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HNO

, Volume 63, Issue 6, pp 402–418 | Cite as

Differenzialindikation aktiver Mittelohrimplantate

  • K. BraunEmail author
  • H.-P. Zenner
  • N. Friese
  • A. Tropitzsch
Leitthema

Zusammenfassung

Einführung

Hörgeräte stellen zwar für viele Schwerhörige die adäquate Versorgung dar, jedoch nicht für alle Betroffenen. Rund ein Drittel von 10.000 Patienten, die mit Hörgeräten versorgt wurden, empfanden im Abbreviated Profile of Hearing Aid Benefit keinen tatsächlichen Nutzen durch das Hörgerät, obwohl sie die notwendige Hörverbesserung in der Sprachaudiometrie aufwiesen. Epidemiologische Daten ergeben v. a. bei älteren Menschen eine schlechte Compliance. Nur jeder dritte Hörgeräteinhaber trug sein Gerät regelmäßig. Für diese Subpopulation von Betroffenen werden seit 1998 aktive Mittelohrimplantate eingesetzt. In der vorliegender Arbeit werden die heutigen Indikationen für derartige Mittelohrimplantate dargestellt.

Material und Methoden

Es wurden eine selektive Literaturrecherche in Pubmed sowie eine Leitlinienrecherche bei der Arbeitsgemeinschaft der Wissenschaftlichen Fachgesellschaften e. V. durchgeführt.

Ergebnisse

Es wird gezeigt, dass bei adäquater Indikationsstellung mithilfe von aktiven Mittelohrimplantaten das Hörvermögen von Patienten ausreichend rehabilitiert und damit die Lebensqualität verbessert werden kann. Obwohl die meisten kommerziell erhältlichen Systeme ein zufriedenstellendes Risikoprofil aufweisen, wurden in älteren Implantatserien erhöhte Extrusionsraten, Funktionsausfälle und Fazialisparesen berichtet. Die Vorzüge aktiver Mittelohrimplantate beinhalten u. a. einen verbesserten Hörgewinn, verringerte Rückkopplungseffekte, verbesserte Hörqualität, verbessertes Sprachverstehen im Störgeräusch und einen fehlenden Okklusionseffekt.

Schlussfolgerung

Die audiologische Indikation implantierbarer Hörgeräte für eine Primärversorgung ist in der Regel zu hinterfragen, da der funktionelle Hörgewinn sowie eine verbesserte Sprachdiskrimination gegenüber modernen konventionellen Hörgeräten gering sein kann. Die Hauptrolle allerdings spielt die Sekundärversorgung von Patienten mit nicht ausreichendem Gewinn oder mit Nebenwirkungen nach einer konventionellen Hörgeräteanpassung.

Schlüsselwörter

Mittelohrimplantat Aktive implantierbare Hörsysteme Innenohrschwerhörigkeit Schalleitungsschwerhörigkeit Kombinierte Schwerhörigkeit 

Differential indication of active middle ear implants

Abstract

Introduction

Hearing aids (HA) provide adequate support for many patients with hearing loss, but not all. Around one third of 10.000 patients provided with hearing aids in the Abbreviated Profile of Hearing Aid Benefit felt no actual benefit when using the hearing aid, although they demonstrated the necessary hearing improvement on speech audiometry. Epidemiological data show bad compliance, especially in older people. Only one in three hearing aid owners wears their device regularly. For this subpopulation of patients active middle ear implants (AMEIs) have been used since 1998. In the present review, the current indications for AMEIs are presented.

Material and methods

A selective literature search in PubMed, as well as a guideline search at the Arbeitsgemeinschaft der Wissenschaftlichen Fachgesellschaften e. V. (German Association of Scientific Societies), was carried out.

Results

The present review shows that when there is an adequate indication the hearing capacity of patients can be thoroughly rehabilitated and thus their quality of life improved with the help of AMEIs. Although most commercially available systems have a satisfactory risk profile, increased extrusion rates, malfunctioning and facial paresis have been reported in older implant series. The advantages of AMEIs include increased hearing gain, reduced feedback, increased hearing quality, increased speech discrimination in the presence of background noise, and an absence of occlusion.

Conclusions

The audiological indication for AMEIs in primary care is usually controversial, since the functional hearing gain and increase in speech discrimination may be small compared with modern conventional hearing aids. AMEIs thus play a main role in the secondary care of patients who do not have sufficient benefit or who have side effects after having a conventional hearing aid fitted.

Keywords

Middle ear implant Implantable middle ear devices Sensorineural hearing loss Air/bone gap Mixed hearing loss 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

K. Braun, H.-P. Zenner, N. Friese und A. Tropitzsch geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • K. Braun
    • 1
    Email author
  • H.-P. Zenner
    • 1
  • N. Friese
    • 1
  • A. Tropitzsch
    • 1
  1. 1.Kopf-Hals-Chirurgie, Plastische OperationenUniversitätsklinik für Hals-Nasen-Ohren-HeilkundeTübingenDeutschland

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