Langzeitstabilität des aktiven Mittelohrimplantates Vibrant Soundbridge in Abhängigkeit vom Ankopplungsort des Aktuators

Long-Term Stability of Active Middle Ear Implant Vibrant Soundbridge Regarding Different Coupling Sites

by Luise Kutsch
Doctoral thesis
Date of Examination:2021-09-01
Date of issue:2021-08-24
Advisor:Prof. Dr. Friedrich Ihler
Referee:Prof. Dr. Friedrich Ihler
Referee:PD Dr. Christian van Oterendorp
Referee:PD Dr. Caspar Stephani
Persistent Address: http://dx.doi.org/10.53846/goediss-8794

 

 

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Abstract

English

Indication of active middle ear implant Vibrant Soundbridge (VSB) is well-established. Choice of the coupling site depends from the individual anatomical situation. To date Long-term results of different coupling sites in terms of complications, functional outcome and patient satisfaction are rare and were investigated in this study. A Retrospective analysis of 46 consecutive patients (50 ears) mean age 56,3±14 years at the coupling sites incus, stapes and round window. Analysis of revision surgeries and explantations, of preoperative, postoperative and long-term results of pure tone average, speech discrimination in quiet at 65 dB and noise (German language Freiburg Monosyllabic Test) and of patient benefit (Glasgow Benefit Inventory). Mean follow-up was 3.2±1.9 years. In terms of revision surgery and explantations, round window patients exhibited the highest rates. Bone conduction was stable in incus and stapes pre- to postoperatively and to the long term. Round window bone conduction decreases, which was not revealed at respective opposite ears. Round window patients benefitting the most from the VSB (functional gain = 40.5±6.6 dB HL). Regarding speech discrimination, incus patients performed the best both in quiet (87.2%) and noise (62.5%). Implantation increased quality of life at all coupling sites, incus patients were the most satisfied (67/100pts). Regarding all coupling sites, satisfying long-term stability results were reported with best performance of coupling to the incus. Round window sensorineural hearing decrease could lead to further clinical and experimental studies.
Keywords: Active Middle Ear Implant; Vibrant Soundbridge; Long-Term Stability
Schlagwörter: Aktives Mittelohrimplantat; Langzeitstabilität; Vibrant Soundbridge
 
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