Long-Term Patient Satisfaction With Different Middle Ear Hearing Implants in Sensorineural Hearing Loss

Introduction: Implantable hearing devices are a viable option for patients with moderate-to-severe sensorineural hearing loss who cannot benefit from the conventional hearing aids. In this study, we focus on the patients' satisfaction with 3 different middle ear implants, the Vibrant SoundBridge (VSB), the semiimplantable Otologics MET implant, and the fully implantable Carina implant. Materials and Methods: Between 1998 and 2008, we have implanted 112 patients with these devices. Hereby, we gathered preimplantation and postimplantation audiologic data to evaluate the functional gains. To assess patient satisfaction, we have used a specific questionnaire focusing on implant dysfunction, audiologic satisfaction in different scenarios, and common daily life practical applications. Our final population included 19 semiimplantable Otologics, 10 Carina, and 45 VSB patients. Results: Free-field functional gain and speech reception threshold improvement were undeniable for all implants. However, this was not reflected in real-life patient satisfaction. Only 20% to 42% of the patients were more satisfied with their implants compared with their contralateral conventional hearing aids. Satisfaction dropped from 70% to 90% during conversations in quiescence to 0% to 20% in crowded situations. Depending on the type of implant, 29% to 67% of patients were satisfied enough to repeat the procedure again. Conclusion: Audiologic results with middle ear implants are encouraging and stable on the long term, but they do not correlate with the patients' index of satisfaction. The implants have to be further improved to offer more patient satisfaction in real-life situations, especially in noisy environments and for multimedia use.