Learning Objectives: Active middle ear implants.

The indication range for implantable hearing devices such as active middle ear implants (AMEI) dramatically changed over the last years. While AMEI were primarily implanted to rehabilitate sensory neural hearing loss, new coupling strategies opened the way to also treat conductive and mixed hearing loss. Today, AMEI are also indicated in cases such as chronic otitis media and/or ear malformations etc.

Using current coupling systems, AMEIs may be adapted to ears with an intact ossicular chain and in cases with partially or complete missing ossicles. According to the remaining middle ear structures, the mechanical transducers of AMEIs may be adapted to different ossicles (incus, stapes) or to structures such as the oval or the round window. We will discuss advantages and disadvantages of different implants such as systems with one or two point fixation. Also, the various surgical techniques to place and adapt the transducers to middle ear structures will be addressed. Finally, we will present the post-operative outcome and want to discuss our experiences with the audience who might have had patients with similar conditions or different pitfalls.