A Farewell to to Direct Acoustic Cochlear Stimulation

Objective: direct acoustic cochlear implants enabled acoustic stimulation with higher energies, which could not be achieved with conventional hearing aids. The device stimulated inner ear fluids through the stapedial piston, which was attached to the artificial incus on the actuator. Candidates for the surgery were adults with severe to profound mixed hearing loss. They had compromised functional hearing or limited benefit with hearing devices. Patients usually had fixed stapes because of otosclerosis or tympanosclerosis. Some of them were already operated in the past with no success. The device is since autumn 2017 not available.

Methods: The surgical approach was combined (transmastoid and transcanal). In the presentation the surgical technique and our experience with 3 patients will be presented. In all we were able to preserve the bone conduction hearing levels an all achieved 100% word understanding.

Results: In all three patients we were able to preserve residual hearing

Conclusion: Direct acoustic stimulation provided gain over a wide frequency range resulting with the real benefit for the correctly selected patients. In comparison to cochlear implants it provided a natural sound.