This post is part of a clinic feature series, where we highlight doctors and clinics who offer the Oticon Medical Bone Anchored Hearing System, the Ponto.
James E. Benecke, MD, FACS is an otologist/neurotologist with Midwest Ear Specialists, part of the BJC Medical Group of Missouri. He is Chief of Otolaryngology at Missouri Baptist Medical Center and Adjunct Professor of Otolaryngology Head & Neck Surgery at St. Louis University School of Medicine.
As a specialist in the ear, Dr. Benecke is consistently recognized on “The Best Doctors in America” list. He and his team offer a full array of diagnostic evaluations for hearing and vestibular (balance) disorders. They provide medical and surgical care of pediatric and adult patients with ear diseases, dizziness & balance disorders, as well as issues with the temporal bone, skull base, and related structures.
Recently, we had the opportunity to talk with Dr. Benecke about his care for patients with hearing loss. Below is our conversation.
How did you get involved with bone anchored hearing?
“When I was a resident, there were many articles in the literature regarding bone anchored hearing systems (BAHS). But there were many technical issues and problems, so these systems never really gained any traction in the US at that time. I was seriously interested in BAHS and kept my finger on the pulse of this research. Years later, surgical obstacles were resolved and I was able to hear first hand from surgeons who were performing BAHS surgery as well as their patients who were the recipients of this technology. I was impressed with the results and patient satisfaction. When it received FDA approval, I immediately began offering this to my patients. My very first bone anchored patient had SSD due to an acoustic neuroma and was implanted 14 years ago. The patient still is using the device with over a decade of marvelous use.”
In your experience, what is the awareness level around bone anchored hearing as a solution?
“This September, I will have been involved in the practice of otology/neurotology for 31 years. I have had the distinct blessing of seeing incredible advancements in the management of hearing loss. With these advancements comes the responsibility of educating professionals as well as patients. There is an increasing awareness of BAHS. In my practice, many patients come by word of mouth from other patients. Oticon Medical, in my opinion, has done a wonderful job of providing patient information through the internet, community seminars, as well as other forms of media.
Additionally, more and more audiologists, especially dispensing audiologists, are aware of BAHS. Many are offering BAHS to their patients as an alternative to a hearing aid. I view it as my responsibility to help to educate other professionals, both audiologists and physicians, regarding solutions for hearing loss and take advantage of speaking opportunities to address a procedure and product I believe in. As a result, we are seeing an increase in the volume of patients who are candidates for BAHS.
Another important aspect of awareness is making certain that the insurance companies understand the benefits of this technology. The issue of reimbursement for BAHS continues to be a bit of an issue. Thankfully, companies like Oticon Medical are of great assistance in working with the payers.”
Tell us about the increase in awareness that you’ve seen over the years.
“We are definitely seeing more patients inquiring about BAHS, both in the pediatric and adult populations. Such technology can be a life changer in the pediatric patient with either SSD or conductive loss that is not amenable to surgical reconstruction. Awareness in the professional community and through other patients taking advantage of the social media have increased the number of patients seeking out our services.”
When did you hear about the new MIPS procedure for the Ponto Bone Anchored Hearing System?
“I first heard about this when I had the privilege to visit Oticon Medical in Copenhagen in April 2015. I was amazed by the prospects of this technique and was awaiting the “green light” from the FDA. I went through the formal training in November of 2015. As the devices were not likely to make it through customs in America until after the first of the year, many of my patients were content to wait until this was available for use in our hospital and my practice.
I have always embraced a policy of “full disclosure” with my patients—letting them know all of the options and having them actively participate in the surgical decision. They all need to know exactly what to expect. The technique I have embraced for the past several years has been far less invasive than prior techniques. The hearing results have been phenomenal and the healing has been excellent in most cases. With MIPS, I anticipate even better healing results, especially early skin healing.”
Why do you advocate for bone anchored hearing?
“Quite simply, I advocate for this because it works. The results have been very predictable and that is extremely important in counseling patients. Although I may have a tendency toward BAHS over a hearing instrument, I strongly believe in thoroughly explaining all relevant options to out hearing impaired patients. This, the MIPS, is certainly one of the most viable options for those who meet candidacy criteria.”