Surgical Options for Hearing Loss

by Dr. Jennifer Stinson

In my previous article in the Spring Issue titled A Different Type of Hearing Aid, I explained amplification options for a person with no useable hearing in one ear. Moving forward, I will write about the different types of surgical options for people with hearing loss. As an Audiologist, I do not perform surgeries; however, Audiologists work closely with Otolaryngologists or ENT (Ear, Nose, and Throat Physicians) who perform surgical procedures to improve hearing. By helping to diagnose the etiology, or the anatomical origin, of the hearing loss, the Audiologists help the ENT to determine if surgery is an option for a patient.

One type of hearing loss that can often be corrected by surgery is conductive or mixed hearing loss. Hearing loss can originate in 3 different places: the outer, middle ear, or inner. If hearing loss is caused by a problem in the middle ear, it is often due to the three tiny bones located in the middle ear. These bones are the smallest bones in the human body and are called the malleus, incus, and stapes. When sound hits the ear drum these bones move together to increase the level of sound that gets introduced to the inner ear. If they do not move correctly in harmony, this is what results in a conductive hearing loss. In this case, the hearing loss is not what is referred to as a nerve or sensorineural hearing loss, and in many cases, the hearing nerve is fully intact, but the problem is in getting the sound to the nerve or the inner ear. If there is any degree of hearing loss at the site of the nerve in addition to the middle ear (or the tiny bones in the middle ear), then this is referred to as a mixed hearing loss.

The type of hearing loss is determined by the Audiologist when completing the full hearing test. If it is determined that there is a conductive or mixed hearing loss, the ENT would order a CT scan of the middle ear to assess the bones. In most cases, if the problem is related to the bones, then it usually is the stapes bone. This disease is called otosclerosis, which is abnormal bone growth on the stapes. If the ENT determines surgery is a good option, the stapes are removed, and a prosthetic device is put in place. This is with the hopes that the hearing will return to normal or near normal.

It is important to remember that this surgery is not always successful. It is up to the ENT to determine if the risk is greater than the reward. If you have hearing loss and are unsure of the type of hearing loss or its cause of your hearing loss, it is best to consult with an Audiologist or an ENT surgeon.

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