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Totally implantable active middle-ear implants: a large, single-surgeon cohort

Published online by Cambridge University Press:  22 March 2021

E McCarty Walsh ,
D R Morrison  and
W J McFeely
E McCarty Walsh
Affiliation:
Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL, USA
D R Morrison*
Affiliation:
Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL, USA
W J McFeely
Affiliation:
North Alabama ENT Associates, Huntsville, USA
*
Author for correspondence: Dr Daniel Morrison, Department of Otolaryngology, University of Alabama at Birmingham, Birmingham35233, Alabama, USA E-mail: drmorrison@uabmc.edu Fax: +1 205 801 7802
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Abstract

Objectives

This study aimed to evaluate hearing outcomes and device safety in a large, single-surgeon experience with the totally implantable active middle-ear implants.

Methods

This was a retrospective case series review of 116 patients with moderate-to-severe sensorineural hearing loss undergoing implantation of active middle-ear implants.

Results

Mean baseline unaided pure tone average improved from 57.6 dB before surgery to 34.1 dB post-operatively, signifying a mean gain in pure tone average of 23.5 dB (p = 0.0002). Phonetically balanced maximum word recognition score improved slightly from 70.5 per cent to 75.8 per cent (p = 0.416), and word recognition score at a hearing level of 50 dB values increased substantially from 14.4 per cent to 70.4 per cent (p < 0.0001). Both revision and explant rates were low and dropped with increasing surgeon experience over time.

Conclusion

This study showed excellent post-operative hearing results with active middle-ear implants with regard to pure tone average and word recognition score at a hearing level of 50 db. Complication rates in this case series were significantly lower with increasing experience of the surgeon. Active middle-ear implants should be considered in appropriate patients with moderate-to-severe sensorineural hearing loss who have struggled with conventional amplification and are good surgical candidates.

Keywords

Hearing Loss, SensorineuralPresbycusisMiddle EarIncusStapesHearing AidsMiddle Ear Implant
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 4 , April 2021 , pp. 304 - 309
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr D Morrison takes responsibility for the integrity of the content of the paper

References

Lin, FR, Niparko, JK, Ferrucci, L. Hearing loss prevalence in the United States. Arch Intern Med 2011;171:1851–2CrossRefGoogle ScholarPubMed
Pittman, AL, Stelmachowicz, PG. Hearing loss in children and adults: audiometric configuration, asymmetry, and progression. Ear Hear 2003;24:198–205CrossRefGoogle Scholar
Lerner, S. Limitations of conventional hearing aids: examining common complaints and issues that can and cannot be remedied. Otolaryngol Clin North Am 2019;52:211–20CrossRefGoogle ScholarPubMed
Boeheim, K, Pok, SM, Schloegel, M, Filzmoser, P. Active middle ear implant compared with open-fit hearing aid in sloping high-frequency sensorineural hearing loss. Otol Neurotol 2010;31:424–9CrossRefGoogle ScholarPubMed
Bittencourt, AG, Burke, PR, Jardim Ide, S, Brito, R, Tsuji, RK, Fonseca, AC et al. Implantable and semi-implantable hearing AIDS: a review of history, indications, and surgery. Int Arch Otorhinolaryngol 2014;18:303–10Google ScholarPubMed
Shohet, JA, Gende, DM, Tanita, CS. Totally implantable active middle ear implant: hearing and safety results in a large series. Laryngoscope 2018;128:2872–8CrossRefGoogle Scholar
Barbara, M, Filippi, C, Covelli, E, Volpini, L, Monini, S. Ten years of active middle ear implantation for sensorineural hearing loss. Acta Otolaryngol 2018;138:807–14CrossRefGoogle ScholarPubMed
Shohet, JA, Kraus, EM, Catalano, PJ, Toh, E. Totally implantable hearing system: five-year hearing results. Laryngoscope 2018;128:210–16CrossRefGoogle ScholarPubMed
Lee, JM, Jeon, JH, Moon, IS, Choi, JY. Benefits of active middle ear implants over hearing aids in patients with sloping high tone hearing loss: comparison with hearing aids. Acta Otorhinolaryngol Ital 2017;37:218–23CrossRefGoogle ScholarPubMed
Ihler, F, Bewarder, J, Blum, J, Matthias, C, Canis, M. Long-term functional outcome and satisfaction of patients with an active middle ear implant for sensorineural hearing loss compared to a matched population with conventional hearing aids. Eur Arch Otorhinolaryngol 2014;271:3161–9CrossRefGoogle ScholarPubMed
Butler, CL, Thavaneswaran, P, Lee, IH. Efficacy of the active middle-ear implant in patients with sensorineural hearing loss. J Laryngol Otol 2013;127(suppl 2):8–16CrossRefGoogle ScholarPubMed
Bruchhage, KL, Leichtle, A, Schonweiler, R, Todt, I, Baumgartner, WD, Frenzel, H et al. Systematic review to evaluate the safety, efficacy and economical outcomes of the Vibrant Soundbridge for the treatment of sensorineural hearing loss. Eur Arch Otorhinolaryngol 2017;274:1797–806CrossRefGoogle ScholarPubMed
Edfeldt, L, Stromback, K, Grendin, J, Bunne, M, Harder, H, Peebo, M et al. . Evaluation of cost-utility in middle ear implantation in the ‘Nordic School’: a multicenter study in Sweden and Norway. Cochlear Implants Int 2014;15(suppl 1):65–7CrossRefGoogle ScholarPubMed
Snik, AF, van Duijnhoven, NT, Mylanus, EA, Cremers, CW. Estimated cost-effectiveness of active middle-ear implantation in hearing-impaired patients with severe external otitis. Arch Otolaryngol Head Neck Surg 2006;132:1210–5CrossRefGoogle ScholarPubMed
Klein, K, Nardelli, A, Stafinski, T. A systematic review of the safety and effectiveness of fully implantable middle ear hearing devices: the carina and esteem systems. Otol Neurotol 2012;33:916–21CrossRefGoogle ScholarPubMed
Pulcherio, JO, Bittencourt, AG, Burke, PR, Monsanto, RC, de Brito, R, Tsuji, RK et al. Carina(®) and Esteem(®): a systematic review of fully implantable hearing devices. PLoS One 2014;9:e110636CrossRefGoogle ScholarPubMed
Seidman, MD, Janz, TA, Shohet, JA. Totally implantable active middle ear implants. Otolaryngol Clin North Am 2019;52:297–309CrossRefGoogle ScholarPubMed
Gerard, JM, Thill, MP, Chantrain, G, Gersdorff, M, Deggouj, N. Esteem 2 middle ear implant: our experience. Audiol Neurootol 2012;17:267–74CrossRefGoogle ScholarPubMed
Barbara, M, Volpini, L, Monini, S. Delayed facial nerve palsy after surgery for the Esteem(®) fully implantable middle ear hearing device. Acta Otolaryngol 2014;134:429–32.CrossRefGoogle ScholarPubMed
Marzo, SJ, Sappington, JM, Shohet, JA. The Envoy Esteem implantable hearing system. Otolaryngol Clin North Am 2014;47:941–52CrossRefGoogle ScholarPubMed