Round window vibroplasty: Long-term results

Böheim, K.; Mlynski, Robert; Lenarz, Thomas; Schlögel, Max; Hagen, Rudolf

doi:10.3109/00016489.2012.684701

Cited by 58 publications

(39 citation statements)

References 22 publications

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“…According to the literature [Böheim et al, 2012;Skarzynski et al, 2014], audiometric thresholds have been reported to be stable 12 months postoperatively, with aided performance significantly improved over preoperative measurements. Additionally, basic audiological tests showed that the air and BC thresholds of the patients were not altered by the operation.…”

Section: Methodsmentioning

confidence: 99%

“…This 'RW vibroplasty' -which bypasses a missing or severely damaged ossicular chain entirely and relies solely on the vibrational energy passed through the FMT -has been shown to be safe and effective, with stable results in longterm studies [Baumgartner et al, 2010;Bernardeschi et al, 2011;Böheim et al, 2012;Skarzynski et al, 2014]. However, placing the FMT at the RW often requires drilling and may be complicated by individual differences in RW size, depth of recession, or in cases of RW sclerosis.…”

Section: Introductionmentioning

confidence: 99%

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Multicenter Clinical Trial of Vibroplasty Couplers to Treat Mixed/Conductive Hearing Loss: First Results

et al. 2016

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Objective: To evaluate the safety and effectiveness of round window (RW), oval window (OW), CliP and Bell couplers for use with an active middle ear implant. Methods: This is a multicenter, long-term, prospective trial with consecutive enrollment, involving 6 university hospitals in Germany. Bone conduction, air conduction, implant-aided warble-tone thresholds and Freiburger monosyllable word recognition scores were compared with unaided preimplantation results in 28 moderate-to-profound hearing-impaired patients after 12 months of follow-up. All patients had previously undergone failed reconstruction surgeries (up to 5 or more). In a subset of patients, additional speech tests at 12 months postoperatively were used to compare the aided with the unaided condition after implantation with the processor switched off. An established quality-of-life questionnaire for hearing aids was used to determine patient satisfaction. Results: Postoperative bone conduction remained stable. Mean functional gain for all couplers was 37 dB HL (RW = 42 dB, OW = 35 dB, Bell = 38 dB, CliP = 27 dB). The mean postoperative Freiburger monosyllable score was 71% at 65 dB SPL. The postimplantation mean SRT₅₀ (speech reception in quiet for 50% understanding of words in sentences) improved on average by 23 dB over unaided testing and signal-to-noise ratios also improved in all patients. The International Outcome Inventory for Hearing Aids (IOI-HA)quality-of-life questionnaire was scored very positively by all patients. Conclusion: A significant improvement was seen with all couplers, and patients were satisfied with the device at 12 months postoperatively. These results demonstrate that an active implant is an advantage in achieving good hearing benefit in patients with prior failed reconstruction surgery.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Multicenter Clinical Trial of Vibroplasty Couplers to Treat Mixed/Conductive Hearing Loss: First Results

et al. 2016

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“…The results for hearing restoration in sensorineural hearing loss and recently in mixed and conductive hearing loss are reliable and stable in the long term [Fisch et al, 2001;Lenarz et al, 2001;Todt et al, 2002;Mosnier et al, 2008;Streitberger et al, 2009;Böheim et al, 2012;Huber et al, 2012]. However, the surgical approach and the variability in audiological outcome as well as the benefit when compared to conventional hearing aids are controversial, especially with regard to the classical application at the long incus process Snik et al, 2001;Junker et al, 2002;Schmuziger et al, 2006;Truy et al, 2006;Bruschini et al, 2009].…”

Section: Surgical Issuesmentioning

confidence: 99%

“…For the classical indication with normal middle-ear anatomy, the FMT is fixed to the long process of the incus [Fisch et al, 2001]. Attachment of the FMT to the stapes or its remnants, the round window (RW) or a variety of coupling elements are alternatives for patients with conductive and mixed hearing loss [Colletti et al, 2006;Streitberger et al, 2009;Baumgartner et al, 2010;Mlynski et al, 2010;Beleites et al, 2011;Böheim et al, 2012;Huber et al, 2012].…”

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confidence: 99%

Alternative Fixation of an Active Middle Ear Implant at the Short Incus Process

et al. 2013

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Introduction: Since 1996, the preferred approach for positioning the active middle-ear implant Vibrant Soundbridge© is a mastoidectomy and a posterior tympanotomy. With this device, placement of the floating mass transducer (FMT) on the long incus process is the standard method for treatment of mild-to-severe sensorineural hearing loss in the case of normal middle-ear anatomy. The aim of this study was to determine the vibrational effectiveness of FMT placement at the short incus process. Materials and Methods: An extended antrotomy and a posterior tympanotomy were performed in 5 fresh human temporal bones. As a control for normal middle-ear function, the tympanic membrane was stimulated acoustically and the vibration of the stapes footplate and the round-window (RW) membrane were (sequentially) measured by laser Doppler vibrometry. Vibration responses for coupling of an FMT to the long incus process (standard coupling) were compared to those for coupling to the short incus process. Results: Apart from narrow frequency bands near 3 and 9 kHz for the stapes footplate and RW membrane, respectively, the velocity responses presented no significant differences between standard coupling of the FMT and coupling to the short incus process. Conclusion: Coupling the FMT to the short incus process may be a viable alternative in cases where the surgical approach is limited to an extended antrotomy. A reliable technique for attachment to the short incus process has yet to be developed.

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“…Very few studies, always through retrospective data collection, have published speech in noise results comparing the use of acoustic hearing implants to preoperative hearing aid scores. When comparing the VSBaided condition to an aided or unaided preoperative condition, reports show a variable improvement of 2.8-5 dB SNR [Beltrame et al, 2009;Böheim et al, 2012;Rajan et al, 2011]. Remarkably, with the current DACI, aided sound field thresholds show amplification on all frequencies, i.e.…”

Section: Study Qualitymentioning

confidence: 99%

A Comparative Study on Speech in Noise Understanding with a Direct Acoustic Cochlear Implant in Subjects with Severe to Profound Mixed Hearing Loss

et al. 2014

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The aim of this study was to investigate the efficacy of a direct acoustic cochlear implant (DACI) for speech understanding in noise in patients suffering from severe to profound mixed hearing loss (MHL) due to various etiologies compared to the preoperative best-aided condition. The study was performed at five tertiary referral centers in Europe (Belgium, Germany, Poland and Spain). Nineteen adult subjects with severe to profound MHL due to (advanced) otosclerosis, ear canal fibrosis, chronic otitis media, tympanosclerosis or previous cholesteatoma were implanted with a DACI (Codacs™ Investigational Device) combined with a conventional stapes prosthesis. Unaided and aided speech reception scores in quiet and in noise, preoperative and postoperative air and bone conduction thresholds and aided and unaided sound field thresholds were measured prospectively during the study. Subjective benefit analysis was determined through the Abbreviated Profile of Hearing Aid Benefit questionnaire. Quality of life was measured by the Health Utilities Index. All subjects were fitted preoperatively with hearing aids and/or a bone conduction implant on a headband before DACI implantation. This allows direct comparison between different hearing rehabilitation solutions. The mean speech reception threshold in noise improved significantly by 7.9 dB signal-to-noise ratio (SNR) after activation of the DACI compared to the preoperative best-aided condition. For all 19 subjects, a mean postoperative aided speech reception threshold of 2.6 dB SNR (standard deviation: 8.3 dB) was measured. On average, no significant shift in the bone conduction thresholds was noted 4-5 months after implantation. A mean sound field threshold improvement of 46 and 16 dB was measured compared to the preoperative unaided and best-aided condition, respectively. Speech perception tests in quiet showed a mean improvement of the word recognition scores by 65 and 48% at 65 dB SPL compared to the preoperative unaided and best-aided condition, respectively. In summary, DACI provides an effective improvement of the speech perception in noise compared to the best-aided condition in subjects suffering from severe to profound MHL.

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Round window vibroplasty: Long-term results

Cited by 58 publications

References 22 publications

Multicenter Clinical Trial of Vibroplasty Couplers to Treat Mixed/Conductive Hearing Loss: First Results

Multicenter Clinical Trial of Vibroplasty Couplers to Treat Mixed/Conductive Hearing Loss: First Results

Alternative Fixation of an Active Middle Ear Implant at the Short Incus Process

A Comparative Study on Speech in Noise Understanding with a Direct Acoustic Cochlear Implant in Subjects with Severe to Profound Mixed Hearing Loss

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