title: Benefits of active middle ear implants in mixed hearing loss: Stapes versus round window.
abstract: We compared the audiologic benefits of active middle ear implants with those of passive middle ear implants with hearing aids in mixed hearing loss, and also compared the outcomes of stapes vibroplasty with those of round window vibroplasty.
  
  
  
  Retrospective chart review.
  
  
  
  Thirty-four patients with mixed hearing loss due to chronic otitis media were treated with a middle ear implant. Of these, 15 were treated with a passive middle ear implant (conventional ossiculoplasty with a partial ossicular replacement prosthesis), nine with an active middle ear implant coupling to the stapes, and 10 with an active middle ear implant coupling to the round window. Patients underwent pure-tone/free-field audiograms and speech discrimination tests before surgery and 6 months after surgery, and the results of these tests were compared.
  
  
  
  The active middle ear implant resulted in better outcomes than the passive middle ear implant with hearing aids at mid to high frequencies (P < .05). Patients who received either a stapes vibroplasty or a round window vibroplasty showed comparable hearing gain except at 8,000 Hz (48.9 dB vs. 31.0 dB, P < .05). Patients who received a stapes vibroplasty showed an improvement even in bone conduction at 1,000 Hz and 2,000 Hz (both P < .05).
  
  
  
  Active middle ear implantation could be a better option than treatment with passive middle ear implants with hearing aids for achieving rehabilitation in patients with mixed hearing loss. Vibroplasty via either oval window or round window stimulation shares similar good results.
  
  
  
  4 Laryngoscope, 127:1435-1441, 2017.
authors: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Jeon Mi
authors: JM
authors: Lee
authors: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Jinsei
authors: J
authors: Jung
authors: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: In Seok
authors: IS
authors: Moon
authors: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Sung Huhn
authors: SH
authors: Kim
authors: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Jae Young
authors: JY
authors: Choi
mesh_terms: D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D012048:Correction of Hearing Impairment / Q000379:methods*; D005260:Female; D006310:Hearing Aids; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009998:Ossicular Prosthesis; D012189:Retrospective Studies; D012405:Round Window, Ear / Q000503:physiopathology / Q000601:surgery*; D013063:Speech Discrimination Tests; D013199:Stapes / Q000503:physiopathology; D013201:Stapes Surgery / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Mixed hearing loss; Vibrant Soundbridge; couplers; middle ear implant; vibroplasty