Surgery on the middle ear (tympanoplasty) and auricle

The typical sign of a chronic, non-purulent middle ear infection is a permanent hole in the eardrum that does not close again on its own.

There are two forms:

• Chronic inflammation of the mucous membrane 
• Chronic bone inflammation (cholesteatoma)

Our surgeons pursue three goals in middle ear surgery (tympanoplasty):

• the permanent closure of the eardrum
• the elimination of chronic inflammation
• the improvement of middle ear hearing (conductive hearing loss)

Prostheses developed in-house

Our surgeons surgically reconstruct the eardrum. They prefer to use materials such as cartilage, cartilage skin and muscle skin. If the auditory ossicles hammer, anvil or stirrup are destroyed by chronic bone inflammation, they replace them with titanium middle ear prostheses. Some of these middle ear prostheses were developed in our clinic. The special feature: the titanium prostheses are very light and are accepted by the body as its own tissue.

Outstanding healing rate

The low weight of the titanium prostheses enables exceptionally good transmission, especially of high tones. For a particularly stable reconstruction of the eardrum, we have developed a so-called cartilage palisade technique, with which we achieve an outstandingly high healing rate of around 95 per cent.

Gentle surgery

Our experts perform all ear surgeries under local anaesthetic or general anaesthetic under a surgical microscope. In order to leave only the smallest scars, they use the endoscope wherever possible. At the end of the surgery, a tamponade is inserted into the ear canal and remains there for three weeks. If it does not dissolve itself, it is removed painlessly.

In the case of malformations of the auricle, the ear canal may be too narrow or not present at all. This leads to hearing loss, as the sound only reaches the inner ear attenuated.

BAHA hearing aid

According to the so-called Branemark method, a bone-anchored hearing aid, also known as a BAHA hearing aid, is helpful for people with sound conduction problems in the middle ear that lead to hearing loss. The abbreviation BAHA stands for ‘bone-anchored hearing aid’. Our surgeons implant a single titanium screw in the bone behind the auricle. Sound is then delivered via this fixed connection: directly to the inner ear via the patient's own bone. A special bone conduction hearing aid is also attached to the titanium screw. The acoustic properties are generally very good. The skin around the titanium screw must be regularly cleaned and carefully cared for by the wearer.

Also possible under the skin

In special cases, the BAHA hearing aid can also be worn over a magnet located under the skin, so that skin care after the surgery is not necessary.

An implantable hearing aid can be the solution if those affected cannot tolerate another hearing aid or if the ear canal is not created.

Best hearing results with partially implantable hearing aids

For patients who have undergone several hearing-improving ear surgeries (tympanoplasty) without a satisfactory improvement in hearing, a partially implantable hearing aid is often well suited. We use the Vibrant Soundbridge system from Med-El. The advantage of this partially implantable system is that the ossicular unit (hammer-anvil-stirrup) is usually retained and the stimulator only needs to be fixed to the anvil and stirrup.

Outer button can be removed at any time

Implanted patients consistently report a natural sound quality without whistling, which in the past was often an indication of a feedback effect. The external audio processor is shaped like a button and contains the microphone, processor, battery and magnets. It can be removed at any time.

Carefree sports and swimming

This means that those affected can do any sport such as cycling, jogging, tennis or golf without any problems. When swimming, they simply remove the outer processor so that it is not damaged in the water.

Special case with missing ossicles

A special situation is the so-called stimulation of the ‘round window’: If the three ossicles are not present due to malformations of the middle ear or had to be removed after previous middle ear surgery, the stimulator can also be positioned directly at the ‘round window’. You can then hear through the ‘round window’ - and not the ‘oval window’ as usual - without having to use an ossicle to transmit sound. The inpatient stay for the procedure usually lasts four to five days.

In cases of severe hearing loss or deafness, hearing can now be restored with the help of a cochlear implant, an ‘electronic inner ear’. This involves electrically stimulating the auditory nerve and auditory nerve cells. This procedure is suitable for infants and small children as well as for adults.

Detailed information on cochlear implants can be found under the cochlea implantat section.

Otosclerosis is often a hereditary disease of the particularly firm labyrinth bone. The stapes slowly grows tight, which leads to a gradual increase in hearing loss. 

Gentle surgical technique

During the surgical correction, we remove the ingrown stapes. However, we only remove it partially, as this is gentler. To replace the stapes, we use a 4.5 mm titanium prosthesis that transmits sound from the eardrum to the opened inner ear.

Success rate: 90 per cent

We usually perform ear surgery under local anaesthetic, but it can also be performed under general anaesthetic. The inpatient stay usually lasts four to five days. The success rate is more than 90 per cent.