Middle ear implants are an emerging option for patients who are no longer satisfied with their hearing aid performance, but are not yet candidates for cochlear implants. The middle ear implants are placed around the ossicles of the middle ear, which vibrate sound energy with higher power than a conventional hearing aid . Middle ear implants can send sound to the inner ear with greater power, quality, clarity, and without feedback.

What are the types of middle ear implants?

There are different brands of middle ear implants on the market. Each implant works differently, so it is important to discuss with your otologist to see which is best for you:

  • Maxum
  • Esteem
  • Vibrant Soundbridge

What is the difference between a middle ear implant, a hearing aid, and a cochlear implant?

A hearing aid works by receiving and amplifying sound into the ear. The hearing aid is best for patients with moderate hearing loss. When sound is amplified into the ear, it causes the ear drum to vibrate and send conduct the mechanical sound energy into the inner ear.

A cochlear implant is an option for patients with severe to profound hearing loss, who feel that a hearing aid no longer provides them with the necessary power and clarity. A cochlear implant works by bypassing the middle ear. Sound is received through an external device and then converted into electrical energy that is sent directly into the inner ear. The hearing nerve is then stimulated and sound signals are sent to the brain.

A middle ear implant works differently from both of the above. The middle ear implant does not use actual sound or direct electric stimulation. It works by converting sound into electromagnetic energy, which then vibrates the ossicles of the middle ear with greater power and clarity. Since there is no speaker, patients do not hear the bothersome feedback associated with a conventional hearing aid.

How do I know if I am a candidate for a middle ear implant?

You should consult an otologist (Ear Surgeon) to check your candidacy. If you suffer from moderate to severe nerve-related hearing loss, conductive hearing loss, or mixed hearing loss, you may be a candidate. If you are not satisfied with the power or clarity of your hearing aids, you may be a candidate for a middle ear implant.

What diagnostic tests are needed?

Your otologist will need to obtain a detailed history and exam of your ears. An audiogram (hearing test) will need to be performed. In most cases, a quick in-office CT scan is also recommended to verify the anatomy of the middle ear. 

How is a middle ear implant placed?

Some middle ear implants, such as the Maxum implant, can be easily placed in a minimally invasive fashion. The procedure is performed in an outpatient surgery center, and the patients usually return home on the same day.

The procedure is performed with the use of an operating microscope, and a small, hidden incision is made inside the ear canal. After lifting the ear drum, the implant is placed around the ossicles of the middle ear, and the ear drum is placed back into its original position. Other implants, such as the Esteem and Vibrant Soundbridge, are placed through a small incision hidden behind the ear.

What is the recovery period?

Patients can usually return to light activity the next day after surgery. Patients usually report very minimal pain that can be treated with over the counter pain medication. The ear takes about a week to heal. The implant is activated a few weeks after surgery.

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