page_title: Management of hearing loss
section_title: Surgery
hierarchical_section_title: Management of hearing loss / Assistive devices / Surgery
context_page_description: Treatment depends on the specific cause if known as well as the extent, type and configuration of the hearing loss. Most hearing loss, that resulting from age and noise, is progressive and irreversible, and there are currently no approved or recommended treatments; management is by hearing aid. A few specific kinds of hearing loss are amenable to surgical treatment. In other cases, treatment is addressed to underlying pathologies, but any hearing loss incurred may be permanent.
context_section_description: There is no treatment, surgical or otherwise, for sensorineural hearing loss due to the most common causes (age, noise, and genetic defects). For a few specific conditions, surgical intervention can provide a remedy:
  surgical correction of superior canal dehiscence
  myringotomy, surgical insertion of drainage ventilation tubes in the tympanic membrane. Such placement is usually temporary until the underlying pathology (infection or other inflammation) can be resolved.
  radiotherapy or surgical excision of vestibular schwannoma or acoustic neuroma, though, in most cases, it is unlikely that hearing will be preserved
  Stapedectomy and stapedotomy for otosclerosis - replacement or reshaping of the stapes bone of the middle ear can restore hearing in cases of conductive hearing loss
  Surgical and implantable hearing aids are an alternative to conventional external hearing aids. 
  If the ear is dry and not infected, an air conduction aid could be tried; if the ear is draining, a direct bone conduction hearing aid is often the best solution. If the conductive part of the hearing loss is more than 30–35 dB, an air conduction device could have problems overcoming this gap. A bone-anchored hearing aid could, in this situation, be a good option. The active bone conduction hearing implant Bonebridge (a product of MED-EL corporation) is also an option. This implant is invisible under the intact skin and therefore minimises the risk of skin irritations.
  Cochlear implants improve outcomes in people with hearing loss in either one or both ears. They work by artificial stimulation of the cochlear nerve by providing an electric impulse substitution for the firing of hair cells. They are expensive, and require programming along with extensive training for effectiveness.
  Cochlear implants as well as bone conduction implants can help with single sided deafness. Middle ear implants or bone conduction implants can help with conductive hearing loss.
  People with cochlear implants are at a higher risk for bacterial meningitis. Thus, meningitis vaccination is recommended. People who have hearing loss, especially those who develop a hearing problem in childhood or old age, may need support and technical adaptations as part of the rehabilitation process. Recent research shows variations in efficacy but some studies show that if implanted at a very young age, some profoundly impaired children can acquire effective hearing and speech, particularly if supported by appropriate rehabilitation.
caption: Illustration of a cochlear implant
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