A Case of Middle Ear Implantation Using the Vibrant Soundbridge in a Patient with Bilateral Mixed Hearing Loss / 대한이비인후과학회지

It is challenging to achieve sufficient hearing gain in patients with mixed hearing loss. In chronic middle ear diseases, conventional passive reconstructive surgeries often result in suboptimal hearing gain and additional hearing aids may have limitations due to insufficient sound amplification, occlusion effect, acoustic feedback, and skin irritation. Middle ear implantation (MEI) using Vibrant Soundbridge (VSB) is another option for auditory rehabilitation in mixed hearing loss as well as sensorineural hearing loss. The floating mass transducer of VSB can be placed on various middle ear structures either directly or using different types of couplers in order to deliver vibratory mechanical energy to the cochlea. We report a patient who presented with bilateral mixed hearing loss due to chronic otitis media and had limitations using conventional hearing aids in the worse hearing ear. The patient was successfully treated with MEI using the Bell coupler together with middle ear surgery in a single step.

Otologic Active Middle Ear Implants / 대한이비인후과학회지

Implantable devices for aural rehabilitation are widely developed worldwide. In the manuscript, we review the implantable middle ear hearing devices currently in use, such as the Vibrant Soundbridge system (Med-El Corporation), the MAXUM system (Ototronix LLC), the fourth-generation of Carina prosthesis (Otologics LLC), and the Esteem device. Implantable hearing aids will unquestionably be the major drivers of advancement in otologic practice in early future, improving the quality of life of an increasingly aged population, which will consequently require increased levels of hearing support.

Implantable and Semi-Implantable Hearing Aids: A Review of History, Indications, and Surgery

Introduction: The complaints associated with the use of conventional amplifying hearing aids prompted research at several centers worldwide that ultimately led to the development of implantable devices for aural rehabilitation. Objectives: To review the history, indications, and surgical aspects of the implantable middle ear hearing devices. Data Synthesis Implantable hearing aids, such as the Vibrant Soundbridge system (Med-El Corporation, Innsbruck, Austria), the Maxum system (Ototronix LLC, Houston, Texas, United States), the fourth-generation of Carina prosthesis (Otologics LLC, Boulder, Colorado, United States), and the Esteem device (Envoy Medical Corporation - Minnesota, United States), have their own peculiarities on candidacy and surgical procedure. Conclusion: Implantable hearing aids, which are currently in the early stages of development, will unquestionably be the major drivers of advancement in otologic practice in the 21st century, improving the quality of life of an increasingly aged population, which will consequently require increased levels of hearing support...

Two Cases of Middle Ear Implantation: Incus Vibroplasty / 대한이비인후과학회지

The Vibrant Soundbridge (VSB) middle ear implant is an alternative rehabilitation option for sensorineural, conductive, and mixed hearing loss. The mechanism of VSB implantation is direct-drive stimulation of the inner ear through a floating mass transducer placed on the ossicular chain. We report our experience of VSB incus vibroplasty, which were successfully performed in two cases without complications and resulted in good functional gain and improve-ment of speech discrimination.

Estudio comparativo en pacientes usuarios de implantes Vibrant Soundbridge® (VSB) y sistema osteointegrado BAHA® / Comparative study on patients users of Vibrant Soundbridge® and osseointegrated BAHA® implants

Objetivo: presentar la experiencia de una institución en la rehabilitación de pacientes con pérdida auditiva utilizando el implante de oído medio Vibrant Soundbridge® (VSB). Diseño: estudio retrospectivo. Materiales y métodos: se revisaron registros médicos, quirúrgicos y audiológicos de pacientes a los que se les implantó el sistema Vibrant Soundbridge (VSB), evaluando la ganancia auditiva establecida por la diferencia en los promedios de las frecuencias 0.5 a 3 kHz en la audiometría tonal postimplante con el sistema y sin él. Se evaluó también la satisfacción de uso con el dispositivo mediante la encuesta Escala de Satisfacción de Audición con Dispositivo (HDSS, Hearing Device Satisfaction Scale). Realizamos comparación de desenlaces audiológicos con una población de usuarios de similares características del sistema osteointegrado BAHA®. Resultados: 25 pacientes con pérdida auditiva predominantemente mixta recibieron un implante VSB colocando el Transductor de Masa Flotante (FMT) en ventana redonda en 23 casos (92%). La ganancia auditiva promedio fue de 36 ± 16 decibeles (dB). No se identificaron diferencias significativas en la ganancia auditiva entre los procesadores AP404-36 dB y Amadé-38 dB, p = 0.6. La ganancia auditiva en el grupo de usuarios del sistema BAHA fue de 37 dB y la discriminación de lenguaje a 65 dB fue de 93% y 100% para VSB y BAHA® respectivamente. En ambos sistemas el puntaje global de satisfacción fue de 4/5.

Objective: Present the institutional experience on the auditory rehabilitation of patients implanted with the middle ear prosthesis Vibrant Soundbridge®. Design: Retrospective study of a cases series. Materials and Methods: Medical, surgical and audiological charts review of patients implanted with the middle ear system VSB. Hearing gain was established by the mean differences calculated on 0.5 to 3 kHz in the pure tone audiometries pre and post implantation, with and without the device. Satisfaction with the device was assessed with the Hearing Device Satisfaction Scale tool. In addition, audiological and satisfaction comparison with a population with similar characteristics of BAHA implant users was made. Results: 25 patients with conductive and mixed hearing loss were implanted with the VSB, placing the FMT on the round window in 23cases (92%). Mean auditory gain was 36 ± 16 decibels (dB). There were no significance gains between processors AP404-36 dB and Amadé-38 dB, p = 0.6. Mean auditory gain in the BAHA® users was 37 dB; speech discrimination at 65 dB was 93% and 100% for VSB and BAHA® users respectively. Overall satisfaction score for both systems was 4/5. Conclusion: The middle ear implant system VSB gives a satisfactory hearing gain to patients with moderate mixed hearing loss comparable with the BAHA® as well in satisfaction and quality of life issues.

Outcome of Vibrant Soundbridge Middle Ear Implant in Cantonese-Speaking Mixed Hearing Loss Adults

OBJECTIVES: To investigate the aided benefits, speech recognition in quiet and in noise, change in hearing and subjective report of satisfaction on mixed hearing loss adults implanted with Vibrant Soundbridge (VSB) middle ear implant. METHODS: Eight Cantonese speaking adult patients with mixed hearing loss were enrolled in a single-subject, repeated measures prospective study design. Audiometric testing, including air and bone conduction and word recognition under sound-field were conducted before surgery. Device activation was arranged 8 weeks after operation. Audiometric testing was taken to evaluate the change in hearing. Patients were asked to wear the device and come back for fine tuning as needed. Outcome measurements were undertaken at 3 and 6 months after device activation. The outcome measures included sound-field thresholds, Cantonese Hearing in Noise Test (CHINT), Abbreviated Profile of Hearing Aid Benefit (APHAB) and International Outcome Inventory for Hearing Aids (IOI-HA). RESULTS: The application of the VSB improved the aided thresholds and improved speech intelligibility in quiet and noise without significant changes in hearing thresholds. CONCLUSION: VSB is considered as a safe, effective and reliable auditory rehabilitation option for Cantonese speaking adults with mixed hearing loss.