1. Surgery for Sensorineural Hearing Los

Cochlear Implant Surgery

• Cochlear implantation is one of the few surgical options for hearing loss caused by damaged or dysfunctional sensory cells.
• No surgery can repair damage to the sensory hair cells themselves, which is common in the case of age-related or noise-induced hearing loss.
• This type of hearing loss is known as sensorineural hearing loss. The only option (for now) is cochlear implants, which bypass the damaged hair cells.

Who are they for?

• Adults and children who are not helped by hearing aids for severe to profound hearing loss.

How does it work?

• Unlike a traditional hearing aid that amplifies sound, a cochlear implant bypasses the damaged part of the auditory system to directly stimulate the auditory nerve.

Components:

• The implant: A small electronic device that is surgically placed under the skin behind the ear. It is connected to electrodes that are inserted in the cochlea.
• The external component: A unit that looks similar to a behind-the-ear (BTE) hearing aid. It has a microphone, speech processor, and battery compartment.

Procedure:

• Cochlear implant surgery is usually performed on an outpatient basis once a thorough evaluation of a person’s health has been completed.
• This includes an examination of the ear and its anatomy, the auditory system, and an overall physical examination.
• Most surgeons will not perform a cochlear implant surgery unless the patient has tried hearing aids without success.
• Because this surgery is invasive, it is reserved for severely hearing-impaired patients.

2. Surgery for Conductive Hearing Loss

Bone-Anchored Hearing Systems

• While many people have heard of cochlear implants, less well-known are bone-anchored hearing systems.
• They consist of an implant that’s surgically inserted into the bone behind the ear and a hearing aid that fits tightly over the implant.
• When sound is detected, vibrations are sent via the bone to the inner ear.

Who are they for?

• Suitable for people with conductive hearing loss, such as children with outer or middle ear malformations.
• They also can be used on kids or adults with single-sided deafness.
• They require at least one functioning inner ear.
• PE Tubes (Pressure Equalization Tubes)
• If your child or grandchild has ever had an ear infection, then you know how agonizing this condition can be.
• According to the American Academy of Otolaryngology-Head and Neck Surgery, every child has at least one ear infection by the age of five.
• Although this condition usually clears on its own without causing permanent damage, some children have chronic episodes that can lead to long-term hearing loss, poor school performance, and behavior or speech problems.

Procedure:

• In these cases, the pediatrician may recommend surgery to insert small tubes, known as pressure equalization (PE) tubes.
• Also referred to as tympanostomy tubes, myringotomy tubes, or ventilation tubes, these tiny cylinders are placed through the eardrum by an ear, nose, and throat surgeon to allow air into the middle ear.

Types of Tubes:

• Short-term tubes usually fall out on their own within six to eighteen months.
• Long-term tubes stay in place longer and may need to be removed by the ENT.

Suitability:

• Toddlers and young children are the most common recipients of PE tubes.
• They might also benefit adults who suffer from the same condition.
• In addition to correcting chronic ear infections, the surgery may also be recommended to correct hearing problems associated with malformed eardrums, eustachian tubes, Down Syndrome, or cleft palate.

Stapedectomy

People with otosclerosis may benefit from having a stapedectomy, a surgical procedure that implants a prosthetic device designed to bypass abnormal hardening of the bone tissue in the middle ear.

What is Otosclerosis?

• Just as atherosclerosis causes hardening of the arteries, otosclerosis causes an abnormal hardening of the bone tissue in the middle ear.
• According to the National Institute of Deafness and Other Communication Disorders (NIDCD), this condition affects as many as three million Americans.
• It typically happens when the stapes bone located in the middle ear becomes stuck in place.
• When this occurs, the bone is unable to vibrate and send sound through the ear, resulting in impaired hearing.

Types of Otosclerosis:

• Stapedial Otosclerosis: Otosclerosis spreads to the stapes bone (stirrup) and prevents it from vibrating. Often surgically corrected with a stapedectomy.
• Cochlear Otosclerosis: Otosclerosis invades the cochlea and causes permanent damage to the sensory hair cells or nerve pathways. Stapedectomy is not an option.
• Mixed Otosclerosis: A combination of both as the disease progresses.

Symptoms:

• Progressive hearing loss, dizziness, and tinnitus.
• Window Reinforcement Surgery
• People suffering from a third mobile window syndrome (like superior semicircular canal dehiscence) can have surgery to repair the tiny hole in their inner ear.
• This procedure is known as window reinforcement surgery or occlusion repair surgery.

Hearing loss surgery is not for everyone.

• In the future, people with hearing loss may have more options for restoring lost hearing.
• Currently, surgeries can only correct very specific types of losses.
• People with the most common types of hearing loss still benefit the most from wearing hearing aids.
• If you have hearing loss, see a hearing healthcare professional for regular evaluations.