title: Does Coupling and Positioning in Vibroplasty Matter? A Prospective Cohort Study.
abstract: OBJECTIVE
  Vibroplasty has offered a new modality of hearing rehabilitation in patients with mixed, conductive, and sensorineural hearing loss who cannot wear hearing aids. Potentially, the positioning of the floating mass transducer (FMT) in vibroplasty surgery has a critical effect on hearing outputs. In this study, the impact on hearing outputs and coupling efficiency are evaluated by comparing various vibroplasty applications in the middle ear. No other study to date has examined the coupling efficiency of round window (RW) versus an ossicular vibroplasty application.
  
  
  METHODS
  Prospective cohort study of patients with underlying ear pathologies who were not able to wear hearing aids.
  
  
  METHODS
  This is an ongoing prospective study of 16 patients. All patients had a standard audiological test battery. Direct drive transfer function analysis results were correlated with bone conduction thresholds to assess the efficiency of the FMT coupling. Speech perception in quiet and quality of life measure questionnaires were used to assess outcomes. Nine patients had round window vibroplasty, six patients had stapes vibroplasty, and one patient had traditional incus vibroplasty.
  
  
  RESULTS
  Patients with a soft tissue coupler between the FMT and the RW had significantly reduced coupling efficiency. Patients who had direct RW contact had significantly improved coupling efficiency. Patients who underwent stapes or incus vibroplasty had the greatest coupling efficiency.
  
  
  CONCLUSIONS
  This study demonstrates that attachment to the stapes or incus provides the best coupling when compared to round window vibroplasty. When applicable, stapes or incus coupling should be the first choice when implementing vibroplasty.
authors.affiliation: *Otolaryngology, Head and Neck Surgery, School of Surgery, University of Western Australia, Perth; †Fiona Stanley Hospital, Murdoch, Western Australia; ‡Fremantle Hospital Campus, Fremantle, Western Australia, Australia; and §Med-EL, Innsbruck, Austria.
authors.forename: Roberta
authors.initials: R
authors.lastname: Marino
authors.forename: Peter
authors.initials: P
authors.lastname: Lampacher
authors.forename: Gregor
authors.initials: G
authors.lastname: Dittrich
authors.forename: Dayse
authors.initials: D
authors.lastname: Tavora-Vieira
authors.forename: Jafri
authors.initials: J
authors.lastname: Kuthubutheen
authors.forename: Gunesh P
authors.initials: GP
authors.lastname: Rajan
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006314:Hearing Loss, Conductive / Q000523:psychology / Q000601:surgery*; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000523:psychology / Q000601:surgery*; D006319:Hearing Loss, Sensorineural / Q000523:psychology / Q000601:surgery*; D006320:Hearing Tests; D006801:Humans; D007188:Incus / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D012405:Round Window, Ear / Q000601:surgery; D013067:Speech Perception; D013201:Stapes Surgery / Q000379:methods; D011795:Surveys and Questionnaires; D014012:Tinnitus / Q000601:surgery; D014159:Transducers; D016896:Treatment Outcome; D055815:Young Adult