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Ears and Hearing Loss

Specialisation: Ears and hardness of hearing at the ENT-Clinic Lucerne

Hardness of Hearing – what next?

«Hearing is mandatory for oral-verbal communication. Accordingly we strive to clarify the reasons for hearing disorders very carefully and to inform extensively about the possibilities for the improvement of hearing  and the solutions which are most promising in individual situations.»

The clarification of the cause of every hearing disorder after a through anamnesis includes a detailed microscopic examination of the ear by an otologist. A series of specific hearing tests allows the assessment of the degree of hearing loss. Often high-resolution computer tomographies or magnet resonance imaging help to accurately evaluate the results. Once all results are available, the otologist will present the treatment plan to the patient.

Possible methods of treatment for hardness of hearing of different causes:

Most recent developments in hearing aids: digital hearing aid technology

Traditional air conduction hearing aids went through a rapid development owing to miniaturisation and digital technologies.

The ENT-Clinic Lucerne closely cooperates with excellent hearing aid acousticians. On the occasion of the initial examination and the final control after the provision of a hearing aid, its correct fitting is also checked qualitatively by the ENT-Clinic. In Switzerland a high-quality and efficient hearing aid provision system is offered, a fact that is also confirmed by the high wearing rate of hearing aids as compared to rates in other European countries.

Article: "Fitting with Hearing Aids"

 

 

Micro surgery of the middle ear in case of conductive deafnes

The treatment of conductive deafness by micro surgery of the middle ear is a core competence of the ENT-Clinic Lucerne. Thereby parts or the complete ossicular chain are reconstructed or replaced by implants. Among these passive middle ear implants especially titan implants proved to be useful. They can be modified individually intra-operatively and be cut exactly on the tenth of a millimeter. The results of these ear surgeries are carefully documented (development of our own database) ) and regularly evaluated. This is the only way to further improve surgery outcomes.

 

Example: Stapedotomy (microsurgical procedure to improve hearing in cases of otosclerosis)

 

   

Bone-anchored hearing aid

Bone-anchored hearing aid BAHA used for conductive deafness or combined hardness of hearing or one-sided deafness

Whereas the conventional hearing aids send sound to the eardrum via air conduction, the bone-anchored hearing aid (Baha) transmits the sound via direct bone conduction to the cochlea by using an osteointegrated titan screw. Thus, the external ear canal remains open and the middle ear is by-passed in the transmission of sound.

The BAHA is suitable for cases of pure conductive deafness, mixed hearing loss with a minimal minimal inner ear component and a big component of air conduction, as well as for single sided deafness.

The following disease patterns can ideally be treated by fitting a BAHA:

  • congenital aural atresia, malformations of the middle ear
  • Chronic otitis media with impossibility of ossicle reconstruction
  • Single sided deafness, e.g. in cases of transverse petrosal fractures, postinfectous, vestibular schwannoma, (acoustic neurinoma).

   

Active middle ear implants

Active middle ear implants in cases of mild to moderate labyrinthine deafness

Active middle ear implants normally consist of an external and an internal part. The external part corresponds to a hearing aid. The internal part is implanted into the middle ear. This implant causes sound amplification by direct stimulation of the ossicles.  Active middle ear implants require an intact ossicular chain and are suitable for the treatment of light to moderate labyrinthine deafness. The external ear canal remains open, wherefore especially patients with recurring inflammations of the ear canal or a distinct occlusion effect can be considered for an active middle ear implant.

Thanks to new coupling techniques the future of the active middle ear implants is promising. The direct connection with the round window membrane or with the mobile stapes (e.g. in cases of aural atresia or multiply pre-operated ears) enable a distinct improvement of hearing. These methods of treatment require a very high level of surgical competence.

 

Example for an active middle ear implant: the Vibrant Soundbridge.

 

     

Cochlear Implants

Cochlear Implants in cases of profound hearing loss or deafness

Cochlear implants are applied for the treatment of cases of bilateral profound hearing loss or deafness. The hearing nerve is directly stimulated by a multi-channel electrode.

Prelingually deaf children as well as postlingually deaf children and adults can be very successfully implanted in most cases today. Most children rehabilitated with a cochlear implant are frequenting main stream school. For children born deaf or prelingually deaf it is crucial that they are implanted at a very early stage. The incidence rate of profound hearing loss in newborns is approximately 1-2%, the incidence for deafness is roughly 0.5%. The newborn hearing screening by means of measurement of otoacoustic emissions (OAE) makes it possible to diagnose these hearing impairments already in the first days of life.

Article: Cochlear Implantation

 

 

The extensive diagnosis and best possible treatment of a hearing disorder are our core competences. 

KLINIK
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Prof. Dr. Thomas Linder