Learning Objectives: Active middle ear implants; Hearing loss.

During the last years, indication range for active middle ear implants (AMEI) has been widely extended. Originally, AMEI were indicated in patients with sensory neural hearing loss. Due to new coupling strategies, these days also patients with conductive and mixed hearing loss can be provided with AMEI. Therefore, these systems are also indicated in cases such as chronic otitis media and/or ear malformations etc.

Using recently introduced coupling techniques, 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.

The post-operative outcome will be presented and we will finish up with a discussion of our experiences with the audience who might have had patients with similar conditions or different pitfalls.