Clinical Experience of Vibroplasty With Direct Coupling to the Oval Window Without Use of a Coupler

Kwak, Sang Hyun; Moon, Young Min; Nam, Gi‐Sung; Bae, Seong Hoon; Kim, Sung Huhn; Jung, Jinsei; Choi, Jae Young

doi:10.1002/lary.28514

Cited by 6 publications

(8 citation statements)

References 18 publications

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“…When direct- and cartilage-AC are not functional, patients who receive the most benefits from CC-HAs are patients with aural atresia. These patients require BC-HAs or implantable devices to achieve sufficient amplification [ 25 , 26 , 27 , 28 , 29 , 30 , 31 ]. However, conventional BC-HAs have disadvantages associated with their fixation style; the transducer is fixed with a headband using static force, which can lead to discomfort, pain, and irritation [ 26 ].…”

Section: CC Applicationsmentioning

confidence: 99%

“…The fixation of the transducer can cause poor esthetics. Surgical procedures, such as implanting bone-anchored hearing aids (BAHAs), are additional options [ 25 , 26 , 27 , 28 , 29 , 30 , 31 ] but involve various risks, such as adverse medical and surgical events, infection, and follow-up surgery [ 32 , 33 ]. Some patients also refuse BAHA implantation because of cosmetic considerations [ 34 ].…”

Section: CC Applicationsmentioning

confidence: 99%

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Cartilage Conduction Hearing and Its Clinical Application

et al. 2021

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Cartilage conduction (CC) is a form of conduction that allows a relatively loud sound to be audible when a transducer is placed on the aural cartilage. The CC transmission mechanism has gradually been elucidated, allowing for the development of CC hearing aids (CC-HAs), which are clinically available in Japan. However, CC is still not fully understood. This review summarizes previous CC reports to facilitate its understanding. Concerning the transmission mechanism, the sound pressure level in the ear canal was found to increase when the transducer was attached to the aural cartilage, compared to an unattached condition. Further, inserting an earplug and injecting water into the ear canal shifted the CC threshold, indicating the considerable influence of cartilage–air conduction on the transmission. In CC, the aural cartilage resembles the movable plate of a vibration speaker. This unique transduction mechanism is responsible for the CC characteristics. In terms of clinical applications, CC-HAs are a good option for patients with aural atresia, despite inferior signal transmission compared to bone conduction in bony atretic ears. The advantages of CC, namely comfort, stable fixation, esthetics, and non-invasiveness, facilitate its clinical use.

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Section: CC Applicationsmentioning

confidence: 99%

Section: CC Applicationsmentioning

confidence: 99%

Cartilage Conduction Hearing and Its Clinical Application

et al. 2021

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“…Zehlicke et al (14) reported results of seven cases after direct OW vibroplasty finding a similar mean FHG with decreased aided speech discrimination in comparison to our data. More recently Kwak et al (33) reported a better FHG of around 44 dB after direct OW vibroplasty and furthermore observed an improvement of passive sound transmission in four cases.…”

Section: Discussionmentioning

confidence: 87%

Combination of Direct Oval Window Vibroplasty With Customized Partial Ossicular Replacement Prosthesis (PORP): A Novel Reconstruction Technique to Rehabilitate Mixed Hearing Loss

Grueninger

Canis²,

Spiegel³

et al. 2021

Otology &Amp; Neurotology

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Objective: Hearing rehabilitation with an active middle ear implant (AMEI) in patients with mixed hearing loss (MHL) after multiple ear surgeries is surgically challenging and requires individual solutions in some cases. Our objective was to introduce a feasible novel technique for direct oval window vibroplasty (OW vibroplasty) using a partial ossicular replacement prosthesis (PORP) to ensure stability and enable active and passive sound transmission. Design: Four patients with MHL following multiple middle ear surgeries and indication for an AMEI received direct OW vibroplasty in combination with a customized PORP between the enwrapped actuator and reconstructed tympanic membrane (TM). Results: Postoperative bone conduction was stable in all patients. All patients benefitted from the AMEI in combination with PORP with a mean functional gain of 31.5 AE 17.0 dB. Mean aided postoperative pure tone average was 27.3 AE 2.6 dB. Speech discrimination in quiet at 65 dB with the German Language Freiburg Monosyllabic Test improved for all patients to 68.8 AE 6.3% and in noise with the German Language Oldenburger Sentence Test to -10.4 AE 3.3 dB SNR. No complications were observed. Conclusions: This novel technique of direct OW vibroplasty extends the portfolio of reconstructive middle ear procedures by combining an intraoperatively customized ''off-the-shelf'' PORP as a coupler between floating mass transducer (FMT) and a cartilage TM. We found satisfying functional hearing results. Benefits of the reported technique comprise 1) stabilization and optimized coupling of the reconstruction, 2) possibility of passive sound transmission, 3) general feasibility due to great availability of a regular PORP, and 4) flexibility in bridging of large gaps between TM and actuator.

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“…Fortunately, the enrolled patients were satisfied with their CC‐HAs and continued to use them. When CC‐HAs cannot sufficiently compensate for hearing loss because of limitations of the output levels, other options, such as BAHA, Bonebridge, VSB, Osia, Ponto, and Alpha 2MPO, 22 , 34 , 35 , 36 , 37 have to be considered.…”

Section: Discussionmentioning

confidence: 99%

Effect of transducer placements on thresholds in ears with an abnormal ear canal and severe conductive hearing loss

Nishimura

Hosoi

Saito

et al. 2021

Laryngoscope Investig Oto

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Objectives Providing hearing compensation to patients with aural atresia is considerably challenging. Hearing aid transducers vibrating the aural cartilage (cartilage conduction; CC) have been devised, and hearing aids utilizing them (CC hearing aids) have quickly become a beneficial option for aural atresia in clinical applications. However, it remains unclear which placement (on the aural cartilage or mastoid) is beneficial to signal transmission. Methods This study included 35 patients (53 ears with an abnormal ear canal and severe conductive hearing loss) who were using CC hearing aids. Thresholds were compared between the transducers on the aural cartilage and on the mastoid. Results In ears with bony aural atresia, thresholds were significantly improved when the transducer was placed on the aural cartilage compared to when it was placed on the mastoid for frequencies ≤ 500 Hz (P < .05). In aural atresia ears with a fibrotic tissue pathway, the aural cartilage stimulation improved the thresholds by approximately 20 dB for frequencies ≤ 1000 Hz (P < .05). In non‐atretic ears, the aural cartilage locations significantly worsened the threshold at 4000 Hz (P < .05). Conclusion Our findings demonstrated that placing the transducer at the aural cartilage improved the mid‐to‐low frequency thresholds compared to mastoid transduction in aural atretic ears. In contrast, no clear improvement to the signal transmission due to the transducer's placement on the aural cartilage was recognized in non‐atretic ears. Level of Evidence 2

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Clinical Experience of Vibroplasty With Direct Coupling to the Oval Window Without Use of a Coupler

Cited by 6 publications

References 18 publications

Cartilage Conduction Hearing and Its Clinical Application

Cartilage Conduction Hearing and Its Clinical Application

Combination of Direct Oval Window Vibroplasty With Customized Partial Ossicular Replacement Prosthesis (PORP): A Novel Reconstruction Technique to Rehabilitate Mixed Hearing Loss

Effect of transducer placements on thresholds in ears with an abnormal ear canal and severe conductive hearing loss

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