Hearing aids in otology
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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

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Hearing Aids in Otology

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Hearing aids in otology

Hearing Aids in Otology

Dr. Jerry Halik FRCSC

Assistant Professor University of Toronto


Hearing aids in otology

  • “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

Expectations of Ear Surgery


Result of hearing gain in ear surgery

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 surgery1

Result of Hearing gain in Ear Surgery

  • Mastoid Surgery

    - 25% Post op SRT <30 dB


Ossiculoplasty

Ossiculoplasty


Ossiculoplasty results

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

Stapes Surgery Goals

  • No Aid

  • No Aid Aid

  • Large Aid Small Aid


Stapes surgery

Stapes Surgery


Stapes surgery result

Stapes Surgery Result

N=135Avg A-B gap closure (Post op air minus pre-op bone)


Stapes surgery result1

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

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

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

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

Why Hearing Aids

Critical for Communication

  • Development speech & Language

  • Education

  • Employment

  • Quality of life


Impact of auditory deprivation

Impact of Auditory Deprivation

  • Problems fitting aids

  • Sometimes permanent effects


Hearing aids

Hearing Aids

  • “ Offering a Solution no One Wants”

  • Otologist- Role of Educator


Conventional hearing aids

Conventional Hearing Aids

  • Analogue Vs Digital

  • “Noise Management”

  • Clarity


Implantable hearing aid

Implantable Hearing Aid

  • Magnet (Implantable)& Electromagnetic Driver

  • Piezo-electrode


Hearing aids in otology

BAHA


Uses for baha

Uses for BAHA

  • Unable to wear conventional Aid in suitable candidate

  • Unilateral complete SNHL (Vs transcranial fitting conventional aid)


Cochlear implants

Cochlear Implants


Summary

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


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