The most advanced, state-of-the-art MAXUM implantable hearing aid has been approved by the FDA and is a semi-implantable hearing aid in which the MAXUM electromagnetic implant is attached to the stapes or anvil bone. It can treat adults and older adults aged 18 years with moderate to severe sensorineural hearing loss, speech recognition equal to or greater than 60% or more, and patients with moderate to severe hearing loss who have difficulty understanding communication with conventional hearing aids. The second generation Maxum II system consists of two components: internal component: a small parcel, titanium, rare earth magnet, surgically implanted in the middle ear (plus a hearing bone chain). The external component: just like a normal headset placed in the external ear canal, ready to be removed. It is called an electromagnetic sound processor (IPC) and is worn in the external ear canal, similar to a traditional hearing aid. the IPC sound processor is a “speaker” but does not directly emit any sound or noise, the signal it emits can only be received by the MAXUM electromagnetic implant, a receiver mounted on the middle ear auditory tuberosity. It is similar to a ‘Bluetooth’ for receiving sound signals. After receiving the signal, the MAXUM electromagnetic implant vibrates, causing the connected auditory tuberosity to vibrate, stimulating the hair cells and generating auditory nerve impulses. The prerequisite is that a small number of hair cells and the auditory nerve are intact. Electromagnetic Advantage: Since the MAXUM device is safe and silent, the electromagnetic signal (speaker) generated in the production of audible sound signals by conventional hearing aid speakers is able to overcome the inherent functional limitations of acoustic hearing aids by direct stimulation of the MAXUM cochlear implant: Increased power: can provide more power and bandwidth than conventional hearing aids (up to 60 dB, functional gain from 125 – 12,000 Hz) there is little or no feedback because there is no leakage of sound back to the microphone. Larger ventilation ports are comfortable and prevent problems with ear canal obstruction. Low distortion due to increased Fidelity: Direct cochlear stimulation with improved sound quality and speech understanding provides a clear signal because distortion of the sound waves is reduced or eliminated. It can effectively address high frequency hearing loss. How MAXUM is implanted: The MAXUM electromagnetic implant needs to be completed under surgery by an otolaryngologist. This can be done under local anesthesia. Operation: Using local anesthesia, sedation, and passage through the ear canal, the middle ear is exposed and a magnetic coupling is implanted to mount the hearing bone. The hearing chain can be mounted on the anvil bone if it is well mobile, and on the stapes if only the stapes is well mobile. This process is reversible; the magnetic implant can be removed or replaced later if necessary. It is easy for a skilled otolaryngologist to do. Postoperative care: The patient is discharged from the hospital on the day of discharge, after a short recovery period. No overnight stay is required. Post-operative medications include mild pain medication for a week and gentle ear drops. Patients may return to work the next day, should not travel by air for three weeks, and should avoid water for three weeks. Healing is complete approximately 4 weeks after surgery. Patients may remove the electromagnetic sound processor from the ear canal at any time, if swimming is required. What are the indications and contraindications for MAXUM? Indications: Adults, 18 years of age or older, moderate to severe sensorineural hearing loss, speech recognition greater than or equal to 60%, and an ear canal of appropriate size to accommodate the MAXUM sound processor. Contraindications: less than 18 years of age, conductive or mixed deafness, postcochlear or central hearing impairment, active otitis media, tympanic membrane perforation caused by recurrent inflammation, patients with auditory bone loss, need for MRI scan.