrode
BAHA
Uses for BAHA
1. Unable to wear conventional Aid in suitable candidate
2. Unilateral complete SNHL (Vs transcranial fitting conventional aid)
Cochlear Implants
Summary …
Be realistic of surgical results especially long term
Greater role for hearing aids on surgical patients over time
Vast majority of patients not Surgical
