Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2012
Oval window membrane vibroplasty for direct acoustic cochlear stimulation: treating severe mixed hearing loss in challenging middle ears.
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Schwab Burkard, Salcher Rolf Benedict, Maier Hannes, Kontorinis Georgios
Аннотация
OBJECTIVE: To date, all the Vibrant Soundbridge (VSB) applications have managed to stimulate the inner ear indirectly. Our objective was to present a new VSB application for direct inner ear stimulation.
STUDY DESIGN: Prospective cohort study.
SETTINGS: Tertiary, referral center
PATIENTS: Three patients with previous middle ear surgery and moderate-to-severe ipsilateral, mixed hearing loss.
INTERVENTIONS: Oval window membrane vibroplasty (OWMV) for direct acoustic cochlear stimulation. A total ossicular replacement prosthesis (TORP) was attached to the floating mass transducer (FMT). Then, the stapes footplate was perforated, and the tip of the FMT-TORP assembly was advanced approximately 1 mm into the inner ear. A silicon ring was placed around the TORP's tip to prevent it from slipping deeper into the inner ear.
MAIN OUTCOME MEASURE: Audiologic assessment involving pure-tone audiometry, aided and unaided free-field audiometry, Freiburg monosyllabic word test, and registration of any complications.
RESULTS: OWMV resulted in an average functional hearing gain of 36.1 dB (range, 24.2-47.5 dB). Although the greatest amplification was observed in the higher frequencies, there also was a significant improvement in the lower frequencies. The surgery was not related to any difficulties; vertigo, inner ear trauma, or further complications did not occur.
CONCLUSION: We present a new method for direct acoustic cochlear stimulation using an active middle ear implant. The preliminary results show that OWMV is a promising and safe option for treating moderate and severe hearing loss, even in challenging cases with previous middle ear operations or fixed stapes footplate.
STUDY DESIGN: Prospective cohort study.
SETTINGS: Tertiary, referral center
PATIENTS: Three patients with previous middle ear surgery and moderate-to-severe ipsilateral, mixed hearing loss.
INTERVENTIONS: Oval window membrane vibroplasty (OWMV) for direct acoustic cochlear stimulation. A total ossicular replacement prosthesis (TORP) was attached to the floating mass transducer (FMT). Then, the stapes footplate was perforated, and the tip of the FMT-TORP assembly was advanced approximately 1 mm into the inner ear. A silicon ring was placed around the TORP's tip to prevent it from slipping deeper into the inner ear.
MAIN OUTCOME MEASURE: Audiologic assessment involving pure-tone audiometry, aided and unaided free-field audiometry, Freiburg monosyllabic word test, and registration of any complications.
RESULTS: OWMV resulted in an average functional hearing gain of 36.1 dB (range, 24.2-47.5 dB). Although the greatest amplification was observed in the higher frequencies, there also was a significant improvement in the lower frequencies. The surgery was not related to any difficulties; vertigo, inner ear trauma, or further complications did not occur.
CONCLUSION: We present a new method for direct acoustic cochlear stimulation using an active middle ear implant. The preliminary results show that OWMV is a promising and safe option for treating moderate and severe hearing loss, even in challenging cases with previous middle ear operations or fixed stapes footplate.