The Hannover Coupler V2: Audiological outcomes of a round window coupler for vibrant soundbridge

The aim of the present study is to report the outcomes of round window reinforcement surgery performed with the application of a Vibrant Soundbridge middle ear implant (VSB; MED-EL) in a patient with superior semicircular canal dehiscence (SSCD) who presented with recurrent vertigo, Tullio phenomenon, Hennebert's sign, bone conduction hypersensitivity, and bilateral moderate to severe mixed hearing loss. Vestibular evoked myogenic potentials (VEMPs) and high-resolution computed tomography (HRCT) confirmed bilateral superior semicircular canal dehiscence while this was not seen in magnetic resonance imaging. The surgical procedure was performed in the right ear as it had worse vestibular and auditory symptoms, a poorer hearing threshold, and greatly altered HRCT and VEMPs findings. With local-assisted anesthesia, round window reinforcement surgery (plugging) with perichondrium was performed with simultaneous positioning of a VSB on the round window niche. At the one and 3 months follow-up after surgery, VSB-aided hearing threshold in the right ear improved to mild, and loud sounds did not elicit either dizziness or pain in the patient.

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Application of the Vibrant Soundbridge middle-ear implant for aural atresia in patients with Treacher Collins syndrome

The Journal of Laryngology & Otology ◽

10.1017/s0022215112002344 ◽

2012 ◽

Vol 126 (12) ◽

pp. 1216-1223 ◽

Cited By ~ 10

Author(s):

E Lesinskas ◽

V Stankeviciute ◽

M Petrulionis

Keyword(s):

Middle Ear ◽

Round Window ◽

Treacher Collins Syndrome ◽

Round Window Membrane ◽

Vibrant Soundbridge ◽

Aural Atresia ◽

Middle Ear Implant ◽

Radiological Score ◽

The Mean ◽

Functional Gain

AbstractObjective:To present results for the auditory rehabilitation of patients with Treacher Collins syndrome with bilateral osseous atresia, using middle-ear implantation with a Vibrant Soundbridge.Methods:Three patients underwent vibroplasty for aural atresia with moderate to severe conductive hearing loss. The pre-operative Jahrsdoerfer radiological score was 4 for all patients. Patients underwent active middle-ear implantation of a Vibrant Soundbridge implant (coupling the floating mass transducer to the rudimentary stapes or footplate distally, and positioning it adjacent to the round window membrane proximally), with audiological analysis as follow up.Results:After implant activation, the mean air conduction threshold ± standard deviation decreased to 22.8 ± 5.5 dB HL, representing a mean functional gain of 44.5 dB. The mean word recognition score (for bisyllabic words at 65 dB SPL) increased from 0 to 97 per cent.Conclusion:Vibrant Soundbridge implantation is an effective hearing rehabilitation procedure in patients with Treacher Collins syndrome with bilateral osseous atresia. This is a versatile implant which can achieve coupling even in cases of severe middle-ear malformation.

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A new coupling device for precise round window coupling of the Vibrant Soundbridge – First audiological results

10.1055/s-0039-1686536 ◽

2019 ◽

Author(s):

N Wardenga ◽

H Maier ◽

T Lenarz

Keyword(s):

Round Window ◽

Vibrant Soundbridge ◽

Coupling Device

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Vibroplasty involving direct coupling of the floating mass transducer to the oval window niche

The Journal of Laryngology & Otology ◽

10.1017/s0022215110000526 ◽

2010 ◽

Vol 124 (7) ◽

pp. 716-719 ◽

Cited By ~ 20

Author(s):

T Zehlicke ◽

R Dahl ◽

T Just ◽

H-W Pau

Keyword(s):

Hearing Loss ◽

Soft Tissue ◽

Clinical Application ◽

Round Window ◽

Oval Window ◽

Speech Understanding ◽

Vibrant Soundbridge ◽

Mixed Hearing Loss ◽

Stapes Footplate ◽

Almost All

AbstractObjective:To demonstrate the technique and clinical application of vibroplasty in which the floating mass transducer component of the Vibrant Soundbridge implant is coupled directly to the oval window niche, in patients with a mobile stapes footplate but a malformed or destroyed stapes suprastructure.Methods:The underlying concept was to create a soft tissue casing for the floating mass transducer, while also firmly connecting the transducer to a small, solid cartilage ‘plunger’ attached to the stapes footplate. This was realised by removing almost all the cartilage from a larger piece of cartilage–perichondrium, leaving only a tiny cartilage island about half a millimetre in diameter, attached to a much wider ‘blanket’ of perichondrium.Results:By coupling the floating mass transducer directly to the oval window niche, patients' speech understanding was improved. Post-operative aided thresholds of 30–40 dB HL were achieved by all patients.Conclusions:In patients with mixed hearing loss combined with a destroyed stapes suprastructure but a mobile stapes footplate, we describe the coupling of the floating mass transducer component of a Vibrant Soundbridge to the stapes footplate, as an alternative to coupling to the round window.

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