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. 2020 Dec;130(12):E926-E932.
doi: 10.1002/lary.28514. Epub 2020 Jan 24.

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

Sang Hyun Kwak  1 , Young Min Moon  1 , Gi-Sung Nam  1 , Seong Hoon Bae  1 , Sung Huhn Kim  1 , Jinsei Jung  1 , Jae Young Choi  1
Affiliations

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

Sang Hyun Kwak et al. Laryngoscope. 2020 Dec.

Abstract

Objectives/hypothesis: To investigate the efficacy of direct implantation of a Vibrant Soundbridge (VSB) implant in the oval window (OW) without the use of an OW coupler in patients with severe mixed hearing loss.

Study design: Retrospective chart review METHODS: A total of 62 patients underwent VSB implantation between July 2016 and December 2018 at Severance Hospital in Seoul, South Korea. Among them, eight patients (nine ears) with moderate-to-severe mixed hearing loss were implanted with a VSB directly in the OW. A floating mass transducer (FMT) was attached to the stapes footplate and covered with tragal cartilage. The outcomes were evaluated using pure-tone audiogram and speech audiogram preoperatively and postoperatively. Word recognition score (WRS; % correct) were measured at the most comfortable loudness (MCL) level to evaluate speech perception.

Results: All cases posed difficulty with round window vibroplasty during surgery, and eventually, an FMT was appropriately placed in the OW without a coupler. Preoperative and postoperative bone conduction thresholds were not different. VSB-aided threshold improved in terms of functional and effective gains. Interestingly, four cases showed improved air conduction thresholds without the use of a VSB. In addition, MCL level with a VSB was significantly lower than that with a hearing aid, and VSB-aided WRS improved over time.

Conclusions: Direct implantation of a VSB in the OW without the use of a coupler showed favorable hearing outcomes, and the OW vibroplasty was safe. Direct OW vibroplasty without a coupler is a reliable procedure and can be a good option for hearing rehabilitation in patients with severe mixed hearing loss.

Level of evidence: 4 Laryngoscope, 2020.

Keywords: Vibrant Soundbridge; hearing rehabilitation; oval window coupler; severe mixed hearing loss.

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References

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