Binaural hearing restoration with a bilateral fully implantable middle ear implant
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OTOLOGY
Binaural hearing restoration with a bilateral fully implantable middle ear implant Domenico Cuda1 · Alessandra Murri1 · Anna Mainardi1 · Francesca Forli2 · Stefano Berrettini2 · Luca Bruschini2 Received: 11 May 2020 / Accepted: 11 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Aim The fully implantable middle ear implant (C-FI-MEI) is designed for patients with moderate-to-severe sensorineural hearing loss or those with mixed hearing loss. To analyze the audiological post-operative results of subjects bilaterally implanted with C-FI-MEI. Materials and methods Retrospective study: 14 patients with bilateral, moderate-to-severe, sensorineural or mixed hearing loss were treated. This clinical sample included 14 cases bilaterally implanted (13 sequentially, 1 simultaneously). The evaluation at each follow-up after surgery included otologic examination, a structured interview, and different audiological tests composed of pure tone audiometry, speech in quiet and in noise test, and localization task. The mean follow-up was 67.2 ± 33 months. Results There were no significant differences between pre and post-operative pure tone averages. The patients showed no significant differences between pre-operatively aided and C-FI-MEI implant-aided conditions in terms of word recognition score. Speech perception in noise under different loudspeaker arrangements and localization tests demonstrated a binaural advantage in bilaterally implanted patients. The mean daily use time was 17.4 and 16.7 h, respectively, for right and left side. Conclusion The results for the 14 patients, bilaterally implanted with C-FI-MEI, suggest that bilateral implantation of fully implantable middle ear hearing devices is an effective procedure. Level of evidence 4. Keywords Fully implantable middle ear implant · Middle ear · Implant · Bilateral
Introduction Middle ear implants (MEIs) are increasingly applied in cases of moderate-to-severe sensorineural or mixed hearing loss (SNHL or MHL). There are semi-implantable and fully implantable MEIs (FI-MEI). The firsts have the electronic components, battery and the microphone housed in an audio processor worn by the patient while the transducer is surgically implanted, conducting the vibratory energy to the ossicular chain and the cochlea.
* Alessandra Murri [email protected] 1
Department of Otorhinolaryngology, “Guglielmo da Saliceto” Hospital of Piacenza, Via Cantone del Cristo 40, 29121 Piacenza, Italy
ENT Audiology and Phoniatric Unit, University Hospital of Pisa, Pisa, Italy
2
Two FI-MEIs were available on the market at the time of writing. In one the microphone is placed under the retroauricular skin. It captures sounds and sends them to the implant for processing. The signals are then converted into mechanical vibrations by an electromechanical transducer (actuator) appropriately secured by a special fixation system. The tip of the actuator is coupled to one of the ossicles or to the middle ear windows. This system includes a recha
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