Post-market Clinical Follow-up of a Magnetic Bone Conduction Implant (Cochlear Baha Attract System)

This investigation was designed to collect data regarding the usability and clinical
performance of the Baha Attract System in subjects with hearing impairment that were
candidates for Baha surgery.

The investigation was performed in an open design since it was not possible to perform the
investigation in a blinded fashion. The main evaluations of the investigation, i.e.
free-field hearing tests, are standard audiological procedures that are routinely used in
daily clinical practice at hospitals worldwide for evaluation of hearing performance in
hearing impaired patients. The primary efficacy evaluation, audiometric thresholds, renders
comparable results across different sites and countries as it is not a language-specific
test. Language-specific audiological tests were performed as secondary efficacy evaluations;
to enable comparison of data across sites, validated word lists were used at all sites and
equivalent speaker configurations (speech from front, noise from behind) and test procedures
(same noise and adaptive speech levels, etc) were used.

For the primary evaluation in the investigation, the Baha Attract System was compared to the
pre-operative unaided situation, as the intended use of the system is to improve hearing
performance in patients with conductive or mixed hearing loss or single-sided sensorineural
deafness. Audiological test results with the Baha Attract System were also compared against
results obtained with the same Sound Processor on a Baha Softband. Use of the Sound Processor
on a Softband is a standard procedure that is routinely used as a pre-operative test prior to
bone conduction hearing implant surgery. The Softband test allows the patient to
pre-operatively experience hearing through the Sound Processor to get an indication of the
post-operative hearing outcome and to choose a suitable Sound Processor.

The generic and hearing-specific quality of life questionnaires used in the investigation
(HUI3, APHAB, SSQ) are validated scales that have been frequently used and reported in the
literature.

Inclusion Criteria:

Adult subject, i.e. ≥ 18 years of age

Conductive or mixed hearing loss in the ear to be implanted:

Bone conduction thresholds with a pure tone average PTA4 of < 30 dB hearing level (mean of
500, 1000, 2000 and 4000 Hz).

OR

Single-sided sensorineural deafness (SSD):

European sites: Bone conduction thresholds with a pure tone average PTA4 of < 30dB hearing
level (mean of 500, 1000, 2000 and 4000 Hz) in the good ear.

US sites: Air conduction thresholds with a pure tone average PTA4 of 20 dB hearing level
(mean of 500, 1000, 2000 and 3000 Hz) in the good ear OR Subject is indicated for an AC
CROS but—for some reason—cannot or will not use an AC CROS.

No previous bone conduction implant on the side of the skull to be implanted. Signed
informed consent.

Exclusion Criteria:

Subjects that are scheduled for simultaneous bilateral implant surgery. The investigation
is limited to subjects with unilateral use of the Baha Attract System (however, bilateral
hearing loss is not an exclusion criterion).

Suitable implant position for the BI300 Implant (4 mm or 3 mm) not found during surgery due
to insufficient bone quality and/or bone thickness.

Less than 3 mm soft tissue thickness at the planned implant site. Subjects that have
received radiation therapy at the same side of the skull where the Baha Attract System will
be positioned.

Condition that could jeopardise osseointegration and/or wound healing as judged by the
investigator (e.g. osteoporosis, psoriasis, use of corticosteroids).

Uncontrolled diabetes as judged by the investigator. Condition that may have an impact on
the outcome of the investigation as judged by the investigator.

Unable to follow investigational procedures (e.g. to complete quality of life scales).

Participation in another investigation with pharmaceuticals and/or medical device.