Application of the vibrant soundbridge® to unilateral osseous atresia cases

Abstract

By circumventing the malformed middle ear and directly stimulating the cochlea, the VSB provides a new rehabilitation option for atresia patients. We conclude that the procedure is safe and effective and can be implemented in combination with outer ear reconstruction.

Functional Results of Vibrant Soundbridge Middle Ear Implants in Conductive and Mixed Hearing Losses

“…Functional results of surgery for aural atresia are often disappointing, and the use of VSB for bypassing the external canal and middle ear structures appears to be an efficacious means of rehabilitation [Frenzel et al, 2009]. However, labyrinthine windows can be difficult to reach and a thorough study of the preoperative CT scan is mandatory.…”

“…Based on these data, and the ability of these devices to deliver amplified sound energy in the middle ear, the idea of placing the transducer close to the cochlea in case of abnormal middle ear emerged. Colletti et al [2009] described the first cases of VSB placed on the round window (RW), followed by other authors employing the VSB in a wide range of middle ear diseases such as otosclerosis with mixed hearing loss [Venail et al, 2009], stabilized chronic otitis media after tympanoplasty failure and aural atresia [Frenzel et al, 2009]. In mixed hearing loss, tympanoossicular chain reconstruction alone often fails to restore an optimal hearing and needs to be associated with a hearing aid.…”

The floating mass transducer at the round window: Direct transmission or bone conduction?

“…An application of this concept is the implantation of the floating mass transducer (FMT) of the MED-EL Vibrant Soundbridge (VSB) at the round window (Colletti et al, 2006), which is a promising method to treat moderate mixed hearing loss. Several authors have reported their procedures with generally favorable outcomes (Ambett et al, 2009;Beltrame et al, 2009;Frenzel et al, 2009;Kiefer et al, 2006;Linder et al, 2009). Various procedures to position the FMT at the round window (rwFMT) have been reported, e.g., the use of soft tissue to either underlay or to overlay the rwFMT, both with or without widening of the round window niche.…”

Conditions for Highly Efficient and Reproducible Round-Window Stimulation in Humans

“…However, current publications [Baumgartner et al, 2010;Boeheim et al, 2010;Colletti et al, 2006;Colletti et al, 2009;Cuda et al, 2009;Frenzel et al, 2009;Kiefer and Staudenmaier, 2010;Linder et al, 2009;Streitberger et al, 2009;Wollenberg et al, 2007] reveal a considerable variability regarding the degree of hearing restoration. To approach this issue, different methods of coupling an actuator to the RW membrane have been investigated in human temporal bone experiments [Arnold et al, 2010;Nakajima et al, 2010].…”