gms | German Medical Science

Active middle ear implants (aMEI) have evolved over the last 20 years and are in use for this time in several areas of otological and audiological applications.

A systematic literature review (Pubmed, EMBASE, SciSearch, Cochrane Library) was conducted to identify studies evaluating the safety, efficacy and outcomes (audiological, otological) of partially implantable aMEIs. Data were extracted on systems with regulatory approval and summarized. Meta-analyses were conducted for aMEIs with more than 100 publications reporting the outcome. Study selection, data extraction and quality appraisal for quantitative data synthesis was carried out by two reviewers.

431 studies included describe the overall good audiological outcomes, clinical safety and subjective well-being of the individual patients. Meta-analysis of the clinical outcomes with the Vibrant Soundbridge (VSB) system showed alow rate of adverse ventss and long-term stable audiological outcome (up to 19 yrs). The derived audiological benefit was similar for all indications and age groups, apart from those with a central presbycusis.

To date, the majority of the literature covers the clinical pllication of the VSB as it is applicable to a wide range of otological and audiological conditions. The overclosure effetc is most remarkable in pure SNHL conditions while the introduction of couplers has opened the field for previous failed middle ear surgery. Other aMEIS (such as the MET system) still have to find their way in clinical routine.

Detailed analyses of the data are provided.