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Overview

Objective: The aim of this study was to evaluate the audiological performance of the ADHEAR system and to compare it with a softband BAHA system in adults with middle ear disease. Study Design: Prospective, single-subject, repeated-measures study Setting: Monocentric study Participants: In 23 patients with mild to moderate isolated conductive or combined hearing loss (CHL) the ADHEAR system was tested, where 12 of them were outside of the ADHEAR indication. In ten patients, testing was performed with the ADHEAR system and a softband BAHA system. A control group consisted of 10 patients with bilateral artificial occluded ear canal. Main outcome measures: Air and bone conduction thresholds and free-field monosyllable speech intelligibility thresholds in quiet and in noise were measured and evaluated in an unaided situation and aided situation. Furthermore, an ADHEAR questionnaire was assessed. Results: In patients with a middle ear disease compared to the unaided situation, the aided situations with the ADHEAR system and the softband BAHA system led to a significant improvement of speech intelligibility in quiet and in noise. In terms of the ADHEAR questionnaire, using the ADHEAR system patients reported about an improvement in sound localization, sound quality and speech intelligibility. Conclusions: The results show that patients with middle ear disease can benefit from the ADHEAR system, even if their hearing loss is outside of its indication. Outside the indication criteria of the ADHEAR system, it can be an option.

PLOS ONEQ3 · CROSS-FIELD

Positioning Accuracy in Otosurgery Measured with Optical Tracking

Q3 · CROSS-FIELD

ArticleOA

Author: Neményi, Dóra ; Óvári, Attila ; Just, Tino ; Schuldt, Tobias ; Buhr, Anne ; Csókay, András ; Valálik, István ; Pau, Hans-Wilhelm ; Mlynski, Robert

OBJECTIVESTo assess positioning accuracy in otosurgery and to test the impact of the two-handed instrument holding technique and the instrument support technique on surgical precision. To test an otologic training model with optical tracking.STUDY DESIGNIn total, 14 ENT surgeons in the same department with different levels of surgical experience performed static and dynamic tasks with otologic microinstruments under simulated otosurgical conditions.METHODSTip motion of the microinstrument was registered in three dimensions by optical tracking during 10 different tasks simulating surgical steps such as prosthesis crimping and dissection of the middle ear using formalin-fixed temporal bone. Instrument marker trajectories were compared within groups of experienced and less experienced surgeons performing uncompensated or compensated exercises.RESULTSExperienced surgeons have significantly better positioning accuracy than novice ear surgeons in terms of mean displacement values of marker trajectories. The instrument support and the two-handed instrument holding techniques significantly reduce surgeons' tremor. The laboratory set-up presented in this study provides precise feedback for otosurgeons about their surgical skills and proved to be a useful device for otosurgical training.CONCLUSIONSSimple tremor compensation techniques may offer trainees the potential to improve their positioning accuracy to the level of more experienced surgeons. Training in an experimental otologic environment with optical tracking may aid acquisition of technical skills in middle ear surgery and potentially shorten the learning curve. Thus, simulated exercises of surgical steps should be integrated into the training of otosurgeons.

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