Abstract Introduction The technology regarding bone-anchored hearing devices has been advancing. Nevertheless, complications are still often reported, which can impair treatment adherence and lead to discontinuation of use. There is a lack of studies conducted in tropical countries, where complications can be even greater, as well as standardized protocols for selection, indication and evaluation. Objective To characterize implanted patients from a Brazilian public institution and describe the medical and audiological assessment protocols to which they were submitted during the selection process and in the follow-up after surgery. Method An observational, cross-sectional study evaluating the medical records of patients with hearing loss and ear malformations and describing the care protocol through which they were treated. Results The medical records of 15 patients were reviewed: 6 received transcutaneous implants, and 9, percutaneous implants; 9 patients reported some type of skin lesion, 2 reported pain on the follow-up visit, and 3 had osseointegration failure. The time between surgery and activation ranged from 2 to 9 months. The median scores on the sentences, Sentences in Noise and Monosyllable tests were 100%, 60% and 80%, respectively. Conclusion It was possible to characterize the patients who received implants at the institution. The patients performed well in silence and had greater difficulty in noise. Even patients who had complications did not complain about the audibility and sound quality. It is essential to develop a model and to standardize the assessment and follow-up methods aimed at the benefit of users of bone-anchored hearing devices, as well as to enable the technico-scientific development in this field.

<sec><title>Introduction</title><p> Periodic follow-up appointments are important to ensure long-term effectiveness of rehabilitation with hearing aids. However, not all users are able to maintain adherence to recommendations prescribed during the fitting process and some do not attend those appointments, which compromises the effectiveness of treatment.</p></sec><sec><title>Objective</title><p> Compare hearing aid use after 1 year between subjects who did not attend a follow-up evaluation appointment at a publicly-funded health service (nonattenders) and those who attended the appointment (attenders). Reasons for nonuse of hearing aids and unscheduled appointments were also analyzed.</p></sec><sec><title>Methods</title><p> Prospective observational cross-sectional study. Nonattenders and attenders in a follow-up evaluation appointment were interviewed by telephone about hearing aid use, reasons for nonuse, and unscheduled appointments.</p></sec><sec><title>Results</title><p> The nonattenders group consisted of 108 subjects and the attenders group had 200 subjects; in both groups, most users kept bilateral use but the nonuse rate was higher in nonattenders. The main reason for nonuse of hearing aids among nonattenders was health problems; fitting problems was the main reason for nonuse in the attenders group. Health problems and issues like unavailable companion and transportation difficulties were the reasons for unscheduled follow-up appointments.</p></sec><sec><title>Conclusion</title><p> Nonattenders had a greater nonuse rate and were more likely to abandon hearing aid use. Measures to increase hearing aid use and adherence to prescribed recommendations are also necessary to ensure long-termeffectiveness of rehabilitation with hearing aids.</p></sec>

Introduction  The complaints associated with the use of conventional amplifying hearing aids prompted research at several centers worldwide that ultimately led to the development of implantable devices for aural rehabilitation. Objectives  To review the history, indications, and surgical aspects of the implantable middle ear hearing devices. Data Synthesis  Implantable hearing aids, such as the Vibrant Soundbridge system (Med-El Corporation, Innsbruck, Austria), the Maxum system (Ototronix LLC, Houston, Texas, United States), the fourth-generation of Carina prosthesis (Otologics LLC, Boulder, Colorado, United States), and the Esteem device (Envoy Medical Corporation - Minnesota, United States), have their own peculiarities on candidacy and surgical procedure. Conclusion  Implantable hearing aids, which are currently in the early stages of development, will unquestionably be the major drivers of advancement in otologic practice in the 21st century, improving the quality of life of an increasingly aged population, which will consequently require increased levels of hearing support.

O uso da prótese auditiva e a satisfação podem ser utilizados para determinar a efetividade da reabilitação auditiva, pouco investigada na população brasileira. OBJETIVO: Avaliar o uso da prótese auditiva em adultos atendidos num serviço público de saúde, as intervenções necessárias e a satisfação após um ano de adaptação. MÉTODO: Estudo prospectivo observacional transversal. Usuários de prótese auditiva foram convocados para avaliação formal do uso. RESULTADOS: Duzentos usuários de prótese auditiva compareceram à avaliação formal (perda de 47% da amostra inicial); 76,5% dos usuários avaliados mantiveram o uso bilateral, 10,5% unilateral e 13% nenhuma; 99,5% necessitaram de algum tipo de intervenção. Os usuários que mantiveram o uso foram considerados "satisfeitos". CONCLUSÃO: Os usuários de prótese auditiva atendidos no serviço público de saúde em questão apresentam dificuldade para comparecer às consultas de seguimento. A maioria dos indivíduos avaliados manteve o uso da prótese auditiva; entretanto, praticamente todos necessitaram de algum tipo de intervenção. Apesar do alto grau de satisfação, estes achados não contemplaram os indivíduos que não compareceram à avaliação formal, que poderiam representar os menos aderidos ao tratamento. Os dados evidenciaram a necessidade de seguimento periódico para garantir a efetividade do uso da prótese auditiva em longo prazo.

Hearing aid use and satisfaction can be used to analyze the effectiveness of hearing rehabilitation, an issue few explored in Brazilian users. OBJECTIVE: Evaluate hearing aid use dispensed in a publicly-funded health service after one year, the interventions needed and users' satisfaction. METHOD: Prospective observational cross-sectional study. Hearing aid users were invited by telephone to participate in an evaluation of hearing aid use. RESULTS: 200 hearing aid users attended the evaluation (47% of sample loss); 76.5% of the subjects were using hearing aids bilaterally, 10.5% unilaterally and 13.0% none of them; 99.5% of users needed some kind of intervention. Users who kept wearing their hearing aids were considered "satisfied". CONCLUSION: Active search by telephone showed that hearing aid users who attend this publicly-funded health service have difficulties to attend follow-up appointments. Most of the users that came for evaluation kept using their hearing aids; non-use rate was 13%. Practically all hearing aid users needed some kind of intervention. Despite the high level of satisfaction, those findings did not include users who did not participate in evaluation, which could represent subjects less adhered to the treatment. Results highlighted the need of periodical follow-ups to ensure the effectiveness of auditory rehabilitation.

INTRODUÇÃO: A prótese auditiva é uma das alternativas utilizadas no processo de reabilitação auditiva que visa auxiliar a comunicação e minimizar as limitações causadas pela deficiência auditiva. Mesmo com o avanço da tecnologia, a seleção e adaptação da prótese auditiva exigem um processo criterioso para maximizar o desempenho, benefício e satisfação do usuário. OBJETIVO: Descrever o protocolo de seleção e adaptação de prótese auditiva para candidatos adultos e idosos utilizado em um centro de audiologia, cuja elaboração foi embasada em protocolos validados e descritos previamente na literatura científica específica e complementada por informações de evidências clínicas do serviço. COMENTÁRIOS FINAIS: O protocolo fonoaudiológico de seleção e adaptação da prótese auditiva para adultos e idosos demonstra que um maior número de informações coletadas propicia melhor orientação da expectativa real e maior efetividade no aconselhamento ao uso da prótese auditiva, favorecendo, desta maneira, o desempenho auditivo, a satisfação e o benefício do indivíduo.

INTRODUCTION: The auditive prosthesis is one of the sed alternative in the auditive rehabilitation process that aims to aid the communication and to diminish the restrictions induced by the auditive deficiency. Even with the techonology advance, the selection and adjustment of the auditive prosthesis require a criteria process to maximize the user's performance, benefit and satisfaction. OBJECTIVE: To describe the protocol of selectiom and adjustment of audictive prosthesis for adults and elderly candidates, used in a Audiology Center, which elaboration ws based in vality protocols and previously described in specific scientific literature and completed by informations of clinic evidences from service. COMMENTS FINAIS: The speech protocol of selection and adjustment of auditicve prosthesis for adults and elderly shows that a great number of collected informations propitiates a better orientation of real expectative and more effectiveness to recommend the audictive prosthesis' usage, favorishing in this way, the audictive performance, the individual satisfaction and benefit.

OBJETIVO: caracterizar o perfil audiométrico e demográfico de pacientes candidatos ao implante coclear encaminhados ao setor de prótese auditiva e entre esses, a frequência de indivíduos que se beneficiaram da amplificação sonora. MÉTODOS: foram estudados os pacientes atendidos no período de maio de 2007 a dezembro 2008. Foi realizado o levantamento do perfil da população segundo sexo, idade, escolaridade e etiologia. Foi calculada a média da melhor e pior orelha e classificada segundo Frota (2003). A média dos limiares auditivos com as próteses auditivas indicadas foi calculada e considerada como benefício quando permitia acesso aos sons da fala do português brasileiro (Russo e Behlau, 1993). RESULTADOS: foram avaliados nesse período 194 prontuários. 108 pacientes já eram usuários de próteses auditivas (55,6%), 100 do sexo masculino (52%), 94 do sexo feminino (48%), 109 eram crianças (56%) e 85 eram adultos (44%). A média de idade foi 4,8 anos (crianças) e 41,9 anos (adultos). Entre os adultos, 24 possuíam ensino fundamental incompleto (33%). A etiologia mais frequente foi a desconhecida (33%). Dezenove pacientes se beneficiaram do uso da prótese auditiva (10%). No grupo de pacientes que se beneficiaram da prótese auditiva, a média dos limiares em campo livre com amplificação foi de 47 dBNA e 48 dBNA, na melhor e na pior orelha, respectivamente, nas crianças e 50 dBNA e 45 dBNA, respectivamente, nos adultos. CONCLUSÃO: o perfil dos pacientes foi: na maioria criança, sexo masculino, etiologia desconhecida, já usuários de próteses auditivas com média de idade 4,8 anos (crianças) e 41,9 anos (adultos), audiometria com perda auditiva neurossensorial profunda bilateral, sendo que a prótese beneficiou 10% dos pacientes.

PURPOSE: to characterize the audiometric and demographic profile of cochlear implant candidates who were referred to hearing aid sector, and if they benefit from the amplification of the hearing aid. METHODS: patients who had been attended from May 2007 to December 2008 were studied. We collected the patients' profile involving: gender, age, education and etiology. The hearing threshold's average for the good and worse ears was calculated and classified according to Frota (2003). The averaged sound field thresholds with hearing aid was calculated for both ears and considered as a benefit when allowed for an access to the speech sounds of Brazilian Portuguese. RESULTS: a hundred and ninety-four medical records were evaluated in this period. Among them, 108 patients had already been wearing hearing aids (55.6%), 100 were male (52%), 94 female (48%), 109 were children (56%) and 85 adults (44%). The average age was 4.8year old for children and 41.9-year old for adults. Among the adults, 24 patients had incomplete high school education (33%). Unknown etiology was the most frequent cause (33%). Nineteen patients have benefited from the use of hearing aids (10%). The averaged sound field thresholds with hearing aid was 47 dBHL and 48 dBHL, in best and worse ears, respectively, for children, and 50 dBHL and 45 dBHL, respectively, for adults. CONCLUSIONS: the profile of the patients was: majority of children, males, unknown etiology, previously hearing aid users, average of age 4.8-year old for children and 41.9 for adults. Pure tone thresholds revealed profound bilateral hearing loss. About 10% of patients were benefited with the use of hearing aids.