Influence of Hearing Rehabilitation With Active Middle Ear and Bone Conduction Implants on Postural Control

Ingmar Seiwerth; Antonia Brylok; René Schwesig; Torsten Rahne; Laura Fröhlich; Andreas Lauenroth; Timothy E Hullar; Stefan K Plontke

doi:10.3389/fneur.2022.846999

Influence of Hearing Rehabilitation With Active Middle Ear and Bone Conduction Implants on Postural Control

Front Neurol. 2022 May 11:13:846999. doi: 10.3389/fneur.2022.846999. eCollection 2022.

Authors

Ingmar Seiwerth¹, Antonia Brylok¹, René Schwesig², Torsten Rahne¹, Laura Fröhlich¹, Andreas Lauenroth², Timothy E Hullar³, Stefan K Plontke¹

Affiliations

¹ Department of Otorhinolaryngology, Head and Neck Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
² Department of Orthopaedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
³ Veterans Administration (VA) Portland National Center for Rehabilitative Auditory Research and Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR, United States.

Abstract

Background: As audition also seems to contribute to balance control, additionally to visual, proprioceptive, and vestibular information, we hypothesize that hearing rehabilitation with active middle ear and bone conduction implants can influence postural control.

Methods: In a prospective explorative study, the impact of hearing rehabilitation with active middle ear [Vibrant Soundbrige (VSB), MED-EL, Innsbruck, Austria] and bone conduction implants [Bonebridge (BB), MED-EL, Innsbruck, Austria] on postural control in adults was examined in three experiments. Vestibulospinal control was measured by cranio-corpography (CCG), trunk sway velocity (°/s) by the Standard Balance Deficit Test (SBDT), and postural stability with a force plate system, each time in best aided (BA) and unaided (UA) condition with frontal-noise presentation (Fastl noise, 65 dB SPL), followed by subjective evaluation, respectively.

Results: In 26 subjects [age 55.0 ± 12.8 years; unilateral VSB/BB: n = 15; bilateral VSB/BB: n = 3, bimodal (VSB/BB + hearing aid): n = 8], CCG-analysis showed no difference between BA and UA conditions for the means of distance, angle of displacement, and angle of rotation, respectively. Trunk sway measurements revealed a relevant increase of sway in standing on foam (p = 0.01, r = 0.51) and a relevant sway reduction in walking (p = 0.026, r = 0.44, roll plane) in BA condition. Selective postural subsystem analysis revealed a relevant increase of the vestibular component in BA condition (p = 0.017, r = 0.47). As measured with the Interactive Balance System (IBS), 42% of the subjects improved stability (ST) in BA condition, 31% showed no difference, and 27% deteriorated, while no difference was seen in comparison of means. Subjectively, 4-7% of participants felt that noise improved their balance, 73-85% felt no difference, and 7-23% reported deterioration by noise. Furthermore, 46-50% reported a better task performance in BA condition; 35-46% felt no difference and 4-15% found the UA situation more helpful.

Conclusions: Subjectively, approximately half of the participants reported a benefit in task performance in BA condition. Objectively, this could only be shown in one mobile SBDT-task. Subsystem analysis of trunk sway provided insights in multisensory reweighting mechanisms.

Keywords: active middle ear implant; balance; bone conduction implants; hearing amplification; postural stability; transcutaneous hearing implant.