Letter to the Editor First bilateral simultaneous implantation with fully implantable middle ear hearing device

Abstract

The majority of moderate to severe sensorineural hearing loss individuals must rely on amplification of the acoustic signal to improve communication skills. This aim is generally accomplished with conventional air conduction hearing aids [1]. In some cases, hearing aid wearers report difficulties and limited adoption of hearing aids due to ear canal occlusion, pain or irritation of the skin in the ear canal, social stigma, and cosmetic issues [2]. The fully implantable middle ear hearing device is now an alternative solution for those patients. It resides completely underneath the skin behind the ear, with nothing in the external ear canal. The Otologics Carina implant is composed of an electronic capsule, microphone, and electromagnetic transducer. The battery, magnet, digital signal processor, coil, and connector make up the electronic capsule [1, 2]. The sensitive subcutaneous microphone picks up the acoustic signal, which is then translated into a digital signal, amplified according to the wearer’s needs, and converted into the electrical signal. This electrical signal is sent to the electromagnetic transducer, which translates it into a mechanical motion that directly stimulates the ossicles. The tip of the transducer touches the middle ear ossicular chain, round or oval window and in this way bypasses the external ear canal [1-5]. Besides the fully implantable part, three other components are also important for this hearing device: the programming system, the charger, and the remote control. The charging time of the battery in the newest Carina device typically requires 45 min to 1 h, if performed daily. The fully implantable middle ear hearing system Carina is designed to deal with moderate to severe hearing loss in adults with normal middle ears, and no signs or symptoms of retrocochlear, central auditory or functional components. Most recently it has been successfully used in patients with ossicular chain malformations in conductive and mixed hearing loss [6-9]. In this paper the authors present a case report of the first bilateral simultaneous implantation with a fully implantable middle ear hearing device. Candidacy criteria and preoperative and postoperative audiological results are reported, and advantages obtained with these implants are discussed. One patient was included in this retrospective case report. To our best knowledge it is the first reported case of bilateral simultaneous implantation with a fully implantable middle ear hearing device. The surgery took place in the Department of Otolaryngology at the Medical University of Corresponding author: Magdalena Lachowska MD, PhD Department of Otolaryngology Medical University of Warsaw 1a Banacha 02-097 Warsaw, Poland Phone: +48 22 5992521 Fax: +48 22 5992523 E-mail: mlachowska@wum.edu.pl Letter to the Editor