title: Exclusive transcanal surgical approach for Vibrant Soundbridge implantation: surgical and functional results.
abstract: OBJECTIVE
  An alternative transcanal surgical technique named "exclusive transcanal approach" for Vibrant Soundbridge (VSB) implantation is presented. The surgical steps and our experience in a series of 12 patients are reported.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  : Tertiary referral center. University hospital.
  
  
  METHODS
  Twelve patients, 8 women and 4 men, mean age 50 years (range, 41-71 yr), were implanted with the VSB through the exclusive transcanal approach. In 7 patients with moderate sensorineural hearing loss, the floating mass transducer (FMT) was placed on the incus, whereas in 5 patients with a mixed hearing loss for chronic otitis media and/or previous middle ear surgeries, the FMT was placed on the round window.
  
  
  METHODS
  Hearing rehabilitation.
  
  
  METHODS
  Postoperative surgical and anatomic results.
  
  
  RESULTS
  Anatomic results and functional results in patients operated with the FMT on the round window.
  
  
  CONCLUSIONS
  The exclusive transcanal approach proved to be faster, simpler, and safer in comparison to the classic surgical technique through the facial recess, reducing the risk of chorda tympani and facial nerve lesions. All the patients and, in particular, those operated placing the FMT on the round window achieved improvements in hearing thresholds and speech perception tests from the use of the VSB. Moreover, after a mean 21-month follow-up (range, 15-32 mo), we did not observe any complication such as tympanic membrane perforations, external ear canal skin lesions, or extrusion of the coil in the external ear canal.
authors.affiliation: Otology and Cochlear Implant Centre, University of Pisa, Pisa, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Bruschini
authors.forename: Francesca
authors.initials: F
authors.lastname: Forli
authors.forename: Michela
authors.initials: M
authors.lastname: Giannarelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Bruschini
authors.forename: Stefano
authors.initials: S
authors.lastname: Berrettini
mesh_terms: D000328:Adult; D000368:Aged; D001309:Auditory Threshold; D004424:Ear Canal / Q000601:surgery*; D020220:Facial Nerve Injuries / Q000209:etiology; D005260:Female; D006310:Hearing Aids; D034381:Hearing Loss / Q000534:rehabilitation / Q000601:surgery; D006801:Humans; D007188:Incus / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D012405:Round Window, Ear / Q000601:surgery; D013067:Speech Perception; D016896:Treatment Outcome; D018058:Tympanic Membrane Perforation / Q000209:etiology