Vibroplasty involving direct coupling of the floating mass transducer to the oval window niche

Zehlicke, Thorsten; Dahl, Rüdiger; Just, Tino; Hw, Pau

doi:10.1017/s0022215110000526

Cited by 27 publications

(32 citation statements)

References 15 publications

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“…Depending on the anatomic and pathological conditions of the middle ear, the VSB transducer, the floating mass transducer (FMT), can be attached to the long process of the incus [13], directly on the round window (RW) membrane [11,12], on the head of the stapes or on the oval window (OW) [14], or may be combined with a passive middle ear prosthesis [15]. Because the middle ear is bypassed and the inner ear is stimulated directly, audiologic selection criteria are based on residual sensorineural hearing (bone conduction (BC) thresholds).…”

Section: Introductionmentioning

confidence: 99%

Active middle ear implants: Vibroplasty™ in children and adolescents with acquired or congenital middle ear disorders

Clarós¹,

Pujol²

2013

Acta Oto-Laryngologica

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No significant changes in mean BC or AC thresholds between preoperative and postoperative conditions were seen in the 22 patients. Mean PTA4 functional gain was 30.7 dB. Averaged over all 22 patients, word recognition at 65 dB SPL changed from an average of 19% in the unaided postoperative condition to 97% in the VSB-aided condition. Functional results were independent of hearing loss etiology and transducer location.

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Section: Introductionmentioning

confidence: 99%

Active middle ear implants: Vibroplasty™ in children and adolescents with acquired or congenital middle ear disorders

Clarós¹,

Pujol²

2013

Acta Oto-Laryngologica

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“…The safety of the VSB and the efficiency of the various coupling modalities within the indication range have been established over many years [Fraysse et al, 2001;Mosnier et al, 2008;Baumgartner et al, 2010;Hütten-brink et al, 2010;Zehlicke et al, 2010;Schwab et al, 2012Schwab et al, , 2013Schwab et al, , 2014Maier et al, 2015]. However, it is still unclear which coupling type and FMT position is most effective for the vibration transmission into the cochlear and what variability can be expected.…”

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confidence: 99%

Comparison of Alternative Coupling Methods of the Vibrant Soundbridge Floating Mass Transducer

Busch

Lenarz²,

Maier³

2016

Audiol Neurotol

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The active middle ear implant Vibrant Soundbridge© provides a variety of coupling modalities of the floating mass transducer (FMT) to various structures of the ossicular chain and the round window. A retrospective analysis was performed on 125 subjects (n = 137 ears) (1) to compare the efficacy of the different FMT coupling modalities with increasing degree of hearing loss, (2) to compare the performance in speech outcome and the effective gain between the coupling types, and (3) to evaluate the risk of additional hearing loss of each coupling procedure. The patients were grouped according to their type of FMT coupling into incus vibroplasty (incus group, n = 59), round window vibroplasty with coupler (RWC group, n = 23), round window vibroplasty without coupler (RW group, n = 22), and oval window vibroplasty with coupler (OWC group, n = 33). For each coupling group, pre- and postoperative thresholds, the results of the Freiburg monosyllable test at 65 dB SPL, and the effective gain across frequencies (0.5-6 kHz) were evaluated. A logistic regression function was used to describe the relationship between word recognition scores (WRS, in % correct) and the mean bone conduction (BC) hearing loss. The surgical procedure had no clinically relevant effect on BC thresholds of patients in each coupling group. The BC pure tone average (PTA₄) for 50% WRS predicted by the model function was similar for the incus (48.2 dB nHL), RW (47.8 dB nHL), and OWC (49.0 dB nHL) groups, but higher for the RWC group (67.9 dB nHL). However, the median WRS was 80% or better with no significant differences in speech perception between coupling types (Kruskal-Wallis test, p = 0.229). The effective gain shows an advantage for the incus coupling between 0.5 and 2 kHz over the other coupling types. The performance of the FMT coupling modalities is equally good for patients with a mild-to-moderate hearing loss, but the efficacy of coupling types differs for patients with greater hearing loss (>48 dB BC HL).

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“…Several studies looking at functional gain with these have noted poorer performance at low frequencies, so the observed difference may be a function of the device itself (7,8). Other studies investigating pBCIs have also noted distortion at 0.5 kHz and below, perhaps caused by the higher power required to drive the inner ear through the skull at low frequencies (9).…”

Section: Discussionmentioning

confidence: 99%

Preoperative Headband Assessment for Semi-Implantable Bone Conduction Hearing Devices in Conductive Hearing Loss

Rainsbury¹,

Williams²,

Gulliver³

et al. 2015

Otology &Amp; Neurotology

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BC thresholds may be a better indicator of implant performance than headband assessment. Candidacy assessment for siBCI implantation that relies on headband testing with pBCI processors should be interpreted with caution because the headband may under-represent the implanted device. This seems to be especially true at 3 kHz and above and may make it difficult for surgeons to conduct accurate informed consent discussions with patients about the realistic anticipated outcomes and benefits of the procedure.

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Vibroplasty involving direct coupling of the floating mass transducer to the oval window niche

Abstract: In patients with mixed hearing loss combined with a destroyed stapes suprastructure but a mobile stapes footplate, we describe the coupling of the floating mass transducer component of a Vibrant Soundbridge to the stapes footplate, as an alternative to coupling to the round window.

Cited by 27 publications

References 15 publications

Active middle ear implants: Vibroplasty™ in children and adolescents with acquired or congenital middle ear disorders

Active middle ear implants: Vibroplasty™ in children and adolescents with acquired or congenital middle ear disorders

Comparison of Alternative Coupling Methods of the Vibrant Soundbridge Floating Mass Transducer

Preoperative Headband Assessment for Semi-Implantable Bone Conduction Hearing Devices in Conductive Hearing Loss

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