Total implantation of the active hearing implant TICA for middle ear disease: A temporal bone study

A subpopulation of hearing-impaired patients has conductive hearing loss th at cannot be improved by classic tympanoplasty. Other patients have a mixed hearing loss and cannot be helped by present forms of car surgery or by he aring aids. Possible help for some patients may come from current implantab le hearing devices if these are modified for the patient's specific anatomi c situation. The TICA LZ 3001 is a hearing implant for total implantation u sed to treat moderate to severe sensorineural hearing loss. Most patients w ho use it have a normal ossicular chain that allows coupling of the implant to the incus. The present temporal bone study demonstrates that the TICA c an also be used in patients with an interrupted ossicular chain. If the inc us long process shows a defect, the TICA may be coupled to the incus body, and connection between the stapes and the long process of the incus can be achieved with a commercially available titanium-angle prosthesis or liquid ionomeric cement. In cases of an absent incus, the coupling axis of the tra nsducer may be coupled to the stapes head via a modified coupling element. With an absent stapes. the coupling axis may be coupled directly to the per ilymph by a coupling element similar to a gold stapes prosthesis.