Third window vibroplasty: an alternative in surgical treatment of tympanosclerotic obliteration of the oval and round window niche.

OBJECTIVE

To describe a new technique in surgical treatment of obliterative tympanosclerosis by applying a floating mass transducer (FMT) to a third window.

PATIENT: A 64-year-old woman with a severe combined hearing loss due to tympanosclerosis received a third window vibroplasty.

INTERVENTION: A mastoidectomy and a posterior tympanotomy via the large facial recess were performed. The promontory was exposed by a transcanal approach. The third window was performed anterior inferior to the round window. The membranous cochlea was left intact. The FMT was gently pushed into the perichondrium-coated cochlear window. All other surgical steps were the same as in conventional FMT application.

RESULTS

Preliminary data of this report reveal that vibroplasty with coupling of the FMT directly to a third window leads to similar audiological results compared with the conventional coupling of the FMT on the round window niche.

CONCLUSION

The presented case demonstrates the applicability of a third window vibroplasty in obliterative tympanosclerosis. Further studies will show if our assumption of a reduced risk for inner ear trauma is justified or not.