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Couplers for Vibrant Soundbridge® implant vs no-Coupler-Vibrant Soundbridge® implant

Presenting Author: Manuel Manrique

Published online by Cambridge University Press:  03 June 2016

Manuel Manrique
Manuel Manrique*
Affiliation:
NA
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Abstract

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Introduction: The middle ear active implant Vibrant Soundbridge® (VSB) is a device designed for the treatment of the sensorineural, mixed and conductive hearing losses. Depending on the type of the hearing loss and the anatomical condition of the different middle ear structures, the placement of its FMT can be carried out in different ossicular chain points or directly on the round or oval window, aimed to obtain a direct stimulation of the inner ear. Recently, new Couplers have been designed to obtain a better coupling of the FMT with these structures.

Objectives: To compare surgical feasibility and auditory performance with VSB traditional system versus the new “Couplers” for the VSB implant

Methods and materials: Thirty eight patients treated with VSB systems are included at the moment. Eleven patients implanted with VSB Coupler versus 27 patients with no-Coupler VSB. Three out of eleven VSB Coupler implants were indicated for sensorineural hearing loss (SNHL) patients and eight of them for conductive and mixed hearing loss patients. Regarding no-Coupler VSB, seven patients were diagnosed of SNHL whereas twenty of conductive and mixed hearing loss patient.

Mean thresholds for 0.5, 1, 2, 3 and 4 KHz frequencies before and after implantation are obtained for r VSB Couple group and no-coupler VSB group. For SNHL air conduction is analysed whereas bone conduction is considered for conductive and mixed hearing loss.

Besides, functional gain and discrimination of disyllabic words at 65 dB in quiet is analyzed.

Results: Surgeon subjective perception is that Couplers simplify the surgical process, allow a more stable coupling and minimize the risks of post-surgical FMT movement as well. Focusing on SNHL patients, the mean hearing thresholds for the air conduction before and after the surgery were respectively 59.25 dB and 29.75 dB for the no-Coupler VSB group, opposite to 63 dB and 24.75 dB for the VSB-Coupler group; and the mean functional gain was 30.25 dB for the no-Coupler VSB group, opposite to 38.25 dB for the VSB-Coupler group. In the disyllabic words test, difference was 78% for the no-Coupler VSB group and 82% for the VSB-Coupler group. For conductive-mixed hearing loss patients, mean hearing thresholds for the air conduction before and after the surgery were 84.75 dB and 85 dB respectively for the no-Coupler VSB group, opposite to 85 dB and 30.75 dB for the VSB-Coupler group; and mean functional gain was 47.5 dB for the no-Coupler VSB group, opposite to 53 dB for the VSB-Coupler group

Conclusions: Surgical procedure is simpler for coupler VSB for both indications (SNHL and conductive and mixed hearing loss). A greater tendency to improve auditory outcomes is described for VSB Coupler group vs no-Coupler VSB group.