Osseointegrated implants in otology: How do they work?

An osseointegrated implant in otology is the placement of a prosthesis fixed to the bone and which will be biocompatible with it. The function of osseointegrated implants is to change the transmission of sounds from the airway to the bone.

When the sounds cannot reach the inner ear due to malformations, lesions in the eardrum or the chain of ossicles of the ear, transmission deafness is produced. The sounds arrive very diminished or do not arrive at all because of the alterations that exist in the anatomical elements of the external and middle ear. This transmission deafness can often be corrected by surgery, called tympanoplasty.

Treatments for conductive deafness

When this surgery is not possible, or in some cases, it cannot be performed, the solution may be the placement of an external auditory prosthesis, being the ideal one that sends the sound through the bone, in cases of conductive hearing loss. These prostheses are placed on top of the mastoid (see image), so they have to contact the skin under pressure. But this skin and sometimes the lack of pressure on it decrease the sound volume.

To improve transmission, systems have been developed whereby the prosthesis is fixed to the bone by means of a screw implanted in the mastoid. The technique is simple: the skin is opened up to the bone and the implant is screwed into it. In a few days the prosthesis can be placed on the implanted screw and the hearing improvement can be appreciated. The hearing loss caused by the lack of sound transmission is completely recovered.

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To indicate this type of implants before surgery, the patient tests the improvement of his hearing with the prosthesis by means of a vibrator and, if he considers it sufficient, the surgery is performed.