title: Vibrant Soundbridge surgery in patients with severe external otitis: complications of a transcanal approach.
abstract: OBJECTIVE
  To evaluate the transcanal surgical implantation of the semi-implantable Vibrant Soundbridge (VSB) device in patients with severe external otitis.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Long-term postoperative complications and postoperative hearing thresholds were evaluated in 13 adults with bilateral sensorineural hearing loss (average of between 40 and 55 dB HL) and therapy-resistant external otitis after implantation of the VSB by a transcanal surgical method.
  
  
  RESULTS
  Postoperative audiometry findings were comparable with those reported after the transmastoidal posterior tympanotomy approach. In 2 patients, the chorda tympani was intentionally sacrificed to maximize the size of the facial recess. Seven postoperative complications occurred in 6 patients (46%) during a mean follow-up period of 51 months: extrusion of the conducting wire into the ear canal (n=5), collapse of the cartilaginous part of the ear canal (n=1), and tympanic membrane perforation (n=1). In the revision operations that added additional layers of fascia for the patients with wire extrusions, repeated extrusion occurred in 3 of 4 cases.
  
  
  CONCLUSIONS
  The transcanal approach for the implantation of the VSB has led to postoperative complications different from those reported after the transmastoidal posterior tympanotomy approach. External otitis should be considered as a contraindication for VSB surgery by the transcanal approach.
authors.affiliation: Department of Otorhinolaryngology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. j.zwartenkot@kno.umcn.nl
authors.forename: Joost W
authors.initials: JW
authors.lastname: Zwartenkot
authors.forename: Jef J S
authors.initials: JJ
authors.lastname: Mulder
authors.forename: Ad F M
authors.initials: AF
authors.lastname: Snik
authors.forename: Cor W R J
authors.initials: CW
authors.lastname: Cremers
mesh_terms: D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010032:Otitis Externa / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000379:methods*; D017060:Patient Satisfaction; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome