A novel implantable hearing system with direct acoustic cochlear stimulation

Area of Science:

• Otolaryngology
• Biomedical Engineering
• Auditory Implants

Background:

• Advanced otosclerosis often leads to severe mixed hearing loss, impacting sound transmission.
• Conventional treatments may not fully restore hearing in complex cases.
• The need for advanced implantable solutions for hearing restoration is critical.

Purpose of the Study:

• To introduce and evaluate the direct acoustic cochlear stimulator (DACS), a novel implantable hearing system.
• To assess the safety and efficacy of the DACS in patients with severe mixed hearing loss due to otosclerosis.
• To determine the impact of DACS on audiological outcomes and speech intelligibility.

Main Methods:

• Implantation of the DACS system, featuring an electromagnetic transducer and a dual stapes prosthesis approach.
• Microsurgical retromeatal approach for device placement.
• Pre- and post-operative audiological assessments, including hearing thresholds, air-bone gaps, and speech intelligibility tests.

Main Results:

• All four patients demonstrated substantial improvements in sound field thresholds and speech intelligibility.
• Significant gains in monosyllabic word recognition scores (45-100 percentage points) were observed.
• The dual stapes prosthesis alone provided initial hearing improvement (14-28 dB).
• No serious device-related complications occurred, with consistent daily use for over two years.

Conclusions:

• The direct acoustic cochlear stimulator (DACS) is a safe and effective treatment for severe mixed hearing loss in otosclerosis.
• The DACS system offers significant audiological and functional hearing benefits.
• This technology represents a promising advancement in implantable hearing solutions.