title: Vibroplasty in mixed and conductive hearing loss: comparison of different coupling methods.
abstract: OBJECTIVE
  To evaluate modified coupling techniques of the Vibrant Soundbridge system in patients with mixed and conductive hearing loss and to compare it with conventional vibroplasty.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Two different groups were evaluated: 1) nine cases of conventional incus vibroplasty in comparison with 2) nine patients with modified coupling of the floating mass transducer. In the modified coupling approach, the vibrant floating mass transducer was attached to 1) the stapes/oval window, 2) the round window, or 3) the drilled promontory bone (promontory fenestration window). In three patients, an additional ossiculoplasty was performed. Preoperative and postoperative aided and unaided pure-tone and free-field audiometry and Freiburg monosyllabic word test were used to assess hearing outcome.
  
  
  RESULTS
  Functional hearing gain obtained in patients with mixed and conductive hearing loss who underwent modified coupling was 39 dB. Patients with pure sensorineural hearing loss who received conventional incus coupling showed a functional hearing gain of 25 dB. Average functional gain was 41 dB in the oval window group, 45 dB in the round window group, and 30 dB in the promontory fenestration window group. Word recognition test revealed an average improvement of 51% and 21% in the modified and in the conventional approach, respectively.
  
  
  CONCLUSIONS
  Modified vibroplasty is a safe and effective treatment for patients with conductive and mixed hearing loss. Coupling the floating mass transducer to the promontory bone (promontory fenestration window) is a viable option in chronically disabled ears if oval and round window coupling is not possible.
  
  
  METHODS
  4.
authors: Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria.
authors: Erich
authors: E
authors: Vyskocil
authors: Dominik
authors: D
authors: Riss
authors: Clemens
authors: C
authors: Honeder
authors: Christoph
authors: C
authors: Arnoldner
authors: Jafar-Sasan
authors: JS
authors: Hamzavi
authors: Wolf-Dieter
authors: WD
authors: Baumgartner
authors: Stefan
authors: S
authors: Flak
authors: Wolfgang
authors: W
authors: Gstoettner
mesh_terms: D000293:Adolescent; D000368:Aged; D001299:Audiometry / Q000379:methods; D001301:Audiometry, Pure-Tone / Q000379:methods; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006314:Hearing Loss, Conductive / Q000175:diagnosis / Q000601:surgery*; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009998:Ossicular Prosthesis; D019933:Ossicular Replacement / Q000379:methods*; D013506:Otologic Surgical Procedures / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012405:Round Window, Ear / Q000503:physiopathology / Q000601:surgery*; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Vibrant Soundbridge; cochlear endosteum; oval window; round window