Clinical feasibility of a novel test setup for objective measurements using the VIBRANT SOUNDBRIDGE

Sprinzl, Georg Mathias; Schörg, Philipp; Edlinger, Stefan; Ploder, Marlene; Magele, Astrid

doi:10.1002/lio2.839

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…It should be noted, however, that direct comparisons between our study and that of Fröhlich et al should be made with caution because Fröhlich et al used a preprogrammed sound processor with an attached insert earphone for each implantation, resulting in different intraoperative ABR measurements. A recent study conducted by Sprinzl et al presented findings similar to our study in terms of test design, measurements, cohort, and data analysis with 14 AMEI implantations ( 16 ). Our results showed an intraoperative ABR threshold almost identical to theirs.…”

Section: Discussionsupporting

confidence: 89%

“…Fröhlich et al conducted a study of 18 patients with similar demographic and audiological characteristics to our cohort (17). They investigated the frequency-specific coupling efficiency and (16). Our results showed an intraoperative ABR threshold almost identical to theirs.…”

Section: Abrsupporting

confidence: 80%

“…It is worth noting that previous studies have not reported the number of failed measurements, but rather only the successful ones (6)(7)(8). The existing literature on evaluating coupling efficiency in AMEIs has primarily focused on ABR measurements (9)(10)(11)(12)(14)(15)(16). It should be noted that the ECochG measurement has limitations, as it requires active participation from the surgeon and is only feasible if the promontory is accessible during surgery.…”

Section: Ecochgmentioning

confidence: 99%

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Comparison of auditory brainstem response and electrocochleography to assess the coupling efficiency of active middle ear implants

Gawliczek,

Mantokoudis,

Anschuetz

et al. 2023

Front. Neurol.

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AimThis study aimed to compare the effectiveness of auditory brainstem response (ABR) and extracochlear electrocochleography (ECochG) in objectively evaluating the coupling efficiency of floating mass transducer (FMT) placement during active middle ear implant (AMEI) surgery.MethodsWe enrolled 15 patients (mean age 58.5 ± 19.4 years) with mixed hearing loss who underwent AMEI implantation (seven ossicular chain and eight round window couplings). Before the surgical procedure, an audiogram was performed. We utilized a clinical measurement system to stimulate and record intraoperative ABR and ECochG recordings. The coupling efficiency of the VSB was evaluated through ECochG and ABR threshold measurements. Postoperatively, we conducted an audiogram and a vibrogram.ResultsIn all 15 patients, ABR threshold testing successfully determined intraoperative coupling efficiency, while ECochG was successful in only eight patients. In our cohort, ABR measurements were more practical, consistent, and robust than ECochG measurements. Coupling efficiency, calculated as the difference between vibrogram thresholds and postoperative bone conduction thresholds, was found to be more accurately predicted by ABR measurements (p = 0.016, R2 = 0.37) than ECochG measurements (p = 0.761, R2 = 0.02). We also found a non-significant trend toward better results with ossicular chain coupling compared to round window coupling.ConclusionOur findings suggest that ABR measurements are more practical, robust, and consistent than ECochG measurements for determining coupling efficiency during FMT placement surgery. The use of ABR measurements can help to identify the optimal FMT placement, especially with round window coupling. Finally, we offer normative data for both techniques, which can aid other clinical centers in using intraoperative monitoring for AMEI placement.

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Section: Discussionsupporting

confidence: 89%

Section: Abrsupporting

confidence: 80%

Section: Ecochgmentioning

confidence: 99%

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Comparison of auditory brainstem response and electrocochleography to assess the coupling efficiency of active middle ear implants

Gawliczek,

Mantokoudis,

Anschuetz

et al. 2023

Front. Neurol.

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“…The intraoperative ABR measurements were performed using an Interacoustics Eclipse device as previously described [ 20 , 21 ]. The system allowed for the generation of the stimulus and the recording of the brainstem potentials.…”

Section: Methodsmentioning

confidence: 99%

The influence of intraoperative auditory brainstem responses on vibroplasty coupling-quality and analysis of the impact of different fixation steps on the coupling

Dejaco,

Riedl,

Gottfried

et al. 2023

Eur Arch Otorhinolaryngol

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Purpose The Vibrant Soundbridge (VSB) is an established active-middle-ear-implant for patients with moderate-to-profound hearing-loss. This surgery is referred to as “Vibroplasty”. Sufficient transfer of the VSB’s floating-mass-transducers (FMT) energy to the inner ear is a crucial factor influencing the coupling-quality (CQ). However, assessing CQ is hamper by two issues: the method of CQ-assessment itself and the method of FMT-fixation during Vibroplasty. Methods This prospective study explored the influence of intraoperative auditory-brainstem-response (+ ABR) measurements and various fixation methods on postoperative CQ after Vibroplasty as compared to matched-patients after Vibroplasty without intraoperative ABR (-ABR). Propensity-score-matching was performed based on preoperative bone-conduction-pure-tone-average-3 (BC-PTA3) at 1-, 2- and 4 kHz. Primary outcome parameters were postoperative CQ-PTA3, intraoperative ABR threshold for various fixation methods and postoperative BC-PTA3. Results A total of 28 patients were included, of which 14 were + ABR. Preoperative BC-PTA3, sex, age, and number of previous surgeries did not differ significantly between groups (all p > 0.301). Mean postoperative CQ-PTA3 was significantly better for + ABR (1.8 vs. 12.3 dB-HL; p = 0.006). Mean intraoperative ABR threshold was superior for cartilage-counter-bearing and cartilage-housing compared to additional fixation with injectable-platelet-rich- fibrin (53 vs. 56 & 57 dB-HL, respectively; p = 0.04; η2 = 0.33). Mean postoperative BC-PTA3 did not significantly differ between patients (41.4 vs. 41.8 dB-HL; p = 0.77). A total of 7% of the patients required intraoperative readjustment of the FMT based on unsatisfactory intraoperative ABR threshold. Conclusion Intraoperative ABR measurement resulted in significantly better postoperative CQ. Cartilage-counter-bearing and cartilage-housing were observed to have superior CQ. A total of 7% of the patients could be spared revision-Vibroplasty due to intraoperative ABR measurement.

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“…Sprinzl et al (27) investigated coupling efficiency in vibroplasty using intraoperative ABR measurements in 13 patients. The mean difference between preoperative bone conduction thresholds and intraoperative ABR thresholds was 7 dB (SD, ±10 dB), which is slightly higher but still within the 10-dB range.…”

Section: Discussionmentioning

confidence: 99%

The Stapes Head Coupler—A Flexible and Safe Option for Vibroplasty

Spahn,

Koestler,

Herrmann

et al. 2023

Otol Neurotol

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Objective To investigate the surgical approach and the audiological outcome of a stapes head coupler in active middle ear implant surgery. Study design Retrospective data analysis. Setting Tertiary referral center with a large active middle ear implant program. Patients Twelve patients with active middle ear implant surgery. Interventions Therapeutic surgical approach for hearing rehabilitation in human subjects. Main Outcome Measure(s) Auditory brainstem response, sound field thresholds, vibrogram, speech perception in the Freiburger monosyllabic word test. Results The stapes head was attached safely in different coupling situations. Audiological outcomes were similar to the audiological performance of established vibroplasty couplers presented in the literature. Conclusion The stapes head coupler is a new and safe tool for vibroplasty with a good audiological outcome.

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Clinical feasibility of a novel test setup for objective measurements using the VIBRANT SOUNDBRIDGE

Cited by 4 publications

References 16 publications

Comparison of auditory brainstem response and electrocochleography to assess the coupling efficiency of active middle ear implants

Comparison of auditory brainstem response and electrocochleography to assess the coupling efficiency of active middle ear implants

The influence of intraoperative auditory brainstem responses on vibroplasty coupling-quality and analysis of the impact of different fixation steps on the coupling

The Stapes Head Coupler—A Flexible and Safe Option for Vibroplasty

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