Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2011
Vibrant Soundbridge surgery in patients with severe external otitis: complications of a transcanal approach.
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Zwartenkot Joost W, Mulder Jef J S, Snik Ad F M, Cremers Cor W R J
Аннотация
OBJECTIVE: To evaluate the transcanal surgical implantation of the semi-implantable Vibrant Soundbridge (VSB) device in patients with severe external otitis.
STUDY DESIGN: Retrospective analysis.
METHODS: Long-term postoperative complications and postoperative hearing thresholds were evaluated in 13 adults with bilateral sensorineural hearing loss (average of between 40 and 55 dB HL) and therapy-resistant external otitis after implantation of the VSB by a transcanal surgical method.
RESULTS: Postoperative audiometry findings were comparable with those reported after the transmastoidal posterior tympanotomy approach. In 2 patients, the chorda tympani was intentionally sacrificed to maximize the size of the facial recess. Seven postoperative complications occurred in 6 patients (46%) during a mean follow-up period of 51 months: extrusion of the conducting wire into the ear canal (n=5), collapse of the cartilaginous part of the ear canal (n=1), and tympanic membrane perforation (n=1). In the revision operations that added additional layers of fascia for the patients with wire extrusions, repeated extrusion occurred in 3 of 4 cases.
CONCLUSION: The transcanal approach for the implantation of the VSB has led to postoperative complications different from those reported after the transmastoidal posterior tympanotomy approach. External otitis should be considered as a contraindication for VSB surgery by the transcanal approach.
STUDY DESIGN: Retrospective analysis.
METHODS: Long-term postoperative complications and postoperative hearing thresholds were evaluated in 13 adults with bilateral sensorineural hearing loss (average of between 40 and 55 dB HL) and therapy-resistant external otitis after implantation of the VSB by a transcanal surgical method.
RESULTS: Postoperative audiometry findings were comparable with those reported after the transmastoidal posterior tympanotomy approach. In 2 patients, the chorda tympani was intentionally sacrificed to maximize the size of the facial recess. Seven postoperative complications occurred in 6 patients (46%) during a mean follow-up period of 51 months: extrusion of the conducting wire into the ear canal (n=5), collapse of the cartilaginous part of the ear canal (n=1), and tympanic membrane perforation (n=1). In the revision operations that added additional layers of fascia for the patients with wire extrusions, repeated extrusion occurred in 3 of 4 cases.
CONCLUSION: The transcanal approach for the implantation of the VSB has led to postoperative complications different from those reported after the transmastoidal posterior tympanotomy approach. External otitis should be considered as a contraindication for VSB surgery by the transcanal approach.