Round window vibroplasty in chronic ear surgery: comparison with conventional hearing rehabilitation

Abstract

Conclusion: Functional hearing results with round window vibroplasty in chronically disabled middle ears were comparable and, at high frequencies, superior to the results achieved with previously used conventional hearing aids even after extended surgery. Soft tissue transfer appears to be more important than floating mass transducer (FMT) alignment with the round window membrane (RWM) for efficient coupling or sonoinversion. Objectives: To evaluate the functional hearing results of an active middle ear implant (AMEI) to the round window niche (RWN). The results were compared with previously used conventional hearing aids. The position of the FMT was determined by cone-beam computed tomography (CBCT). Methods: This was a prospective cohort study carried out in a tertiary referral center. Seven patients with severe middle ear disease were implanted with an AMEI with round window application. The postoperative hearing outcome was compared with preoperative hearing using unaided and conventionally aided conditions. The results were correlated with the physical/geometric relation of the FMT to the RWM as determined with CBCT. Results: Dislocation of the FMT was not observed. One patient was re-implanted due to accidental damage to the electrode. In all patients, the pertinent functional hearing results were achieved and were comparable to previous rehabilitation results.

Keywords::

• Round window vibroplasty
• chronic ear surgery
• hearing restoration
• CBCT

Acknowledgments

Associate professor Johan Wikström MD PhD, Department of Radiology, Oncology and Radiation Science assisted in evaluation of the CBCT imaging. This study was supported by the Uppsala University Hospital ALF grant. It was also supported by grants from generous private donations BR, Tysta Skolan and Sellanders Foundation.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.