ABSTRACT
The primary impetus for active middle ear implant (AMEI) development is the desire to overcome many of conventional hearing aid shortcomings such as distortion, feedback, occlusion effect, discomfort and ear canal irritation. Next to that, AMEIs offer the potential for improved sound clarity, because most AMEIs bypass the external auditory canal (EAC) and do not use a speaker for signal amplification. The Vibrant Soundbridge (VSB) developed by Symphonix and currently by MED-EL is an active semi-implantable hearing device. The SOUNDTEC Direct Drive Hearing System (DDHS), initially designed by SOUNDTEC Direct, is another semi-implantable device containing an electromagnetic transducer. For the AMEIs on the market today the surgical approach is similar to that of a cochlear implant. It compromises retroauricular transmastoidal access to the middle ear via the facial recess (VSB) atticus (Carina) or a slightly different approach is needed to gain access to the round window niche (Codacs).
