The KOPFZENTRUM Group’s Cochlea and Hearing Implant Centre (CHIC) is the overarching concept of CI care for patients with severe hearing impairment. More than 20 employees from disciplines such as acoustics, auditory training, music therapy, psychotherapy, ENT and ergotherapy are on hand to assist patients while they train.
The insertion of cochlear implants constitutes the entire surgical side of the procedure and is performed at the ACQUA Klinik. With approximately two hours of surgery time and a recovery period of six to 24 hours at the clinic, this procedure is one of the middle ear operations we offer. This procedure is performed by just three surgeons at the ACQUA Klinik, so as to ensure the necessary level of routine from their high number of cases.
Opening and cleaning of the tympanic cavity
The middle ear (tympanic cavity) is filled with air. Sound travels to the inner ear via the eardrum and the auditory ossicles inside the middle ear. If the middle ear is poorly aerated, this can hinder the transmission of sound and impair the mucous membrane. At first runny and later on thick mucus forms and remains inside the middle ear. This further restricts the person’s ability to hear and may result in frequent or even chronic inflammation of the middle ear. In children, this leads to a delay in language development.
Operation on the middle ear to improve hearing
A disease of the stapes can disrupt the transmission of sound from the middle ear to the inner ear. This disorder causes the stapes to ossify and in turn inhibit the transmission of sound waves to the inner ear (otosclerosis). In many cases, this diagnosis can only be confirmed by operative inspection of the middle ear (tympanoscopy). In the same session, it is then possible to remedy the cause of the poor transmission from the stapes to the inner ear.
Eustachian tube dilation
Ventilation via the Eustachian or auditory tube is essential for the middle ear to function properly. The auditory tube is something of a functional weak spot, since there are an above-average number of cases where ventilation does not function sufficiently and/or continuously. This affects children as well as adults. Consequences include chronic underventilation of the tympanic cavity, poor sound transmission coupled with hearing loss and an unpleasant feeling of pressure, chronic irritation of the middle ear mucosa and the formation of chronic inflammation, which typically results in damage to the eardrum or the chain of auditory ossicles. Once other causes have been ruled out or eliminated, dilating the entrance and first portion of the Eustachian tube can improve, stabilize or even fully normalize ventilation.
Inner ear operation to remedy an inflammation; restoration of middle ear structures in order to improve hearing where possible
Inflammation of the middle ear causes damage to the middle ear (e.g. mucous membrane, bone, eardrum, auditory ossicles). This disrupts the function of the middle ear. Frequent consequences include hearing loss, discharge from the ear, dizziness and earache. Particularly aggressive forms of middle ear inflammation (cholesteatoma) can even destroy solid bone, blood vessels and nerves. The inflammation may spread and damage the surrounding structures (e.g. inner ear, facial nerve, vestibular system, meninges). Even with high-resolution CT or MRI scans, it is not always possible to predict the exact nature of the inflammation. This is why operations on the middle ear are still frequently indicated today, in order to avoid complications.
Examination of the middle ear
Symptoms such as sudden hearing loss, dizziness and tinnitus may be caused by disturbances in the tympanic cavity or the boundary between the middle and inner ear (e.g. round window). Despite all the available diagnostics, some of these disorders (e.g. round window membrane rupture, inflammation of the middle ear passing over to the inner ear) can only be confirmed or ruled out by looking directly inside the middle ear itself. There are also therapy methods which require a direct injection of the active ingredient into the middle ear (e.g. prednisolone, gentamicin). A tympanoscopy can combine these diagnostic and therapeutic aims.