Rehabilitation of severe-to-profound sensorineural hearing loss with an active middle ear implant

Background: Severe-to-profound sensorineural hearing loss (spSNHL) is mostly relying on the use of a cochlear implant (CI). Aims: The present study reports on the auditory outcome from a group of subjects affected by spSNHL who received an AMEI application. Materials and methods: Nine out of 43 subjects who received a fully-implantable AMEI were initially candidated as off-label (primary off-label group or POLG). Twelve subjects showed over time a decrease in bone conduction threshold (BCT) in the operated ear (Secondary Off-Label Group or SOLG): SOLGa with no detectable BCT (9 subjects), SOLGb with residual low-frequency BCT (3 subjects). The auditory assessment included pure tone audiometry and speech audiometry in quiet and noise. Results: A significant PTA5 difference was found at activation in SOLGb group and at the last fitting in SOLGa Group in respect to the label control group. No significant difference was found between POLG group and control group. Speech audiometry in noise revealed a significant lower gain in all three groups in comparison to the control group. Conclusions: The adoption of an AMEI in unconventional indications could be beneficial also for subjects with spSNHL, although this solution can in some cases only be transient before performing CI surgery.