Another Achievement by the Cochlear Implant Team of Shiraz University of Medical Sciences (SUMS): First Bonebridge Implant

The world’s pioneering approach to bone conduction implant known as Bonebridge implant was successfully performed at SUMS Organ Transplant Hospital, Abu Ali Sina Hospital, on Oct. 14, 2019, for the first time in Iran.

The Head of SUMS Cochlear Implant Center, Dr. Seyed Basir Hashemi explained that semi-hearing individuals, who couldn’t have their hearing restored through surgery on the ossicular chain (the malleus, incus, and stapes) and to whom hearing aids could not be of any help, can benefit from Bonebridge implant. Moreover, as he added, congenital absence of the ear canal or failure of the ear canal to be open at birth, and congenital absence, permanent malformation, or dysfunction of the middle ear structures causes conductive hearing loss. Thus, patients with this type of congenital hearing loss resulted from the foregoing factors are regarded as appropriate candidates for Bonebridge implant.

As Dr. Hashemi elaborated, this partially implantable hearing system consists of a receptor and a convertor which are placed under the skin and in the skull just behind the ear. An externally worn audio processor is also held in place above the implant by magnetic attraction. The external processor receives sound and converts it into a signal that is transmitted through the skin to the internal implant. The internal implant converts the signal from the external processor into vibrations that are transmitted to the inner ear to achieve an optimal auditory perception.

As the most advanced active bone conduction implant, Bonebridge implant, is also eminent for restoring hearing of the patients with conductive and mixed hearing losses as well as single-sided deafness. Conductive hearing loss can be caused by infection, tumors, middle ear fluid from infection or Eustachian tube dysfunction, a foreign body, trauma (as in a skull fracture), and otosclerosis. Mixed hearing loss is a combination of a sensorineural and conductive hearing loss. It results from problems in both the inner and outer or middle ear. Single-sided deafness (SSD) is a condition of profound unilateral sensorineural hearing loss, with normal hearing in the better hearing ear. SSD is a severe impairment that makes it hard to understand speech and sounds especially in noisy environments, as well as causes difficulties in determining the direction of a sound's location.

SUMS first Bonebridge implant was conducted in the presence of Austrian specialists, who were the representatives of the Bonebridge prosthesis manufacturer. The candidate was a 40-year-old patient suffering from hearing loss caused by infection and perforated eardrums. Hearing aids and several operations on the patient’s ears disclosed unsatisfactory results. Therefore, incisive analysis of the test results derived from audiology and radiologic tests proved the patient to be an ideal candidate for the entirely new approach to bone conduction hearing technology.