title: A middle ear implant with a titanium canal wall prosthesis for a case of an open mastoid cavity.
abstract: OBJECTIVE
  Open mastoid cavity rehabilitation should focus on both anatomical and functional aspects. We hereby report the technique and results of a combined strategy to reconstruct the external ear canal using a titanium wall implant and the middle ear using a fully implantable active middle ear device.
  
  
  METHODS
  A fully implantable active middle ear implant was used to rehabilitate the mixed hearing loss of a 63-year-old woman, and a titanium posterior canal wall prosthesis was used to reconstruct the external ear canal during the same procedure. The middle ear implant was placed directly on the footplate. The auditory results were compared to the preoperative unaided thresholds and to the amplification of a conventional hearing aid.
  
  
  RESULTS
  Following the procedure, there was an anatomically normal external ear canal with a healed tympanic membrane separating the external from the middle ear spaces. The postoperative auditory gains were on average 31.8 dB on pure-tone audiometry, and 20 dB on speech reception threshold. No complications occurred.
  
  
  CONCLUSIONS
  The rehabilitation of the external ear canal in an open mastoid cavity allows for clinical follow-up of the patient, and the implantation of an active middle ear implant provides appropriate auditory gains both in pure tones and in speech reception thresholds.
authors.affiliation: Department of Oto-Rhino-Laryngology and Skull Base Surgery, University Hospital Nord - University La Méditerranée and Assistance Publique Hôpitaux de Marseille, Marseille, France. arnaud.deveze@ap-hm.fr
authors.forename: Arnaud
authors.initials: A
authors.lastname: Deveze
authors.forename: Charbel
authors.initials: C
authors.lastname: Rameh
authors.forename: Mélanie
authors.initials: M
authors.lastname: Sanjuan
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Lavieille
authors.forename: Jacques
authors.initials: J
authors.lastname: Magnan
mesh_terms: D001301:Audiometry, Pure-Tone; D001302:Audiometry, Speech; D001309:Auditory Threshold; D001844:Bone Conduction; D018424:Cholesteatoma, Middle Ear / Q000601:surgery; D038524:Diffusion Magnetic Resonance Imaging; D004424:Ear Canal / Q000601:surgery*; D005260:Female; D006310:Hearing Aids; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000601:surgery*; D006801:Humans; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D009998:Ossicular Prosthesis; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D011474:Prosthesis Design; D012086:Reoperation; D014025:Titanium; D014057:Tomography, X-Ray Computed
chemical_list: D014025:Titanium