Implantable Hearing Aids: Specialists and Information

Hearing aids are designed to compensate for existing hearing loss and to counteract progressive hearing loss.

Implantable hearing aids is an umbrella term for particularly advanced device systems: Unlike conventional hearing aids, they are not placed in the ear canal but are implanted under the skin in close proximity to the ear.

Implantable hearing aids utilize the body’s own sound amplification via bone conduction. The implant also includes a speech processor with an integrated microphone. It converts the sound received by the microphone into vibrations and transmits these to the implant.

In other words, the sound reaches the inner ear directly through the skull bone without any detours.

Unlike conventional systems, implants do not rely on acoustic amplification of sound. Instead, the sound is converted into mechanical vibrations and transmitted to the ossicles in the middle ear.

Implantable hearing aids often prove to be the last ray of hope when conventional systems fail or no longer show any success.

Additional benefits, particularly when compared to non-implantable conventional hearing aids, include

• generally better sound quality,
• the absence of unpleasant noises such as the characteristic whistling, and
• a comparatively low risk of infection.

The latter will be particularly appealing to people for whom wearing portable hearing aids has already caused inflammation in the ear canal.

As a rule, the ENT specialist will first try conventional hearing aids, such as

• in-the-ear (ITE) hearing aids or
• behind-the-ear (BTE) hearing aids.

Unlike
conventional hearing aids, implantable hearing aids are implanted under the skin, as shown here © WavebreakMediaMicro | AdobeStock

If these hearing aids are not sufficient, an implantable hearing aid may be an option. Other possible reasons include

• malformations of the outer ear,
• material incompatibility, as well as
• injuries or diseases of the middle ear.

Some people affected suffer not only from impaired hearing but also from the stigma associated with this condition. In such cases, an implant that is invisible to the outside world is also an advantage.

Medical professionals generally distinguish between three types of implantable hearing systems:

• the middle ear implant
• the bone-anchored implant, and
• the cochlear implant.

The middle ear implant consists of a combination of a microphone and electronic components, which are held in place by a magnet attached to the implant. Sound travels from the microphone through the implant, which is located under the skin, to the electronic component (“floating mass transducer”) connected to the ossicles.

With the bone-anchored implant, the microphone is located behind the ear. From there, it transmits the sound—converted into vibrations—to the skull bone. Optimal sound transmission is ensured by a tiny titanium implant embedded in the skull bone behind the outer ear. The hearing aid is secured in place here using a snap-lock mechanism.

The so-called cochlear implant, on the other hand, is generally used only in cases of extreme damage to the inner ear. Those affected experience severe hearing loss, ranging up to complete deafness.

The cochlea is the snail-shaped part of the inner ear. This is where the actual perception of sound occurs in humans. Consequently, damage to this area has serious consequences for hearing ability. In short, the cochlear implant bypasses the damaged regions by first converting sound into electrical signals. It then transmits these signals to the auditory nerve.

When implanting a hearing aid, hearing aid specialists and medical specialists—primarily ENT specialists and surgeons—should work closely together. This is the only way to achieve the best possible results.

Furthermore, every surgical procedure requires a comprehensive evaluation and consultation beforehand. This should include not only the various options tailored to the individual case but also a discussion of potential risks.

Depending on the type of hearing system, different measures are recommended for optimal postoperative care. As a patient, it is essential that you follow your doctor’s instructions regarding wound care and hygiene.

In general, pain and swelling may occur after surgery. These symptoms may intensify when chewing or speaking.

For example, when a cochlear implant is inserted, a hospital stay of at least five days is to be expected. The sutures are removed after six to ten days.

All of the listed types of implantable hearing devices require precise adjustment and fine-tuning. Intensive hearing rehabilitation is required after surgery, especially in cases of severe hearing loss or deafness. This process can extend over a period ranging from several months to more than a year, particularly following cochlear implant surgery.

According to manufacturers, cochlear implants have a lifespan of 30 years.

No general statements can be made regarding the prognosis. As a patient, please consult your doctor regarding this matter. The same applies to all questions before, during, and after the use of an implantable hearing device.