Experience With Vibroplasty Couplers at the Stapes Head and Footplate

Beleites, Thomas; Neudert, Marcus; Beutner, Dirk; Hüttenbrink, Karl-Bernd; Zahnert, Thomas

doi:10.1097/mao.0b013e3182380621

Cited by 45 publications

(40 citation statements)

References 19 publications

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“…For the classical indication with normal middle-ear anatomy, the FMT is fixed to the long process of the incus [Fisch et al, 2001]. Attachment of the FMT to the stapes or its remnants, the round window (RW) or a variety of coupling elements are alternatives for patients with conductive and mixed hearing loss [Colletti et al, 2006;Streitberger et al, 2009;Baumgartner et al, 2010;Mlynski et al, 2010;Beleites et al, 2011;Böheim et al, 2012;Huber et al, 2012].…”

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confidence: 99%

Alternative Fixation of an Active Middle Ear Implant at the Short Incus Process

et al. 2013

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Introduction: Since 1996, the preferred approach for positioning the active middle-ear implant Vibrant Soundbridge© is a mastoidectomy and a posterior tympanotomy. With this device, placement of the floating mass transducer (FMT) on the long incus process is the standard method for treatment of mild-to-severe sensorineural hearing loss in the case of normal middle-ear anatomy. The aim of this study was to determine the vibrational effectiveness of FMT placement at the short incus process. Materials and Methods: An extended antrotomy and a posterior tympanotomy were performed in 5 fresh human temporal bones. As a control for normal middle-ear function, the tympanic membrane was stimulated acoustically and the vibration of the stapes footplate and the round-window (RW) membrane were (sequentially) measured by laser Doppler vibrometry. Vibration responses for coupling of an FMT to the long incus process (standard coupling) were compared to those for coupling to the short incus process. Results: Apart from narrow frequency bands near 3 and 9 kHz for the stapes footplate and RW membrane, respectively, the velocity responses presented no significant differences between standard coupling of the FMT and coupling to the short incus process. Conclusion: Coupling the FMT to the short incus process may be a viable alternative in cases where the surgical approach is limited to an extended antrotomy. A reliable technique for attachment to the short incus process has yet to be developed.

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confidence: 99%

Alternative Fixation of an Active Middle Ear Implant at the Short Incus Process

et al. 2013

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“…The authors expect that by using titanium couplers, described by Hüttenbrink et al [2011] as a clip vibroplasty, surgeries with AMEI will be performed in a more standardized manner, possibly diminishing the current variable functional hearing gain after VSB implantation [Luers et al, 2013]. In several studies, stapes fixation was encountered during VSB implantation without safe access to the round window, mainly due to congenital middle ear malformation [Beleites et al, 2011;Verhaert et al, 2011]. Some authors, mostly for safety, coupled the floating mass transducer to the fixed stapes, as that procedure follows the normal auditory pathway, keeping the round window as a pressure outlet, achieving however suboptimal amplification.…”

Section: Study Qualitymentioning

confidence: 99%

A Comparative Study on Speech in Noise Understanding with a Direct Acoustic Cochlear Implant in Subjects with Severe to Profound Mixed Hearing Loss

et al. 2014

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The aim of this study was to investigate the efficacy of a direct acoustic cochlear implant (DACI) for speech understanding in noise in patients suffering from severe to profound mixed hearing loss (MHL) due to various etiologies compared to the preoperative best-aided condition. The study was performed at five tertiary referral centers in Europe (Belgium, Germany, Poland and Spain). Nineteen adult subjects with severe to profound MHL due to (advanced) otosclerosis, ear canal fibrosis, chronic otitis media, tympanosclerosis or previous cholesteatoma were implanted with a DACI (Codacs™ Investigational Device) combined with a conventional stapes prosthesis. Unaided and aided speech reception scores in quiet and in noise, preoperative and postoperative air and bone conduction thresholds and aided and unaided sound field thresholds were measured prospectively during the study. Subjective benefit analysis was determined through the Abbreviated Profile of Hearing Aid Benefit questionnaire. Quality of life was measured by the Health Utilities Index. All subjects were fitted preoperatively with hearing aids and/or a bone conduction implant on a headband before DACI implantation. This allows direct comparison between different hearing rehabilitation solutions. The mean speech reception threshold in noise improved significantly by 7.9 dB signal-to-noise ratio (SNR) after activation of the DACI compared to the preoperative best-aided condition. For all 19 subjects, a mean postoperative aided speech reception threshold of 2.6 dB SNR (standard deviation: 8.3 dB) was measured. On average, no significant shift in the bone conduction thresholds was noted 4-5 months after implantation. A mean sound field threshold improvement of 46 and 16 dB was measured compared to the preoperative unaided and best-aided condition, respectively. Speech perception tests in quiet showed a mean improvement of the word recognition scores by 65 and 48% at 65 dB SPL compared to the preoperative unaided and best-aided condition, respectively. In summary, DACI provides an effective improvement of the speech perception in noise compared to the best-aided condition in subjects suffering from severe to profound MHL.

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“…Audiometric candidacy criteria include bone conduction thresholds up to 65 dB HL at 500 Hz and 85 dB HL at 6,000 Hz [29]. Uses for both children and mixed hearing loss have also been investigated [29,30,33]. Like the Otologics MET and Carina, flexibility of the internal component placement has the potential to make this device appropriate for patients with a wide range of middle ear anomalies.…”

Section: Clinical Indicationsmentioning

confidence: 99%

“…There are concerns regarding possible necrosis of the ossicle using a clip; however, significant widespread cases of necrosis were not identified in a literature search [30,32]. Investigations of alternative coupling sites in the middle ear have been explored to address instances where conductive or mixed hearing loss is present because of ossicular structural abnormalities.…”

Section: Surgery and Outcomesmentioning

confidence: 99%

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Implantable Hearing Devices

Kozlowski

Friedland

2014

Curr Surg Rep

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There are many barriers that prevent the use of traditional acoustic amplification including anatomic and medical conditions and patient preference. Implantable hearing devices typically avoid the use of the ear canal and can overcome many of these barriers. Current options include partially and fully implantable devices, devices that make use of bone conduction, devices that directly couple to the ossicular chain, and those that provide more direct cochlear stimulation. This article reviews the major devices that are currently available or in development providing information regarding clinical indications, device components, the general surgical procedure, and typical outcomes. This review should help the clinician understand device options to fit specific patient anatomy and amplification needs.

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Experience With Vibroplasty Couplers at the Stapes Head and Footplate

Abstract: OW- or Clip-Coupler-Vibroplasty using couplers was found to be a straightforward procedure, which produced good results in this group of patients.

Cited by 45 publications

References 19 publications

Alternative Fixation of an Active Middle Ear Implant at the Short Incus Process

Alternative Fixation of an Active Middle Ear Implant at the Short Incus Process

A Comparative Study on Speech in Noise Understanding with a Direct Acoustic Cochlear Implant in Subjects with Severe to Profound Mixed Hearing Loss

Implantable Hearing Devices

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