Efficacy of Auditory Implants for Patients With Conductive and Mixed Hearing Loss Depends on Implant Center

Introduction: Although from a technological point of view, progress is impressive, most implantable hearing devices for conductive or mixed hearing loss have a limited capacity. These devices all bypass the impaired middle ear; therefore, the desired amplification (gain) should be based on the cochlear hearing loss (component) only. The aim of the study is to review the literature with regard to accomplished gain with current implantable devices. Method: Thirty-one articles could be included. Aided thresholds were compared with prescribed values, based on cochlear hearing loss (bone-conduction thresholds), according to the well-validated NAL rule. Results: For the majority of the studies, NAL targets were not met. Variation in accomplished gain between implant teams was unacceptably large, largely independent of the type of device that was used. NAL targets were best met at 2 kHz, with worse results at the other frequencies. Conclusion: Large variations in reported results were found, which primarily depended on implant center. Based on the analyses, a pragmatic fitting procedure is proposed which should minimize the differences between implant centres.