The method of attachment of the connecting cable of middle ear active implant “vibrant soundbridge” during vibration plastic reconstruction in patients after the middle ear radical surgery

Abstract

The paper presents a new method of attachment of the connecting cable of middle ear active implant “vibrant soundbridge” during vibration plastic reconstruction in patients after the middle ear radical surgery. This type of surgery involves cable attachment in the bone transverse, made from the inner wall of the spur towards the lower bone wall of the external auditory canal. The transverse envelopes trepanation cavity, departing for 2–3 mm from its edge, and without entering it, reaches the rear wall of the mastoid, where a cavity is generated for excess cable. The whole surgery is accompanied by intraoperative monitoring of the facial nerve by the needle electromyography method under continuous stimulation with a drilling machine. Six patients have been operated on by this method. The follow-up term constituted 1 year to 2 years after surgery. This attachment option has proven it effectiveness, providing the connecting cable insulation from the trepanation cavity and making it possible to prevent such complications as its extrusion and migration. Monitoring, in turn, minimizes the probability of the facial nerve paresis development.