PERSPECTIVE article
Front. Audiol. Otol.
Sec. Technology and Innovation in Auditory Implants and Hearing Aids
Surgical Treatment of Sensorineural Hearing Loss: An Ethical Dilemma in the 21st Century
Provisionally accepted
- University Hospital La Paz, La Paz, Spain
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Almost seventy years after Shea's first successful stapedectomy, this operation remains the gold standard for otosclerosis, providing excellent outcomes with minimal risk. In contrast, the situation is quite different for sensorineural hearing loss. The development of new middle ear active implants, such as the Vibrant Soundbridge, now provide hearing outcomes comparable to conventional hearing aids, with very low surgical risk and added acoustic benefits. However, their clinical adoption is still limited, often influenced more by economic and ethical dilemmas than by scientific evidence. In some public healthcare systems, active middle ear implants for sensorineural hearing loss are fully funded, while conventional hearing aids are not. This creates an inequity that leaves many patients unable to access non-surgical hearing solutions. This article reflects on that paradox and argues that, as technology continues to evolve, one principle must remain clear: the patient's right to hear should always take precedence over financial or bureaucratic constraints.
Keywords: Sensorineural hearing loss (SNHL), Active middle ear implants, Vibroincudesis, Medical Ethics, health care equity, access to hearing technology
Received: 08 Nov 2025; Accepted: 11 Dec 2025.
Copyright: © 2025 Gavilan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Javier Gavilan
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