Download 13th International Conference on Cochlear Implants and Other

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The PowerMax middle ear implant for mixed hearing loss
Glasscock III M.E.
Vanderbilt University Medical School, Otolaryngology, Austin, United States
In chronic ear disease surgery it has always been a challenge to improve the postoperative hearing. Not only
must the pure tone average improve, but the SNHL component must be improved as well. In the past, this
challenge has been relegated to hearing aids (HA). Unfortunately, it is not possible for a hearing aid to produce
enough functional gain to accomplish this goal. The conductive component of the mixed loss has been
addressed in the past with the use of TORPS and PORPS. The results have been less than stellar. There are
several reasons for this failure. The prosthesis must be interspersed between the stapes superstructure or the
stapes footplate and the tympanic membrane. Even when the middle ear is packed with gealfoam, the prosthesis
is subject to the effects of gravity. Not only that, but the SN component is not addressed. So, how is the best way
to deal with this situation? The solution must include a method to improve the conductive as well as the SN
component. It has been well established that direct driving the stapes or the stapes footplate will result in
improvement of both a conductive loss as well as a sensorineural one. That would imply that the solution to this
problem lies with a combination of a middle ear prosthesis and a Maxum magnet. This devise is referred to as a
PowerMax. By attaching the device to the EAC at the annulus with a special anchor it is possible to negate the
effect of gravity. The power of the magnet attached to the prosthesis will drive the stapes of stapes footplate
directly overcoming both the conductive as well as the SN component of the hearing loss. This course will
describe the surgical process and give laboratory data obtained on fresh temporal bones to prove the validity of
the concept.