69714 Implantation, osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; without mastoidectomy

Name of the Procedure:

Implantation, osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; without mastoidectomy

Summary

This procedure involves placing a special type of hearing implant into the temporal bone behind the ear. Unlike some other hearing implants, this one does not require removal of part of the mastoid bone.

Purpose

This procedure is designed to help individuals with severe hearing loss or deafness. The goal is to improve auditory perception by directly stimulating the cochlea through an implanted device, connected to an external speech processor.

Indications

• Severe or profound sensorineural hearing loss.
• Patients who cannot benefit sufficiently from conventional hearing aids.
• Suitable for adults and children, typically over the age of five.

Preparation

• Patients may need to undergo audiometric and imaging tests.
• Fasting may be required if the procedure involves general anesthesia.
• Discuss current medications with the healthcare provider, as some may need to be adjusted.

Procedure Description

1. An incision is made behind the ear.
2. A small hole is drilled into the temporal bone to place the osseointegrated implant.
3. The implant is positioned and secured in place.
4. An abutment is attached, which will later connect to the external speech processor.
5. The incision is closed with sutures.

The procedure typically involves local or general anesthesia.

Duration

The procedure usually takes between one to two hours.

Setting

The procedure is commonly performed in a hospital or specialized surgical center.

Personnel

• Otolaryngologist (ENT surgeon)
• Audiologist
• Anesthesiologist
• Surgical nurses

Risks and Complications

• Infection at the implant site.
• Skin irritation around the abutment.
• Device failure or malfunction.
• Minor dizziness or vertigo.
• Rarely, facial nerve damage.

Benefits

• Significant improvement in hearing ability.
• Enhanced ability to understand speech.
• Better quality of life and ease of communication.
• Benefits are typically noticeable within a few weeks after activation of the external processor.

Recovery

• Mild discomfort and swelling around the incision site are expected.
• Patients are advised to keep the area clean and dry.
• Follow-up appointments are necessary to monitor healing and to activate the external processor.
• Most patients can resume normal activities within a week, but full recovery and device optimization may take several months.

Alternatives

• Conventional hearing aids.
• Bone-anchored hearing aids (BAHA).
• Cochlear implants with mastoidectomy.
• Medications or therapies for less severe hearing loss.

Each alternative has its own set of advantages and disadvantages regarding invasiveness, effectiveness, and suitability for the individual patient.

Patient Experience

• During the procedure, patients under general anesthesia will not feel anything. Those with local anesthesia will feel some pressure and vibrations.
• Post-surgery, patients may experience mild pain, managed with prescribed pain relievers.
• There might be some discomfort as the incision heals, and gradual acclimatization to the external speech processor once activated.