Osseointegrated implants and microsurgery of the ear to restore hearing

In 1990 I presented the results of the first cochlear implants performed in Spain since 1985. A path of hope was opened so that totally deaf or children born deaf could recover their hearing. Today this technology allows the hearing recovery of thousands of patients with profound hearing difficulties, even total deafness.

Today’s miniaturized hearing aids also help thousands of people in the world with some types of deafness. Proper fitting and selection is very important for a successful outcome. When conventional hearing aids or surgery are not effective, bone anchored implants have been of great help to certain types of people in their hearing recovery. The most recent novelty in this type of hearing aid is the osseointegrated implants totally hidden under the skin that only require the adaptation by magnetic induction of a small external element when the patient wants to use it. This allows patients who are totally deaf in one ear due to infections, trauma, malformations, or who have had tumors of the auditory nerve removed and whose only option for hearing is by means of these implants.

Ear microsurgery

However, ear microsurgery and the use of lasers are still the best solution for certain types of hearing loss, such as otosclerosis, which causes the fixation of a small bone in the ear, the stapes, which must be replaced by a prosthesis to restore its mobility and, therefore, hearing.

Chronic otitis or otorrhea cause destruction of the ear in addition to infections that endanger other nearby structures. Surgery allows to control most of these infections correcting the infection and achieving, in many cases, hearing recovery.

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Otologic vertigo, the so-called Meniere’s disease, is a fairly frequent pathology caused by a lesion in the labyrinth and inner ear, which causes violent vertiginous episodes, tinnitus and progressive hearing loss. In patients who do not respond to medical treatment it is always possible to control them with the surgical option, which gives excellent results.

Another type of deafness caused by a pathology, acoustic neurinoma (vestibular schwannoma), is potentially very serious due to the intercranial progression of a tumor which, although benign, can be dangerous for the patient due to its characteristics. Its removal is currently performed by means of microsurgery, laser and ultrasound, although in many cases it would lead to total deafness as the auditory nerve would have to be severed.

Nowadays it is possible to recover the hearing of these patients with the latest generation of osseointegrated implants that allow hearing to be captured on the affected side and transmitted to the healthy ear, giving the impression that the patient hears through the deaf ear.

In general, we can say that the current microsurgery sometimes associated with increasingly advanced electronics makes it possible to recover hearing in patients who would otherwise be hopeless.