Is tympanoplasty accepted in SSB medicine

Middle ear and auricle surgery

Information about the keywords:

  • Chronic otitis media
  • Cholesteatoma
  • Eardrum hole
  • Conductive hearing loss
  • Otosclerosis
  • Implantable hearing aids

Chronic otitis media

Middle ear surgery treats chronic otitis media. The permanent one Hole in the eardrumthat does not close by itself is the typical sign of chronic non-purulent otitis media. A distinction must be made here between two forms, namely

  1. chronic inflammation of the mucous membranes and
  2. chronic bone inflammation (Cholesteatoma)

The surgery of the middle ear has three goals, namely 1. the permanent closure of the eardrum, 2. the elimination of chronic inflammation and 3. the improvement of middle ear hearing (the Conductive hearing loss). The eardrum is surgically reconstructed, whereby cartilage, cartilage skin and muscle skin are used as preferred materials.

If the ossicles of the hammer, anvil or stapes are destroyed by chronic bone inflammation, they are replaced by middle ear prostheses made of titanium. Some of these middle ear prostheses were developed in-house in our clinic. The titanium prostheses are particularly light; they are accepted by the body as the body's own tissue. Due to the low weight, the transmission of high tones is particularly cheap. For a particularly stable reconstruction of the eardrum, we have developed a so-called cartilage palisade technique, which has a particularly high healing rate of around 95%.

All ear operations can be performed under local or general anesthesia. All operations are performed under the surgical microscope, some with an endoscope (smaller scars). At the end of the operation, a tamponade is placed in the ear canal, which is left in place for 3 weeks. It partially dissolves itself or is removed painlessly after 3 weeks.

Implantable bone conduction hearing aids, BAHA (Bone-Anchored-Hearing-Aid)

With auricular malformations, the ear canal may be too narrow or not created. This results in hearing loss, as the sound only reaches the inner ear at a muffled level. According to the Branemark method, a bone-anchored hearing aid is very helpful for this. For this purpose, a single titanium screw is implanted in the bone behind the auricle; The sound is then fed via the bone directly to the inner ear via this fixed connection. A special bone conduction hearing aid is then attached to the titanium screw. The acoustic properties are usually very good. The skin around the titanium screw must be cleaned regularly and carefully cared for by the wearer.

In special cases, the BAHA can also be worn over a magnet located under the skin, so that there is no need for skin care after the operation.

Partially implantable hearing aids

If a hearing aid is not tolerated or if the ear canal is not open, then an implantable hearing aid can lead to excellent hearing results. Ears that have received several operations to improve their hearing (tympanoplasty) without a satisfactory hearing improvement are often well suited for a partially implantable hearing aid. We use the Vibrant Soundbridge system from Med-El. The advantage of this partially implantable system is that mostly the ossicles: hammer-anvil-stapes are retained and the stimulator only needs to be fixed to the anvil and stapes.

The implanted patients consistently report a natural sound quality without whistling as an indication of a feedback effect. The external audio processor is shaped like a button and includes a microphone, processor, battery and magnets. It can be removed at any time.

Any sport such as cycling, jogging, tennis or golf can be carried out with it. When swimming, you simply remove the outer processor so that it is not damaged in the water.

The stimulation of the "round window" represents a special situation. If the 3 ossicles are not present due to middle ear malformations or had to be removed after previous middle ear operations, the stimulator can also be positioned directly at the "round window". You can then hear through the "round window" (and not, as usual, through the "oval window") without having to use an ossicle for sound transmission. The inpatient stay is usually 4–5 days.

Cochlear Implant Surgery

In the case of severe hearing impairment or deafness, hearing ability is achieved again today with the help of an "electronic inner ear" (cochlear implant). This leads to electrical stimulation of the auditory nerve and the auditory nerve cells (spiral ganglion). This procedure is suitable for infants, young children as well as adults.

For more information about the Cochlear Implant, please scroll to the focus area "Cochlear Implant Surgery" or click here.

Otosclerosis

Otosclerosis is a peculiar disease of the particularly firm labyrinth bone. The stirrup slowly grows solid, resulting in a slowly increasing hearing loss. Often there is a family disposition.

The operative correction consists in the partial removal of the firmly grown stapes. We don't remove the entire stirrup as this is the gentler procedure. A 4.5 mm titanium prosthesis is used to replace the stapes, which transmits sound from the eardrum to the opened inner ear.

The operation is usually performed under local anesthesia, it can also be done under general anesthesia. The inpatient stay is usually 4-5 days. The success rate is more than 90%.

Appointment 
General outpatient clinic or children's consultation: Tel. 0941 944-9410
Private consultation with Prof. Dr. Christopher Bohr:
Mrs. Feuerer
Tel. 0941 944-9406
 
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