Implantable acoustic devices (IADs)

ENT and Audiology Services

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How IADs work

Instead of sending sound through the ear canal like conventional hearing aids, IADs transmit sounds through the skull and middle ear bones to the hearing organ.

They are usually suggested for people who cannot wear conventional hearing aids due to their ear not developing in the usual way, or have a certain type of hearing loss.

There are three types of IADs available at Alder Hey:

1. Percutaneous bone conduction implant (BCI).
2. Active transcutaneous BCI
3. Middle ear implant.

Each type has it’s own advantages and disadvantages. Not everyone is suitable for each type of device. Your child’s ENT surgeon or Audiologist will discuss the options that are suitable for your child.

Initial assessment

Different hearing tests, examination and history will guide the clinicians on whether your child may be a suitable candidate.

If suitable, you are initially offered a choice of devices then a trial arranged with your preferred device. This usually lasts 4-6 weeks.

You will then be reviewed and, if suitable, given the option if you would like more information about surgical options.

Below, we explain each of the different IADs available:

1 – Percutaneous bone conduction implant

An abutment is visible through the skin on the scalp attached to the sound processor on the outside and the skull on the inside which sends vibrations through the skull.

This is suitable for single sided deafness, conductive and mixed hearing losses and will provide:

• Better hearing outcomes
• You will also be able to have certain MRI Scans

2 – Active transcutaneous bone conduction implant

An implanted magnet sits under the skin attached to an implant that sends vibrations through the skull. The sound processor is held on the outside of the skin with a magnet and send signal through the scalp.

This type of implant is suitable for single sided deafness, conductive and mixed hearing losses. The benefits of using an active transcutaneous bone conduction implant, are:

• Better hearing outcomes
• Implant under the skin, reducing the risk of complications such as skin irritation
• Processor is held on by a magnet, and is available in different strengths
• There is lower risk of acoustic feedback
• You are able to swim whilst wearing the processor.

3 – Middle ear implant

This sound processor works in a similar way to an active transcutaneous BCI with a magnet. It sends sounds directly to the bones in the middle ear rather than the skull.

This implant is suitable for mixed and certain sensorineural hearing losses. Benefits of using the middle ear implant are:

• The implant is under the skin, reducing the risk of complications such a skin irritation
• No part of the implant is protruding through the skin, when the device is not worn,there are no parts to see
• The processor is held on by a magnet; this is available in different strengths
• There is a lower risk of acoustic feedback

Surgery

The ENT surgeon will discuss what to expect before and on the day of your surgery. We encourage you to ask any questions and ask you to sign a consent form to give your permission.

The operation will be carried out under general anesthetic.
Your child’s hair may need to be shaved and following surgery they will have either a bandage or protective cover (healing cap) over the site.
Rarely some operations are carried out over two stages.

Are there any risks?

All surgery and anesthesia carries risk, but we do everything we can to minimise it. The risk of anaesthetic will depend on your child’s medical conditions, but an anaesthetist monitors their progress during surgery very closely.

All of these types of surgery carry the risk of bleeding or infection. Blood loss during this type of surgery is usually minimal, and we may give antibiotics to help reduce the risk of infection. Infections may require implants to be removed. The implants can become loose due to infection or trauma.

Specific to middle ear implants, there are added risks of causing a permanent hearing loss or damaging the nerve that moves the face.
There is a small risk that your child may not feel they get enough hearing benefit from the IAD.

Going home after surgery

If your child recovers well they will be able to go home on the same day. You will be given more information before you leave the hospital on how to monitor your child and look after the operation site.

What happens after surgery?

You will be asked to keep the dressing or healing cap on for around 7 days and not get the site wet. After 7 days you will come back to see the Ear Nose and Throat (ENT) nurse to check your site.

Around 6 weeks after surgery, your device will then be ‘loaded’ (the hearing device will be activated and you are shown how to wear with your surgical implant).

Contact details

Audiology: [email protected] or 0151 252 5943
ENT: 0151 228 4811 ext 3757 or 0151 252 2506

Useful websites

www.cochlear.com/uk
www.oticonmedical.com/uk
www.medel.com/uk
www.ndcs.org.uk

This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.

This information can be made available in other languages and formats if requested.

PIAG: 485