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ABOUT THE BONEBRIDGE
The Bonebridge is very new and has just been released in the UK. A very powerful vibrator is placed in a recess drilled into the mastoid bone and screwed to the surface of the skull. The outside part is held over the inner part by magnets. There is nothing sticking through the skin.
Below is a video from the manufacturers showing what the Bonebridge is and how it works.
WHO MIGHT BENEFIT FROM A BONE BRIDGE DEVICE?
Three groups of people may benefit from a Bonebridge:
- Patients with a CONDUCTIVE hearing loss
- Patients with a MIXED loss
- Patients with a ONE SIDED severe to profound nerve hearing loss (= a sensori-neural hearing loss)
This is where sound can not get through to the inner ear. Possible causes are listed below. Often this sort of hearing loss can be treated with a normal hearing aid but some people can not use a normal hearing aid either because it causes ear infections or because the patient may not have an ear or ear canal.
For people with a conductive hearing loss and repeated infections whenever they use a normal hearing aid the Bonebridge can be effective at not only helping the hearing but also allowing the ear to dry up and avoid infections because the ear canal is no longer blocked.
Causes of a conductive hearing loss where the Bonebridge may help:
- abnormal or absent pinna
- blocked or absent ear canal
- recurring ear canal infections
- chronically infected hole in the ear drum
- any cause of a conductive hearing loss where a normal hearing aid causes problems.
In some people with a conductive hearing loss the inner ear is also not working very well. For these people a certain degree of amplification is needed. The Bonebridge may be more powerful than other bone conduction devices – meaning that it will have the power to put more energy into the cichlear and so deal with a greater degree of nerve hearing loss. Time will tell.
People who have only one hearing ear often have a lot of problems:
- hearing people on their deaf side
- hearing in background noise
- localising where sounds come from
A normal hearing aid doesn’t work because the inner ear on that side is not working. However if the other ear has normal nerve hearing then the output from a bone conduction device will reach that normal nerve allowing the patient to hear.
Causes of a single sided deafness:
- Trauma
- Viral infection
- Labyrinthitis
- Severe Menieres disease
- Sudden sensori-neural hearing loss
- Acoustic neuroma removal
- Congenital (i.e. born with only one hearing ear)
The Bonebridge is attached to the deaf side. When someone speaks on the patients deaf side the sound is picked up by the Bonebridge microphone. The Bonebridge device vibrates the skull sending sound to both cochleas (inner ears). The good cochlear on the other side will detect the sound and convert it to nerve impulses and send it up to the brain so the patient can hear that person speaking.
THE OPERATION
The operation is performed under a general anaesthetic.
It takes about 45-60 minutes to perform.
A cut is made behind the ear. The skin is lifted up to expose the mastoid bone. This bone is usually hollow. A ecess is drilled into the mastoid bone to accept the vibrating part of the Bonebridge device. The vibrating part is anchored to the bone with two screws. The receiver/stimulator part slides into a pocket between the skin behind the mastoid and the bone of the skull. The skin incision is closed with absorbable stitches.
At the end of the operation a pressure bandage is applied for a few hours. The bandage is then removed and you can go home the same day.
The operation is not performed on the NHS at the present time.
AFTER THE OPERATION
You should plan to have a couple of weeks off work.
The Steristrip plasters covering the wound can be removed after a week. The wound area needs to be kept dry for 10 days. After about 1 month the external part of the device can be fitted.
Manufacturers
The device is made by the Medel – an Austrian Cochlear Implant and Hearing device company.