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Hearing Disorders: HELP
Articles by Angel Batuecas Caletrio
Based on 8 articles published since 2010
(Why 8 articles?)
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Between 2010 and 2020, A. Batuecas-Caletrio wrote the following 8 articles about Hearing Disorders.
 
+ Citations + Abstracts
1 Guideline Clinical guideline on bone conduction implants. 2019

Lavilla Martín de Valmaseda, María José / Cavalle Garrido, Laura / Huarte Irujo, Alicia / Núñez Batalla, Faustino / Manrique Rodriguez, Manuel / Ramos Macías, Ángel / de Paula Vernetta, Carlos / Gil-Carcedo Sañudo, Elisa / Lassaletta, Luis / Sánchez-Cuadrado, Isabel / Espinosa Sánchez, Juan Manuel / Batuecas Caletrio, Ángel / Cenjor Español, Carlos. ·Servicio de Otorrinolaringología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Miembro de la Comisión de Audiología, Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Electronic address: mjlavilla2004@yahoo.es. · Departamento de Otorrinolaringología, Hospital Universitario La Fe, Valencia, España; Miembro de la Comisión de Audiología, Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. · Departamento de Otorrinolaringología, Clínica Universidad de Navarra, Pamplona, Navarra, España; Miembro de la Comisión de Audiología, Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. · Servicio de Otorrinolaringología, Hospital Central de Asturias, Oviedo, Asturias, España; Miembro de la Comisión de Audiología, Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. · Departamento de Otorrinolaringología, Clínica Universidad de Navarra, Pamplona, Navarra, España; Miembro de la Comisión de Otología, Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. · Departamento de Otorrinolaringología, Hospital Universitario Materno-Infantil , Las Palmas de Gran Canaria, Las Palmas, España; Miembro de la Comisión de Otología, Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. · Departamento de Otorrinolaringología, Hospital Universitario La Fe, Valencia, España; Miembro de la Comisión de Otología, Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. · Departamento de Otorrinolaringología, Hospital Universitario Rio Hortega, Valladolid, España; Miembro de la Comisión de Otología, Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. · Servicio de Otorrinolaringología, Hospital Universitario La Paz, IdiPAZ. Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, España; Miembro de la Comisión de Otoneurología, Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. · Servicio de Otorrinolaringología, Hospital Universitario La Paz, IdiPAZ. Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Madrid, España. · Servicio de Otorrinolaringología, Hospital Universitario Virgen de las Nieves, Granada, España; Miembro de la Comisión de Otoneurología, Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. · Servicio de Otorrinolaringología, Hospital Universitario de Salamanca, Salamanca, España; Miembro de la Comisión de Otoneurología, Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. · Servicio de Otorrinolaringología, Fundación Jiménez Díaz, Madrid, España; Miembro de la Comisión de Otoneurología, Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. ·Acta Otorrinolaringol Esp · Pubmed #29656762.

ABSTRACT: INTRODUCTION AND GOALS: During the last decade there have been multiple and relevant advances in conduction and mixed hearing loss treatment. These advances and the appearance of new devices have extended the indications for bone-conduction implants. The Scientific Committee of Audiology of the Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello SEORL-CCC (Spanish Society of Otolaryngology and Head and Neck Surgery), together with the Otology and Otoneurology Committees, have undertaken a review of the current state of bone-conduction devices with updated information, to provide a clinical guideline on bone-conduction implants for otorhinolaryngology specialists, health professionals, health authorities and society in general. METHODS: This clinical guideline on bone-conduction implants contains information on the following: 1) Definition and description of bone-conduction devices; 2) Current and upcoming indications for bone conduction devices: Magnetic resonance compatibility; 3) Organization requirements for a bone-conduction implant programme. RESULTS AND CONCLUSIONS: The purpose of this guideline is to describe the different bone-conduction implants, their characteristics and their indications, and to provide coordinated instructions for all the above-mentioned agents for decision making within their specific work areas.

2 Review Towards personalized medicine in Ménière's disease. 2018

Lopez-Escamez, Jose Antonio / Batuecas-Caletrio, Angel / Bisdorff, Alexandre. ·Otology & Neurotology Group CTS495, Department of Genomic Medicine, Centro de Genómica e Investigación Oncológica, Pfizer/Universidad de Granada/Junta de Andalucía (GENYO), Granada, Spain. · Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg. · Department of Otolaryngology, Instituto de Investigación Biosanitaria, ibs.GRANADA, Hospital Universitario Virgen de las Nieves, Universidad de Granada, Granada, Spain. · Department of Otolaryngology, Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain. · Clinique du Vertige, Centre Hospitalier Emile Mayrisch, Esch-sur-Alzette, Luxembourg. ·F1000Res · Pubmed #30430003.

ABSTRACT: Ménière's disease (MD) represents a heterogeneous group of relatively rare disorders with three core symptoms: episodic vertigo, tinnitus, and sensorineural hearing loss involving 125 to 2,000 Hz frequencies. The majority of cases are considered sporadic, although familial aggregation has been recognized in European and Korean populations, and the search for familial MD genes has been elusive until the last few years. Detailed phenotyping and cluster analyses have found several clinical predictors for different subgroups of patients, which may indicate different mechanisms, including genetic and immune factors. The genes associated with familial MD are

3 Review Systematic review of outcome domains and instruments used in clinical trials of tinnitus treatments in adults. 2016

Hall, Deborah A / Haider, Haula / Szczepek, Agnieszka J / Lau, Pia / Rabau, Sarah / Jones-Diette, Julie / Londero, Alain / Edvall, Niklas K / Cederroth, Christopher R / Mielczarek, Marzena / Fuller, Thomas / Batuecas-Caletrio, Angel / Brueggemen, Petra / Thompson, Dean M / Norena, Arnaud / Cima, Rilana F F / Mehta, Rajnikant L / Mazurek, Birgit. ·National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK. deborah.hall@nottingham.ac.uk. · Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK. deborah.hall@nottingham.ac.uk. · ENT Department of Hospital Cuf Infante Santo - Nova Medical School, Travessa do Castro 3, 1350-070, Lisbon, Portugal. · Department of Otorhinolaryngology, Charite University Hospital, Chariteplatz 1, 10117, Berlin, Germany. · Institute of Biomagnetism and Biosignalanalysis, University Hospital Münster, Malmedyweg 15, 48149, Münster, Germany. · Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium. · National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK. · Centre for Reviews and Dissemination, University of York, York, YO10 5DD, UK. · Service ORL et CCF, Consultation Acouphène et Hyperacousie, Hôpital Européen G. Pompidou, 20, rue Leblanc, 75015, Paris, France. · Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, Von Eulers väg 8, 171 77, Stockholm, Sweden. · Department of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics, |Medical University of Lodz, 90-549 Lodz, 113 Zeromskiego Street, Lodz, Poland. · Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, PO Box 616, 6200, MD, Maastricht, The Netherlands. · Adelante, Centre of Expertise in Rehabilitation and Audiology, Zandbergsweg 111, 6432 CC, Hoensbroek, The Netherlands. · Department of Otorhinolaryngology, IBSAL, University Hospital of Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain. · Tinnitus Center, Charite University Hospital, Chariteplatz 1, 10117, Berlin, Germany. · Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK. · Laboratory of Adaptive and Integrative Neuroscience, Centre National de la Recherche Scientifique, Fédération de Recherche 3C, Aix-Marseille Université, Marseille, France. ·Trials · Pubmed #27250987.

ABSTRACT: BACKGROUND: There is no evidence-based guidance to facilitate design decisions for confirmatory trials or systematic reviews investigating treatment efficacy for adults with tinnitus. This systematic review therefore seeks to ascertain the current status of trial designs by identifying and evaluating the reporting of outcome domains and instruments in the treatment of adults with tinnitus. METHODS: Records were identified by searching PubMed, EMBASE CINAHL, EBSCO, and CENTRAL clinical trial registries (ClinicalTrials.gov, ISRCTN, ICTRP) and the Cochrane Database of Systematic Reviews. Eligible records were those published from 1 July 2006 to 12 March 2015. Included studies were those reporting adults aged 18 years or older who reported tinnitus as a primary complaint, and who were enrolled into a randomised controlled trial, a before and after study, a non-randomised controlled trial, a case-controlled study or a cohort study, and written in English. Studies with fewer than 20 participants were excluded. RESULTS: Two hundred and twenty-eight studies were included. Thirty-five different primary outcome domains were identified spanning seven categories (tinnitus percept, impact of tinnitus, co-occurring complaints, quality of life, body structures and function, treatment-related outcomes and unclear or not specified). Over half the studies (55 %) did not clearly define the complaint of interest. Tinnitus loudness was the domain most often reported (14 %), followed by tinnitus distress (7 %). Seventy-eight different primary outcome instruments were identified. Instruments assessing multiple attributes of the impact of tinnitus were most common (34 %). Overall, 24 different patient-reported tools were used, predominantly the Tinnitus Handicap Inventory (15 %). Loudness was measured in diverse ways including a numerical rating scale (8 %), loudness matching (4 %), minimum masking level (1 %) and loudness discomfort level (1 %). Ten percent of studies did not clearly report the instrument used. CONCLUSIONS: Our findings indicate poor appreciation of the basic principles of good trial design, particularly the importance of specifying what aspect of therapeutic benefit is the main outcome. No single outcome was reported in all studies and there was a broad diversity of outcome instruments. PROSPERO REGISTRATION: The systematic review protocol is registered on PROSPERO (International Prospective Register of Systematic Reviews): CRD42015017525 . Registered on 12 March 2015 revised on 15 March 2016.

4 Article Extended phenotype and clinical subgroups in unilateral Meniere disease: A cross-sectional study with cluster analysis. 2017

Frejo, L / Martin-Sanz, E / Teggi, R / Trinidad, G / Soto-Varela, A / Santos-Perez, S / Manrique, R / Perez, N / Aran, I / Almeida-Branco, M S / Batuecas-Caletrio, A / Fraile, J / Espinosa-Sanchez, J M / Perez-Guillen, V / Perez-Garrigues, H / Oliva-Dominguez, M / Aleman, O / Benitez, J / Perez, P / Lopez-Escamez, J A / Anonymous7350895. ·Otology & Neurotology Group CTS495, Department of Genomic Medicine- Centro de Genómica e Investigación Oncológica - Pfizer/Universidad de Granada/Junta de Andalucía (GENYO), Granada, Spain. · Department of Otolaryngology, Hospital Universitario de Getafe, Getafe, Spain. · Department of Otolaryngology, San Raffaelle Scientific Institute, Milan, Italy. · Division of Otoneurology, Department of Otorhinolaryngology, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain. · Division of Otoneurology, Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain. · Department of Otolaryngology, Clinica Universidad de Navarra, Pamplona, Spain. · Department of Otolaryngology, Complexo Hospitalario de Pontevedra, Pontevedra, Spain. · Department of Otolaryngology, Hospital de Poniente, El Ejido, Almería, Spain. · Department of Otolaryngology, Hospital Universitario Salamanca, Salamanca, Spain. · Department of Otolaryngology, Hospital Miguel Servet, Zaragoza, Spain. · Department of Otorhinolaryngology, Hospital San Agustin, Linares, Jaen, Spain. · Department of Otorhinolaryngology, Hospital Universitario La Fe, Valencia, Spain. · Department of Otorhinolaryngology, Hospital Costa del Sol, Marbella, Malaga, Spain. · Department of Otolaryngology, Hospital General Universitario de Alicante, Alicante, Spain. · Department of Otolaryngology, Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas, Spain. · Department of Otorhinolaryngology, Hospital Universitario de Cabueñes, Gijon, Spain. · Department of Otolaryngology, Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitalario Universidad de Granada (CHUGRA), Granada, Spain. ·Clin Otolaryngol · Pubmed #28166395.

ABSTRACT: OBJECTIVES: To define clinical subgroups by cluster analysis in patients with unilateral Meniere disease (MD) and to compare them with the clinical subgroups found in bilateral MD. DESIGN: A cross-sectional study with a two-step cluster analysis. SETTINGS: A tertiary referral multicenter study. PARTICIPANTS: Nine hundred and eighty-eight adult patients with unilateral MD. MAIN OUTCOME MEASURES: best predictors to define clinical subgroups with potential different aetiologies. RESULTS: We established five clusters in unilateral MD. Group 1 is the most frequently found, includes 53% of patients, and it is defined as the sporadic, classic MD without migraine and without autoimmune disorder (AD). Group 2 is found in 8% of patients, and it is defined by hearing loss, which antedates the vertigo episodes by months or years (delayed MD), without migraine or AD in most of cases. Group 3 involves 13% of patients, and it is considered familial MD, while group 4, which includes 15% of patients, is linked to the presence of migraine in all cases. Group 5 is found in 11% of patients and is defined by a comorbid AD. We found significant differences in the distribution of AD in clusters 3, 4 and 5 between patients with uni- and bilateral MD. CONCLUSIONS: Cluster analysis defines clinical subgroups in MD, and it extends the phenotype beyond audiovestibular symptoms. This classification will help to improve the phenotyping in MD and facilitate the selection of patients for randomised clinical trials.

5 Article A novel missense variant in PRKCB segregates low-frequency hearing loss in an autosomal dominant family with Meniere's disease. 2016

Martín-Sierra, Carmen / Requena, Teresa / Frejo, Lidia / Price, Steven D / Gallego-Martinez, Alvaro / Batuecas-Caletrio, Angel / Santos-Pérez, Sofía / Soto-Varela, Andrés / Lysakowski, Anna / Lopez-Escamez, Jose A. ·Otology & Neurotology Group CTS495, Department of Genomic Medicine, GENYO - Centre for Genomics and Oncological Research - Pfizer/University of Granada/Junta de Andalucía, PTS, Granada 18016, Spain. · Dept. of Anatomy and Cell Biology, Univ. of Illinois at Chicago, Chicago, IL 60612, USA. · Department of Otolaryngology, Hospital Universitario Salamanca 37007, Spain. · Division of Otoneurology, Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela 15706, Spain. · Dept. of Otolaryngology-Head and Neck Surgery, Univ. of Illinois at Chicago, Chicago IL 60612, USA. · Otology & Neurotology Group CTS495, Department of Genomic Medicine, GENYO - Centre for Genomics and Oncological Research - Pfizer/University of Granada/Junta de Andalucía, PTS, Granada 18016, Spain antonio.lopezescamez@genyo.es. · Department of Otolaryngology, Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitalario Universidad de Granada (CHUGRA) Granada 18016, Spain. ·Hum Mol Genet · Pubmed #27329761.

ABSTRACT: Meniere's Disease (MD) is a complex disorder associated with an accumulation of endolymph in the membranous labyrinth in the inner ear. It is characterized by recurrent attacks of spontaneous vertigo associated with sensorineural hearing loss (SNHL) and tinnitus. The SNHL usually starts at low and medium frequencies with a variable progression to high frequencies. We identified a novel missense variant in the PRKCB gene in a Spanish family with MD segregating low-to-middle frequency SNHL. Confocal imaging showed strong PKCB II protein labelling in non-sensory cells, the tectal cells and inner border cells of the rat organ of Corti with a tonotopic expression gradient. The PKCB II signal was more pronounced in the apical turn of the cochlea when compared with the middle and basal turns. It was also much higher in cochlear tissue than in vestibular tissue. Taken together, our findings identify PRKCB gene as a novel candidate gene for familial MD and its expression gradient in supporting cells of the organ of Corti deserves attention, given the role of supporting cells in K

6 Article Development and evaluation of an audiology app for iPhone/iPad mobile devices. 2015

Larrosa, Francisco / Rama-Lopez, Julio / Benitez, Jesus / Morales, Jose M / Martinez, Asuncion / Alañon, Miguel A / Arancibia-Tagle, Diego / Batuecas-Caletrio, Angel / Martinez-Lopez, Marta / Perez-Fernandez, Nicolas / Gimeno, Carlos / Ispizua, Angel / Urrutikoetxea, Alberto / Rey-Martinez, Jorge. ·a 1 Department of Otolaryngology, Hospital Alt Penedes , Barcelona, Spain. · b 2 Department of Otolaryngology, Hospital Universitario Son Espases , Palma de Mallorca, Spain. · c 3 Department of Otolaryngology, Hospital Universitario de Gran Canaria Dr. Negrín , Las Palmas, Spain. · d 4 Department of Otolaryngology, Hospital General Universitario Ciudad Real , Ciudad Real, Spain. · e 5 Department of Otolaryngology, Hospital Universitario de Salamanca, IBSAL , Salamanca, Spain. · f 6 Department of Otolaryngology, Clinica Universidad de Navarra , Pamplona, Spain. · g 7 Department of Otolaryngology, Clinica Rotger, Palma de Mallorca , Mallorca, Spain. · h 8 Department of Otolaryngology, Hospital Universitario Donostia , San Sebastian, Spain. · i 9 Department of Otolaryngology, Hospital Comarcal del Bidasoa , Hondarribia, Spain. · j 10 Otolaryngology Unit ORLGipuzkoa, Clínica Quirón Donostia , San Sebastian, Spain. ·Acta Otolaryngol · Pubmed #26144548.

ABSTRACT: CONCLUSION: The application described in this study appears to be accurate and valid, thus allowing calculation of a hearing handicap and assessment of the pure-tone air conduction threshold with iPhone/iPad devices. OBJECTIVE: To develop and evaluate a newly developed professional, computer-based hearing handicap calculator and a manual hearing sensitivity assessment test for the iPhone and iPad (AudCal). METHODS: Multi-center prospective non-randomized validation study. One hundred and ten consecutive adult participants underwent two hearing evaluations, a standard audiometry and a pure-tone air conduction test using AudCal with an iOS device. The hearing handicap calculation accuracy was evaluated comparing AudCal vs a web-based calculator. RESULTS: Hearing loss was found in 83 and 84 out of 220 standard audiometries and AudCal hearing tests (Cohen's Kappa = 0.89). The mean difference between AudCal and standard audiogram thresholds was -0.21 ± 6.38 dB HL. Excellent reliability and concordance between standard audiometry and the application's hearing loss assessment test were obtained (Cronbach's alpha = 0.96; intra-class correlation coefficient = 0.93). AudCal vs a web-based calculator were perfectly correlated (Pearson's r = 1).

7 Article Vestibular function in cochlear implantation: Correlating objectiveness and subjectiveness. 2015

Batuecas-Caletrio, Angel / Klumpp, Micah / Santacruz-Ruiz, Santiago / Benito Gonzalez, Fernando / Gonzalez Sánchez, Enrique / Arriaga, Moises. ·Department of Otorhinolaryngology, Otoneurology Unit, University Hospital of Salamanca, University of Salamanca, Salamanca, Spain. · Department of Otolaryngology and Neurosurgery, Louisiana State University Health Sciences-New Orleans, Division of Otology and Neurotology-Hearing and Balance Center, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, U.S.A. ·Laryngoscope · Pubmed #25891786.

ABSTRACT: OBJECTIVE: To evaluate vestibular function before and after cochlear implantation (CI) STUDY DESIGN: A prospective descriptive study. MATERIAL AND METHODS: Thirty consecutive patients with profound sensorineural hearing loss undergoing CI. Objective assessment of vestibular function was performed with the caloric test and video head impulse test (vHIT) in patients before and after CI. Dizziness Handicap Inventory (DHI) was used for subjective assessment before and after CI. RESULTS: Thirty patients received CI with 21 by round window approach and nine by anteroinferior cochleostomy. Vestibular results were categorized into four groups: no changes (20 patients), changes in the caloric test and vHIT (3 patients, all with DHI changes; P = 0.0001), changes in vHIT gain but not in caloric test (3 patients, all with DHI changes; P = 0.005), no changes in the caloric test and vHIT gain but only saccades appear (4 patients, all with DHI changes; P = 0.011). CONCLUSIONS: Although CI is a safe surgery with few major complications, it is a procedure that can produce dizziness. The vHIT reveals that 30% of patients demonstrate postoperative change in vestibular function. Therefore, when examining a CI patient with postoperative symptoms of dizziness, results of the vHIT test and gain as well as the presence of saccades, along with an increase DHI score, are parameters to consider in their evaluation. LEVEL OF EVIDENCE: 4.

8 Article [Treatment of severe to profound mixed hearing loss with the BAHA Cordelle II]. 2011

Orús Dotú, César / Santa Cruz Ruíz, Santiago / De Juan Beltrán, Julia / Batuecas Caletrio, Angel / Venegas Pizarro, María del Prado / Muñoz Herrera, Angel. ·Sección de Otología, Hospital de la Santa Creu i Sant Pau, Barcelona, España. corus@santpau.cat ·Acta Otorrinolaringol Esp · Pubmed #21300323.

ABSTRACT: GOALS: Evaluation of the audiological outcome and subjective satisfaction of BAHA Cordelle II in the treatment of patients with severe to profound bilateral mixed hearing loss. MATERIAL AND METHOD: Retrospective study of 12 patients suffering a severe to profound bilateral sensorineural hearing loss, using pure tone audiometry (PTA), speech audiometry and subjective evaluation before and after the implantation of a BAHA Cordelle II (Cochlear(®)). RESULTS: The average gain in conversational frequencies (0.5 to 4kHz) with BAHA in free field was 43, 51, 47 and 44dB, respectively. We observed a GAP over closure in 10 of the 12 patients. Speech audiometry improved from 85% at 83dB of maximum discrimination to 96% at 62dB. The subjective evaluation questionnaires showed great satisfaction with a slight decrease in noisy or windy environments. The great majority of our patients used the BAHA device throughout the entire day. CONCLUSIONS: The BAHA Cordelle II (Cochlear(®)) is a good option in the treatment of severe to profound bilateral mixed hearing loss. Its best advantages are a low risk of labyrinthization, high result predictability, easy and step-by-step surgery, no need for general anaesthesia, and the GAP over closure in all frequencies. Active middle ear devices represent another alternative, but specific indications have not been defined yet because of low universal experience. When the intelligibility of the patient is poor, cochlear implantation should be considered.