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Hearing Aids in Otology

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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  1. Hearing Aids in Otology Dr. Jerry Halik FRCSC Assistant Professor University of Toronto

  2. “Only 5% of patients seen for hearing loss may benefit from surgery” John Shea MD

  3. Surgeon Safe Eradicate Disease Dry Function Patient Dry Function Safe Eradicate Disease Expectations of Ear Surgery

  4. 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)

  5. Result of Hearing gain in Ear Surgery • Mastoid Surgery - 25% Post op SRT <30 dB

  6. Ossiculoplasty

  7. 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)

  8. Stapes Surgery Goals • No Aid • No Aid Aid • Large Aid Small Aid

  9. Stapes Surgery

  10. Stapes Surgery Result N=135Avg A-B gap closure (Post op air minus pre-op bone)

  11. Stapes Surgery Result • Post-op SRT< 30dB=111 • Pre-op possible SRT<30db=107 • %Improvement=111/107 (103%) (Raut, Halik 2002)

  12. 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)

  13. Time to Hearing Aids Post Stapedectomy (Aided at 40 dB Level) • Large Fenestra – 13 Years • Small Fenestra – 21 Years (Smyth, Hassard; 1986)

  14. 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

  15. Why Hearing Aids Critical for Communication • Development speech & Language • Education • Employment • Quality of life

  16. Impact of Auditory Deprivation • Problems fitting aids • Sometimes permanent effects

  17. Hearing Aids • “ Offering a Solution no One Wants” • Otologist- Role of Educator

  18. Conventional Hearing Aids • Analogue Vs Digital • “Noise Management” • Clarity

  19. Implantable Hearing Aid • Magnet (Implantable)& Electromagnetic Driver • Piezo-electrode

  20. BAHA

  21. Uses for BAHA • Unable to wear conventional Aid in suitable candidate • Unilateral complete SNHL (Vs transcranial fitting conventional aid)

  22. Cochlear Implants

  23. 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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