Middle ear implants (MEIs) such as VSB® (Vibrant soundbridge), BB® (Bonebridge) and the BAHA® (Bone-anchored hearing aid) osseointegrated implant for bone conduction are attractive and alternative treatments for patients with conductive, sensorineural or mixed hearing loss who do not benefit from, or who choose not to wear, conventional hearing aids (HAs). Recent studies have suggested that MEIs and BAHA can provide better improvements in functional gain, speech perception and quality of life than HAs, while some definite risks associated with the surgery should be taken into consideration, including bleeding, wound infections, facial nerve or chorda tympanic nerve damage, dysfunction of the middle or inner ear, and the future risk of device failure/explantation. Furthermore, some types of MEI may involve restricted access to MRI scans. In the future, it is likely that there will be an increasing population even in Japan that will meet the new criteria for these implantable hearing devices. However, the long-term efficacy and safety of these devices should be established.
Epidemiological investigation of congenital unilateral hearing loss has become possible with the spread of newborn hearing screening. We clarified the incidence of congenital unilateral hearing loss in newborns and their background using the hearing-impaired child support system of Miyazaki Prefecture. Of 35,095 babies born in Miyazaki Prefecture between January 2010 and December 2012, 36 (0.10%) had congenital bilateral hearing loss and 30 (0.09%) had congenital unilateral hearing loss. Complications were noted in 17 children (47%) with bilateral hearing loss and 17 children (57%) with unilateral hearing loss. The complication was developmental retardation in 15 children (42%) with bilateral hearing loss, while it was malformation of the head-and-neck region in 11 children (37%) with unilateral hearing loss. Among children with sensorineural hearing loss, bilateral hearing loss was noted in 31 (0.09%), whereas unilateral hearing loss was noted in only 17 (0.05%), about half the number ; severe unilateral sensorineural hearing loss, i.e., unilateral deafness, was noted in 11 (0.03%) of these 17 children. In conclusion, the incidences of bilateral and unilateral congenital hearing loss appear to be similar, but when the analysis was limited to children with sensorineural hearing loss, the incidence of unilateral hearing loss was only half of the incidence of bilateral hearing loss. Reportedly, the incidence of mumps deafness has been increasing recently, however, in the majority of cases, unilateral deafness in infants may be due to a congenital predisposition.
Hearing aid fitting adaptation was assessed by using the speech audiogram, word recognition score, subjective tests for environmental noise, and the questionnaire test for hearing ability according to the guideline for hearing aid fitting tests (2010) in 23 ears of 21 patients who visited our department. The rate of hearing aid adaptation was 95.7% (22/23 ears) as assessed by the speech audiogram, 82.6% (19/23 ears) as assessed by the word recognition score, 87.0% (20/23 ears) as assessed by the subjective tests for environmental noise, and 66.7% (14/21 patients) as assessed by the questionnaire test for hearing ability. Poor improvement in word recognition in adverse conditions tended to be recognized in seven patients who showed inadequate adaptation according to the questionnaire test for hearing ability. The rates of hearing aid adaptation in the overall assessment of the required items was 69.6% (16/23 ears), but it decreased to 47.8% (11/23 ears) when the assessment by the questionnaire test for hearing ability was added. In the present study, the assessment results did not necessarily conform among the test items. Identification of which items should be selected from the reference items in the guideline for hearing aid fitting tests (2010) is an issue that must be addressed in the future.
Although intratympanic steroid therapy for idiopathic sudden sensorineural hearing loss (ISSNHL) has been practiced for the last 10-15 years, its efficacy has not been clarified. We treated ISSNHL patients by daily short-term intratympanic dexamethasone administration (IT-DEX). The purpose of this study was to carry out a retrospective evaluation of the efficacy of IT-DEX. Ninety-six ISSNHL patients who were treated with IT-DEX were enrolled in this study. Dexamethasone was injected through a perforation made with a CO2 laser unit and administered for 8 sequential days, without any other concurrent treatment. Only 38 out of the 96 patients (39.6%) showed complete recovery. However, of the 27 out of the 96 patients who had received no previous treatment, i.e., were treated with only IT-DEX initially, 20 (74.1%) showed complete recovery. Initial IT-DEX represents effective treatment for ISSNHL, however, only 27 out of the 96 patients (28.1%) had received no previous treatment, therefore, a multicenter trial may be necessary to more definitively examine the effectiveness of IT-DEX as the initial and sole treatment for ISSNHL.
We examined the questions posed by the parents of 0-2-year-old children with hearing loss in a school for the deaf to Educational Audiologists. The maximum number of questions were posed by the parents of under 1-year-old children, the number of questions decreasing with increasing age of the children (school year). In particular, questions pertaining to“A hearing aid” and“welfare” decreased conspicuously with age. There was it for reasons of the decrease in question about wearing hearing aids and the welfare procedure. It is necessary to inspect correspondence to a question from infant's parents.