title: A Retrospective Multicentre Cohort Review of Patient Characteristics and Surgical Aspects versus the Long-Term Outcomes for Recipients of a Fully Implantable Active Middle Ear Implant.
abstract: To summarise treatment outcomes compared to surgical and patient variables for a multicentre recipient cohort using a fully implantable active middle ear implant for hearing impairment. To describe the authors' preferred surgical technique to determine microphone placement.
  
  
  
  Multicentre retrospective, observational survey.
  
  
  
  Five tertiary referral centres.
  
  
  
  Carina recipients (66 ears, 62 subjects) using the current Cochlear® Carina® System or the legacy device, the Otologics® Fully Implantable Middle Ear, with a T2 transducer.
  
  
  
  Patient file review and routine clinical review. Patient outcomes assessed were satisfaction, daily use and feedback reports at the first fitting and ≥12 months after implantation. Descriptive and statistical analysis of correlations of variables and their influence on outcomes was performed. Independently reported preferred methods for microphone placement are collectively summarised.
  
  
  
  The average implant experience was 3.5 years. Satisfaction increased significantly over time (p < 0.05). No correlation with covariates examined was observed. Feedback significantly decreased over time, showing a significant correlation with microphone location, primary motivation, gender, age at implantation, and contralateral hearing aid use (p < 0.05). Patient satisfaction was inversely correlated with reports of system feedback (p < 0.05). The implantable microphone was most commonly on the posterior inferior mastoid line, in 42/66 (65%) cases, correlating with less likelihood for feedback and consistent with author surgical preference.
  
  
  
  Carina recipients in this study present as satisfied consistent daily users with very few reports of persistent feedback. As microphone location is an influencing factor, a careful surgical consideration of microphone placement is required. The authors prefer a posterior inferior mastoid line position whenever possible.
authors.affiliation: Department of Otorhinolaryngology, CHU de Liège, Liège, Belgium.
authors.forename: Philippe P
authors.initials: PP
authors.lastname: Lefebvre
authors.forename: Javier
authors.initials: J
authors.lastname: Gisbert
authors.forename: Domenico
authors.initials: D
authors.lastname: Cuda
authors.forename: Stéphane
authors.initials: S
authors.lastname: Tringali
authors.forename: Arnaud
authors.initials: A
authors.lastname: Deveze
mesh_terms: D000328:Adult; D004432:Ear, Middle / Q000601:surgery*; D005260:Female; D006310:Hearing Aids; D034381:Hearing Loss / Q000534:rehabilitation; D006319:Hearing Loss, Sensorineural / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008416:Mastoid; D008875:Middle Aged; D017060:Patient Satisfaction; D019736:Prostheses and Implants; D012189:Retrospective Studies; D014159:Transducers; D016896:Treatment Outcome