Hearing loss is a widespread issue, affecting over 12 million people in the UK. For many, hearing implants offer a life-changing solution, enabling improved communication and quality of life. Among these implants, transcutaneous hearing systems are particularly innovative, as they rely on a magnetic connection through intact skin to transmit sound to the auditory system. However, before surgery can proceed, clinicians must ensure that the patient’s skin flap is thin enough to maintain the secure magnetic attraction necessary for the implant’s function.
Traditionally, this involves an invasive process: patients are prepared for surgery, and immediately before the procedure, a needle is inserted down to the bone to measure the skin’s thickness. If the flap is too thick, the surgery cannot proceed—leading to patient disappointment, wasted resources, and unnecessary stress. MRIs have also been used as an alternative measuring procedure, but again, this method is expensive and sometimes stressful for the patient.
The good news? Ultrasound technology may hold the key to transforming this process. A collaboration between PUM and the University of Southampton Auditory Implant Service is exploring this groundbreaking potential.
Introducing a Non-Invasive Solution
PUM recently supplied an Apogee 1000 Lite with a linear probe to the Southampton Auditory Implant Service to support research into a less invasive alternative for measuring skin flap thickness. Ultrasound is already widely used in medical settings for its accuracy, safety, and ability to deliver real-time imaging. By adapting it for this specific application, researchers hope to reduce patient anxiety, eliminate unnecessary invasive procedures, lower costs and improve overall outcomes.
Our very own Catherine Stowell, PUM’s founder and an experienced sonographer, has been instrumental in launching this initiative. Catherine spent a morning at the University of Southampton, demonstrating and troubleshooting the use of the Apogee 1000 Lite. Her guidance helped the team establish an initial protocol, laying the foundation for a repeatable, reliable process that could ultimately become the standard for pre-surgical testing of auditory implants.
This collaborative research effort involves gathering skin flap measurements using both the Apogee 1000 Lite and the traditional needle method. By cross-referencing results, the team can validate the ultrasound’s accuracy, ensuring it meets the stringent requirements needed for clinical use.
Why Skin Flap Thickness Matters
In transcutaneous hearing implants, a secure magnetic connection between the internal and external components is critical for proper functionality. The skin covering the implant must be below a certain thickness to maintain this magnetic attraction. If the skin flap is too thick, the sound processor may not stay in place, rendering the implant ineffective.
The current invasive method, while effective, poses challenges for both patients and clinicians. Patients face the stress of uncertainty until the very last moment, and surgeons risk wasting valuable operating room time if the procedure cannot proceed. A non-invasive alternative using ultrasound would be a game-changer—reducing pre-surgical stress, providing clarity, and improving patient experience.
Understanding Hearing Loss and Implant Options
Before delving further into the significance of ultrasound, it’s helpful to understand the context of hearing loss. There are three main types:
- Conductive hearing loss: Caused by issues in transmitting sound from the ear drum to the inner ear (e.g., earwax, middle ear congestion).
- Sensorineural hearing loss: Originates in the cochlea or auditory nerve, often due to ageing, noise exposure, or genetics.
- Mixed hearing loss: A combination of conductive and sensorineural loss.
Transcutaneous implants are primarily used for patients with conductive or mixed hearing loss, offering a straightforward solution for sound transmission. Unlike their percutaneous counterparts, which require a permanent opening through the skin, transcutaneous systems maintain skin integrity, reducing the risk of infection and improving overall comfort.
The Promise of Ultrasound
The Apogee 1000 Lite is already demonstrating significant potential in this research. The device is compact, user-friendly, and capable of producing detailed images of the skin and underlying structures. By refining its use in this specific application, the team at the University of Southampton hopes to establish a non-invasive testing protocol that is just as accurate as the needle method- if not more so.
The benefits of using ultrasound extend far beyond accuracy. Patients can avoid the discomfort and anxiety associated with needles, while clinicians gain the ability to assess suitability earlier in the process. This means fewer last-minute cancellations, better resource management, and an enhanced patient experience overall.
Pioneering Customised Support for Global Clients
For this project, PUM supplied a linear probe, which is ideally suited to the task. At PUM, we pride ourselves on tailoring our solutions to meet specific clinical needs. If required, we can source a variety of probes and configurations to suit different applications. Our services extend globally, and we offer Zoom consultations to ensure that, no matter where our clients are located, they can access expert guidance and support. Whether troubleshooting equipment, developing protocols, or providing demonstrations, we are committed to helping clinicians deliver exceptional care.

Pioneering the Future of Hearing Care
As research progresses, the hope is that ultrasound will become the standard method for skin flap measurements in transcutaneous hearing implants, revolutionising care for the millions of people affected by hearing loss.
With innovations like the Apogee 1000 Lite, the future of hearing healthcare is brighter than ever—proving that even the smallest advancements in technology can have a profound impact on patients’ lives.