gms | German Medical Science

Introduction: The Vibrant Soundbridge (VSB) has been introduced in 1996. It provides treatment options for patients with conductive hearing loss (HL) and mixed moderate to severe sensorineural hearing loss (SNHL). A current paper analyses indications for these patient groups and reports long term results for up to 12 years of use.

Patients and methods: More than 330 VSB surgeries have been performed at Hanover Medical School. The VSB allows coupling to different ossicles or the round window membrane. Incus coupling was used in N=131 patients with SNHL. In patients with mixed HL coupling was done either on the round window membrane (N=165), the stapes or the oval window. Thresholds, functional gain and speech perception with Freiburg monosyllables were measured.

Results: Improvements in speech recognition can be achieved in patients with bone conduction (BC) <50dB at 500Hz and <70dB at 4 kHz having pure SNHL or mixed HL. The large variability might be explainable by mode and quality of coupling. Long term results show stable speech perception with minor deterioration of the average BC thresholds in the implanted ear.

Discussion and conclusion: Middle ear implants such as VSB are a true treatment option for patients with pure SNHL, having insufficient benefit from acoustic hearing aids (HA), or suffering from chronic or external otitis. Patients with mixed HL show major improvements in speech perception and better performance compared to HA. It is the treatment of choice in patients with malformations of the outer and middle ear, conductive HL that cannot be improved by tympanoplasty or stapesplasty, or patients with non-satisfactory improvement by HA. Long term results show stable performance over a long period of observation reflecting very good safety of these implants.

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