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Two hearing prostheses combined and implanted in a world first

(Vienna, 28 June 2012) In the University Department of Ear, Nose and Throat Diseases at the MedUni, part of Vienna General Hospital, a 48-year-old female patient who has had severe hearing difficulties for ten years has undergone a completely new surgical procedure. The procedure was led by the Head of Department Wolfgang Gstöttner and his team and involved the implantation of two combined hearing prostheses. This was needed because the patient was suffering from two different conditions of the left middle ear.

“Chronic inflammation had destroyed the hammer, anvil and stirrup. The entrance to the inner ear was also heavily ossified as a result of an undiagnosed otosclerosis. The patient therefore had an empty middle ear and an ossified inner ear, and was unable to detect vibrations,” explains Gstöttner. Otosclerosis is a condition affecting the bone surrounding the inner ear.

During the surgery, which took around two hours, the hammer and anvil were first replaced with a small titanium prosthesis. A second prosthesis, the stirrup prosthesis, was then attached to this first one, secured in place and orientated towards the inner ear. Says Gstöttner: “This procedure has never been carried out before.”

The two conditions had reduced the patient’s hearing by 70 per cent. An initial audiogram carried out just a few days after the operation showed that her hearing defect was now just 30 per cent. Says Gstöttner: “I anticipate that she will soon be able to hear almost normally – and without any hearing aids, too.” The patient will undergo further surgery to her right ear in a few weeks’ time. In this case, however, “only” the otosclerosis needs to be treated.

Numerous innovations
The ENT Department at the MedUni Vienna, part of the Vienna General Hospital, is renowned for its frequent innovations: in September 2011, an ultra-thin “floating electrode” was used for the first time ever as part of a cochlear implant aimed at preserving a patient's remaining hearing. Researchers at the MedUni Vienna at Vienna General Hospital also developed a new, less invasive surgical procedure and played a key role in the development of the electrode, which is just 0.2 mm thick instead of the usual 0.5 mm. The first cochlear implant carried out at Vienna's ENT Department in 1977 was also the first multi-channel cochlear implant worldwide.

In April 2012, the ENT Department was also the first worldwide to provide a child with a new bone conduction implant which was attached directly to the patient’s skull bones as he had no outer ears. This enabled the eleven-year-old boy from Vienna to live a normal life in terms of hearing.