Premium
Clinical Experience of Vibroplasty With Direct Coupling to the Oval Window Without Use of a Coupler
Author(s) -
Kwak Sang Hyun,
Moon Young Min,
Nam GiSung,
Bae Seong Hoon,
Kim Sung Huhn,
Jung Jinsei,
Choi Jae Young
Publication year - 2020
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.28514
Subject(s) - medicine , footplate , stapes , audiogram , bone conduction , audiology , immittance , loudness , hearing loss , round window , surgery , middle ear , cochlea , mechanical engineering , electrical engineering , engineering
Objectives/Hypothesis To investigate the efficacy of direct implantation of a Vibrant Soundbridge (VSB) implant in the oval window (OW) without the use of an OW coupler in patients with severe mixed hearing loss. Study Design Retrospective chart review Methods A total of 62 patients underwent VSB implantation between July 2016 and December 2018 at Severance Hospital in Seoul, South Korea. Among them, eight patients (nine ears) with moderate‐to‐severe mixed hearing loss were implanted with a VSB directly in the OW. A floating mass transducer (FMT) was attached to the stapes footplate and covered with tragal cartilage. The outcomes were evaluated using pure‐tone audiogram and speech audiogram preoperatively and postoperatively. Word recognition score (WRS; % correct) were measured at the most comfortable loudness (MCL) level to evaluate speech perception. Results All cases posed difficulty with round window vibroplasty during surgery, and eventually, an FMT was appropriately placed in the OW without a coupler. Preoperative and postoperative bone conduction thresholds were not different. VSB‐aided threshold improved in terms of functional and effective gains. Interestingly, four cases showed improved air conduction thresholds without the use of a VSB. In addition, MCL level with a VSB was significantly lower than that with a hearing aid, and VSB‐aided WRS improved over time. Conclusions Direct implantation of a VSB in the OW without the use of a coupler showed favorable hearing outcomes, and the OW vibroplasty was safe. Direct OW vibroplasty without a coupler is a reliable procedure and can be a good option for hearing rehabilitation in patients with severe mixed hearing loss. Level of Evidence 4 Laryngoscope , 2020