More than 600 scientists, audiologists, and otologists from 36 countries learned about the latest developments in hearing rehabilitation made possible by bone conduction and related technologies at OSSEO 2019, held December 11-14 in Miami Beach.
Hosted by the University of Miami Miller School of Medicine Department of Otolaryngology-Head & Neck Surgery, the 7th International Congress on Bone Conduction Hearing and Related Technologies included updates on research studies, new surgical techniques and leading-edge technologies, along with panels on atresia and microtia, conditions that involve reconstructing the outer ear as well as restoring hearing.
“Bone conduction hearing is a highly specialized field, so it is important for clinicians and researchers to meet every two years to see where the field is moving,” said conference co-chair Fred F. Telischi, M.E.E., M.D., Chandler Chair in Otolaryngology, chairman of the Department of Otolaryngology, and professor of neurological surgery and biomedical engineering.
Noting that bone conduction devices are commonly used in cases of single-sided deafness or mixed hearing loss in which conventional hearing aids or cochlear implants are not indicated or tolerated, Dr. Telischi added, “We learn from each other to apply devices and techniques in novel ways.”
Conference co-chair, Hillary Snapp, Au.D., Ph.D., chief of audiology and associate professor of otolaryngology, said attendance at OSSEO 2019 was the highest ever for the biennial conference.
“The University of Miami’s strong connections with Latin America brought in many Spanish-speaking professionals,” added Dr. Snapp, who also participated in an expert panel session on the bilateral fitting of implantable devices.
In the opening session, Chrisanda Sanchez, Au.D., a pediatric audiologist at the UM Ear Institute Children’s Hearing Program presented a “SuperHEARo Award” to 12-year-old Julia Portales, who was born with Crouzon syndrome, causing facial, cranial and hearing abnormalities. At age 6, she was fitted with her first bone conduction hearing devices, which transmit sound waves through the bones of the skull.
“Despite hearing and vision losses, nothing gets in Julia’s way,” Dr. Sanchez said. “She is an aspiring singer with her own YouTube channel and Instagram account. Most important, she is a constant reminder to be positive, regardless of what you face in life.”
Receiving the award, Julia said, “I love music and with my Bahas (bone conduction devices). I feel alive. I want to thank everyone for making this possible, and remember to always be kind, no matter what.”
Audio augmented reality
Researcher, artist and MIT-educated electrical engineer Gershon Dublon, Ph.D., took attendees into the uncharted future with his keynote talk, “Sensing to Hearing: Extending Perception through Audio Augmented Reality.”
For instance, Dr. Dublon developed “fox ears,” high-gain parabolic microphones attached to a bicycle helmet equipped with bone transducers. The device allows the wearer to hear normally through the ears, as well as distant sounds through bone conduction.
Another project was the “Listen Tree,” which allowed children and adults to put their ear to the bark and hear stories conveyed by transducers at the roots.
“Technology can bring us closer to the natural world,” said Dr. Dublon, who outlined his HearThere project on a former cranberry bog in the Northeast. “We put in hundreds of sensor devices, such as microphones near a bird’s nest, recorded 300,000 hours of natural sounds, and built a deep learning neural net.”
By wearing a bone-conduction headset, visitors to the wetland area can hear augmented sounds, blended with their natural hearing.
“It’s confusing for first-timers, because they can’t tell the two sound worlds apart, Dr. Dublon said. “However, as they adapted to the headphones, they would use visual cues, such as looking toward a river and hearing water flowing. I think the tactility of the bone conduction provides a cue that listeners pick up over time, but it’s an area that needs research.”
Another application was Masque, which senses and plays back synthetic sounds of an individual’s breathing.
“We found we could reduce stress by lengthening the augmented sounds or the breath,” Dr. Dublin said. “That’s one of the potential wellness applications.”
Asked by Dr. Telischi about other medical applications, Dr. Dublon noted there are many potential opportunities to bring wearable and assistive technology together.
“For instance, you could have a phone with a conduction implant that augments the auditory information a patient would normally hear,” he said. “That could be very helpful when interacting with audiologists in a clinic setting.”
University of Miami faculty members gave a number of presentations throughout the three-day symposium. Michael E. Ivan, M.D., M.B.S., assistant professor of neurosurgery, and director of research for the UM Brain Tumor Initiative, and Timur Urakov, M.D., assistant professor of clinical medicine, gave the Saturday opening keynote talk, “The Future is Now: Augmented Reality in Surgery and Medical Education.”
“Augmented reality is a novel technology for many clinicians,” said Dr. Urakov. “We are pioneering its use in the neurosurgical field, such as brain tumor resections, but there is great potential for conducting otolaryngology procedures using 3D holographic images.”
Dr. Ivan noted that neurosurgeons in the operating room must look up from the patient to see a video image on the screen.
“With AR, a surgeon could see the same 3D image on digital glasses, making it easier to determine the best approach to remove a tumor more quickly and with greater patient safety,” he said. “AR systems also can be used for medical education, providing 3D images for residents, medical students and patients.”
Ivette Cejas, Ph.D, associate professor of otolaryngology and psychology, and director of the UM Ear Institute Family Support Services in the Division of Audiology, spoke on “Depression and Anxiety: Prevalence in Hearing Loss and Screening Implementation.” She is studying these conditions in patients with different hearing devices, including cochlear implants and bone conduction devices.
“Patients with bone conduction devices are not showing elevations in depression or anxiety, unlike those with cochlear implants or CROS aids for single-sided hearing loss,” she said. “While we need a bigger sample, it seems that patients with single-sided hearing loss may be most affected by psychological issues, possibly because there is more support available to those with bilateral severe to profound hearing losses.”
In her presentation on “Comparison of Remote Microphone Technology in Bone Conduction Devices,” Dr. Sanchez reviewed a study of children who wear bone conduction devices in noisy environments.
“We wanted to see if their hearing performance improved when wearing a remote microphone with their device, or when using an FM system often found in schools,” she said. “The literature supports remote microphones in hearing aids and cochlear implants, but has not been studied in bone conduction technology.”
Advancing the field
Dr. Telischi said bone conduction hearing technology has improved dramatically in the past 15 years, and the University of Miami’s program is now at the forefront of the field. “We work with virtually all the R&D companies, and offer clinical trials for new devices,” he said. For instance, Cochlear Limited announced Food and Drug Administration clearance of its new Cochlear™ Osia® 2 System at OSSEO 2019.
“Based on our extensive experience, we are one of a handful of U.S. sites that will have this system available in 2020,” he added. “We look forward to continuing our collaborative efforts with many companies toward advancing the field and improving outcomes for individuals with hearing loss.”