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Coupling of Active Middle Ear Implants to the Ossicles and the Cochlea

Presenting Author: Joachim Mueller

Published online by Cambridge University Press:  03 June 2016

Joachim Mueller  and
John Martin Hempel
Joachim Mueller
Affiliation:
Section Otology and Cochlear Implants
John Martin Hempel
Affiliation:
Dept of Otorhinolayryngology, Munich University
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Abstract

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Learning Objectives: In general, the audiological results achieved after tympanoplasty showed postoperatively for 80 % of the patients an improved or equal hearing compared to preoperatively. Thus 20% of the patients are not satisfied with their hearing. Active middle ear implants offer new possibilities for the improvement of hearing. In principle, active middle ear implants can directly drive any vibratory structure of the middle ear. The lecture uses video sequences to describe and discusses the coupling techniques of active devices to the ossicular chain (Incus, Stapes), to partial or total prosthesis, directly to the round or oval window. For some attachments, special elements had been developed. Also accompanying procedures, such as tympanic membrane reconstruction with cartilage are discussed. In cases of a atelectatic middle ear the alternative application of the device directly to the round oval or round window is advantageous. Active middle ear implants enrich the field of reconstructive middle ear surgery and enable a detailed discussion on different ways of reconstruction.

Since the basic principles of tympanoplasty had been developed in the early 50ties, many otologists made additional contributions to our current knowledge of tympanoplasty procedures.

In general, the audiological results achieved after tympanoplasty showed postoperatively for 80 % of the patients an improved or equal hearing compared to preoperatively. Thus 20% of the patients are not satisfied with their hearing.

Active middle ear implants offer new possibilities for the improvement of hearing.

In principle, active middle ear implants can directly drive any vibratory structure of the middle ear. The lecture describes and discusses, based on short videosequences, the coupling techniques to the ossicular chain (Incus, Stapes), to a partial or total prosthesis, or directly to the cochlea, via the round or oval window. For some couplings methods, special elements had been developed.

Also accompanying procedures, such as tympanic membrane reconstruction with cartilage are discussed.

In cases of a atelectatic middle ear some of the above mentioned alternative applications of the active device directly to the round oval or round window is advantageous.

Active middle ear implants enrich the field of reconstructive middle ear surgery and enable a detailed discussion on different ways of reconstruction.