Middle ear implant

A middle ear implant is a hearing device that is surgically implanted into the middle ear. They help people with conductive, sensorineural or mixed hearing loss to hear. Middle ear implants work by improving the conduction of sound vibrations from the middle ear to the inner ear. There are two types of middle ear devices: active and passive. Active middle ear implants (AMEI) consist of an external audio processor and an internal implant, which actively vibrates the structures of the middle ear. Passive middle ear implants (PMEIs) are sometimes known as ossicular replacement prostheses, TORPs or PORPs. They replace damaged or missing parts of the middle ear, creating a bridge between the outer ear and the inner ear, so that sound vibrations can be conducted through the middle ear and on to the cochlea. Unlike AMEIs, PMEIs contain no electronics and are not powered by an external source. PMEIs are the usual first-line surgical treatment for conductive hearing loss, due to their lack of external components and cost-effectiveness. However, each patient is assessed individually as to whether an AMEI or PMEI would bring more benefit. This is especially true if the patient has already had several surgeries with PMEIs. An active middle ear implant (AMEI) has two parts: an internal implant and an external audio processor. The microphone of the audio processor picks up sounds from the environment. The processor then converts these acoustic signals into digital signals and sends them to the implant through the skin. The implant sends the signals to the Floating Mass Transducer (FMT): a small vibratory part that is surgically fixed either on one of the three ossicles or against the round window of the cochlea. The FMT vibrates and sends sound vibrations to the cochlea. The cochlea converts these vibrations into nerve signals and sends them to the brain, where they are interpreted as sound. AMEIs are intended for patients with mild-to-severe sensorineural hearing loss, as well as those with conductive or mixed hearing loss.