Passive middle ear implants
What are passive middle ear implants?
Passive middle ear implants have revolutionised the treatment of hearing loss, explicitly addressing conductive and mixed hearing loss caused by impaired sound conduction in the middle ear. These tiny prostheses can restore hearing capabilities and significantly improve the quality of life for individuals with hearing impairments.
Passive middle ear implants are a potential alternative to traditional hearing aids. In some instances, these implants have shown an ability to improve the overall outcome when used in conjunction with a hearing aid.
Partial ossicular replacement prosthesis (PORP)
The Partial Ossicular Replacement Prosthesis (PORP) is a commonly used middle ear implant. This device is designed to replace a damaged or missing ossicle, tiny bones responsible for transmitting sound vibrations in the middle ear. Restoring the ossicles can significantly improve sound conduction, resulting in better hearing outcomes.
Total ossicular replacement prosthesis (TORP)
Another type of middle ear implant is the Total Ossicular Replacement Prosthesis (TORP). Unlike the PORP, the TORP replaces all three ossicles, replicating the function of the damaged ossicles and restoring sound transmission. This is particularly effective in treating severe hearing loss and enabling individuals to regain their hearing abilities.
In some cases, additional middle ear surgery, such as tympanoplasty, may be required in conjunction with placing a passive middle ear implant. This ensures the optimal patient outcome and addresses related issues contributing to hearing loss, such as infections and diseases like cholesteatoma.
Stapes replacement prosthesis
The stapes replacement prosthesis is a passive middle ear implant designed to address hearing loss caused by stapes fixation. Stapes fixation is often caused by otosclerosis, and this prosthesis is used to replace the fixed stapes bone and improve hearing loss. By addressing the underlying cause, individuals can experience significant improvements in their hearing abilities and, in most cases, will not need hearing aids.
Which material is used in passive middle ear implants?
Thematerials used for these prostheses are mainly titanium, given its numerous advantages. Titanium is lightweight, durable, compatible with the human body, and easy to work with. However, other materials like Teflon, platinum, and nickel may also be utilised, depending on the patient’s specific needs.
MRI compatibility with passive middle ear implants
One common concern regarding these implants is their safety during magnetic resonance imaging (MRI) scans. However, it is essential to note that passive middle ear implants, including those of titanium, are safe for MRI investigations. Patients can rest assured knowing they can undergo necessary medical imaging without any risks or complications.
3D reconstructed titanium ossicles are unsatisfactory in addressing hearing impairments. There is no evidence supporting its use. The challenges associated with accurately reproducing the delicate anatomy, the mass of printed ossicles and the difficulties in integrating the reconstructed ossicles within the middle ear ultimately contribute to their lack of success.
What is required before surgery?
In determining whether an individual qualifies for a passive middle ear implant, a comprehensive evaluation comprising a clinical ear examination, diagnostic hearing test, and a cone beam computed tomography (CT) scan of the middle ear is essential. These examinations provide valuable insights into the individual’s auditory system and help assess their candidacy for a passive middle ear implant.
Would you like to know more about passive middle ear implants?
At the CHi, our team of skilled surgeons is experienced in performing middle ear implants. We recognise the significance of these prostheses in improving the quality of life for individuals with conductive and mixed hearing loss. We are committed to providing the best possible solutions for our patients and restoring their hearing capabilities by utilising the latest technology and expertise.