Facial plast Surg 2015; 31(06): 581-586
DOI: 10.1055/s-0035-1569062
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Surgical and Technical Modalities for Hearing Restoration in Ear Malformations

Stefan Dazert1, Jan Peter Thomas1, Stefan Volkenstein1
  • 1Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr-University Bochum, Bochum, Germany
Further Information

Publication History

Publication Date:
14 December 2015 (online)

Abstract

Malformations of the external and middle ear often go along with an aesthetic and functional handicap. Independent of additional aesthetic procedures, a successful functional hearing restoration leads to a tremendous gain in quality of life for affected patients. The introduction of implantable hearing systems (bone conduction and middle ear devices) offers new therapeutic options in this field. We focus on functional rehabilitation of patients with malformations, either by surgical reconstruction or the use of different implantable hearing devices, depending on the disease itself and the severity of malformation as well as hearing impairment. Patients with an open ear canal and minor malformations are good candidates for surgical hearing restoration of middle ear structures with passive titanium or autologous implants. In cases with complete fibrous or bony atresia of the ear canal, the most promising functional outcome and gain in quality of life can be expected with an active middle ear implant or a bone conduction device combined with a surgical aesthetic rehabilitation in a single or multi-step procedure. Although the surgical procedure for bone conduction devices is straightforward and safe, more sophisticated operations for active middle ear implants (e.g., Vibrant Soundbridge, MED-EL, Innsbruck, Austria) provide an improved speech discrimination in noise and the ability of sound localization compared with bone conduction devices where the stimulation reaches both cochleae.