Consensus statement on round window vibroplasty.
OBJECTIVE
This study aimed to review current knowledge regarding implantation of the Vibrant Soundbridge floating mass transducer (FMT) at the round window (round window vibroplasty) as well as to form a consensus on steps for a reliable, stable surgical procedure.


METHODS
Review of the literature and experimental observations by the authors.


CONCLUSIONS
Round window (RW) vibroplasty has been established as a reliable procedure that produces good and stable results for patients with conductive or mixed hearing loss. The experience gained over the past few years of the authors' more than 200 implantations has led to consensus on several key points: (1) a wide and bloodless access to the middle ear with facial nerve monitoring, (2) the careful and correct identification and exposure of the round window membrane, (3) a good setup for efficient energy transition of the FMT, namely, perpendicular placement of the FMT with no contact to bone and the placement of cartilage behind the FMT to create a preloaded "spring" function, and (4) 4 points of FMT fixation: a rim of the round window bony overhang left intact both anterior and posterior to the FMT, conductor link stabilization, and cartilage behind the FMT. In addition, the FMT should be covered with soft tissue.
Centro Clinico, Rovereto, Trento, Italy.
Achille M
AM
Beltrame
Department of Otolaryngology at UKB, Hospital of the University of Berlin (Charité Medical School), Berlin, Germany todt@gmx.net.
Ingo
I
Todt
Landesklinikum St Poelten, St Poelten, Austria.
Georg
G
Sprinzl
Department of Otorhinolaryngology, Slovak Medical University, Bratislava, Slovak Republic.
Milan
M
Profant
Department of Otorhinolaryngology, Hannover Medical University, Hannover, Germany.
Burkhard
B
Schwab
D032921:Consensus; D006314:Hearing Loss, Conductive / Q000601:surgery*; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000601:surgery*; D006319:Hearing Loss, Sensorineural / Q000601:surgery*; D006801:Humans; D009998:Ossicular Prosthesis; D019933:Ossicular Replacement / Q000379:methods*; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D012405:Round Window, Ear / Q000601:surgery*; D014159:Transducers
Vibrant Soundbridge; conductive hearing loss; floating mass transducer; mixed hearing loss; round window; vibroplasty