Inner Ear Active Hearing Device in Non-Otosclerotic, Severe, Mixed Hearing Loss.
To verify the efficacy of a powerful active hearing device in a patient different from far-advanced otosclerosis, specifically when the stapes footplate is mobile.



A patient with severe-to-profound mixed hearing loss, who was not benefiting from the use of a conventional hearing aid, was selected for an inner ear active implant. This was justified by a bone conductive threshold above 60 dB, which had discouraged any other rehabilitative solutions such as a bone conductive implant, or an active middle ear implant (AMEI).



The hearing device was surgically applied using a combined transmastoid/transcanal approach. During surgery, a mobile stapes were found and was perforated for the insertion of a piston prosthesis, crimped on the new-incus of the device.



The bone conduction threshold was assessed postoperatively to identify any possible surgery-related hearing deterioration. Pure tone audiometry was conducted in a sound field, and a speech reception threshold test was performed with the contralateral ear masked. The hearing outcome was assessed soon after the implant activation (6 weeks after surgery), and 6 months after surgery.



Upon activation of the device, a PTA of 45 dB was obtained (at 0.5, 1, 2 and 4 kHz). At 6 months after surgery, the speech discrimination score reached 90% at 80 dB SPL.



The application of the Codacs device has shown to be compatible with a mobile stapes footplate, as demonstrated in this report. The footplate perforation did not cause any further hearing deterioration, and has allowed to achieve a favorable auditory outcome.
Otolaryngology Clinic, NESMOS Department, Medicine and Psychology, Sapienza University, Rome, Italy.
Maurizio
M
Barbara
Luigi
L
Volpini
Edoardo
E
Covelli
Chiara
C
Filippi
Simonetta
S
Monini
D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000502:physiology; D007758:Ear, Inner / Q000601:surgery; D005260:Female; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000601:surgery*; D006801:Humans; D019919:Prosthesis Implantation / Q000379:methods*; D013069:Speech Reception Threshold Test; D013201:Stapes Surgery / Q000379:methods*