Comparative Analysis of Intervention With Hearing Implants

INTRODUCTION: Hearing rehabilitation aims to enhance or restore auditory perception, which is critical for oral language development and to mitigate the cognitive and psychosocial impacts of hearing loss. Although air-conduction hearing aids represent the standard approach, they may be unsuitable for conductive or mixed hearing loss, particularly in cases of ear malformations or chronic otitis media. In such cases, bone-conduction implants, available since the 1980s, offer an alternative by bypassing the outer and middle ear. These implants, passive or active transcutaneous, percutaneous, and middle ear, differ in surgical approach, coupling to the sound processor, and sound-transmission mechanisms. OBJECTIVE: To evaluate and compare the audiological performance and speech recognition in individuals with conductive and mixed hearing loss implanted with different hearing implants. MATERIALS AND METHODS: A retrospective, comparative longitudinal study analyzed audiological outcomes in 101 individuals implanted with 5 implant types. Free-field pure-tone audiometry and speech recognition were analyzed unaided, at activation, and at 3-month follow-up. RESULTS: All implants yielded improvements compared with the unaided condition. Aided free-field thresholds showed mean gains of 15.59 to 39.41 dB at activation and 20.00 to 39.71 dB at follow-up. Speech recognition also improved, with mean gains in silence of 19.95 to 31.99 dB at activation and 25.07 to 35.15 dB at follow-up, and in noise of 1.97 to 6.95 dB at activation and 2.16 to 7.56 dB at follow-up. Additional advantages were observed for Baha-p and Ponto. CONCLUSIONS: All implants provided benefits in audibility and speech perception. However, percutaneous implants, Baha-p and Ponto, offered superior overall performance compared with other implants.