Middle Ear Implant versus Hybrid Cochlear Implant for High-Frequency Sensorineural Hearing Loss

Abstract

Objectives:

Profound SNHL responds well to a standard cochlear implant (CI) with rewarding results. However, if the individual has residual hearing in the low frequencies there is a reasonable chance that the pure tones will be lost. Hybrid cochlear implants have been suggested as a solution for this problem. Unfortunately, there continues to be a loss of the low frequency pure tones in a large number of these patients.

Methods:

One solution would be to use a middle ear implant instead of a hybrid CI. The Maxum middle ear implant has the advantage of being a minimally invasive surgical procedure that can be performed under local anesthesia. A small magnet is attached to the stapes through a transcanal approach.

Results:

After 3 weeks an integrated processor coil (IPC) is inserted into the external auditory canal. The IPC has an electromagnet driver. By driving the stapes directly it is possible to obtain as much as 60 dB of functional gain in the high frequencies without distortion, acoustic feedback, or the sensation of occlusion.

Conclusions:

For these reasons the author believes a Maxum should be considered in these patients before a Hybrid Cochlear Implant. If the SNHL progresses, then a CI can still be performed at a later date. This sequence of events delays the invasion of the cochlea and in some cases prevents the need for a CI altogether.