Abstract
The objectives of the study were to report a vibrant soundbridge (VSB) implant revision surgical method involving adhesiolysis at the short incus process under local anesthesia and demonstrate successful hearing performance after surgery. Three cases of VSB surgery, performed in 2016, were enrolled. All cases had diagnoses of device failure. This ‘seven-incision line’ exposed the floating mass transducer directly, after which the three steps (adhesiolysis, curettage, and hydrocortisone injection) were performed. Upon fitting the VSB, sound fields were evaluated immediately and at 3 months after the revision. During the revisions of surgery, all patients achieved immediate hearing gains and noticed differences in the outer devices with different amplifications. Satisfactory improvements in hearing thresholds and speech recognition abilities were confirmed by improvements of 20–30 dB in hearing loss 3 months after revision surgery. The VSB implant revision surgical method involving adhesiolysis is safe and efficient for patients who experience a VSB device failure. This method will reduce the requirement for surgery under general anesthesia, reduce the overall period of clinical therapy and, therefore, minimize patients’ medical costs.
Level of Evidence 4
Similar content being viewed by others
References
Fisch U, Cremers WRJ, Lenarz T et al (2001) Clinical experience with the vibrant soundbridge implant device. Otol Neurotol 22:962–972
Mosnier I, Sterkers O, Bouccara D et al (2008) Benefit of the vibrant soundbridge device in patients implanted for 5 to 8 years. Ear Hear 29:281–284
Maier H, Hinze AL, Gerdes T et al (2015) Long-term results of incus vibroplasty in patients with moderate-to-severe sensorineural hearing loss. Audiol Neurootol 20:136–146
Sterkers O, Boucarra D, Labassi S et al (2003) A middle ear implant, the symphonix vibrant soundbridge: retrospective study of the first 125 patients implanted in France. Otol Neurotol 24:427–436
Rameh C, Meller R, Lavieille JP et al (2010) Long-term patient satisfaction with different middle ear hearing implants in sensorineural hearing loss. Otol Neurotol 31:883–892
Schraven SP, Dalhoff E, Wildenstein D et al (2014) Alternative fixation of an active middle ear implant at the short incus process. Audiol Neurootol 19:1–11
Reich H (1995) Laparoscopic surgery for adhesiolysis. In: Arregui ME, Fitzgibbons RJ Jr, Katkhouda N et al (eds) Principles of laparoscopic surgery. Springer, New York, pp 283–298
Morgan DE, Dirks DD, Bower DR (1979) Suggested threshold sound pressure levels for frequency modulated (warble) tones in the sound field. J Speech Hear Disord 44:37–54
Lenarz T, Weber BP, Issing PR et al (2001) Vibrant soundbridge system: ein neuartiges hörimplantat für innenohrschwerhörige—teil 2: audiologische ergebnisse. Laryngo Rhino Otol 80:370–380
Todt I, Seidl RO, Gross M et al (2002) Comparison of different vibrant soundbridge audioprocessors with conventional hearing aids. Otol Neurotol 23:669–673
Beltrame AM, Martini A, Prosser S et al (2009) Coupling the vibrant soundbridge to cochlea round window. Otol Neurol 30:194–201
Böheim K, Mlynski R, Lenarz T et al (2012) Round window vibroplasty: long-term results. Acta Otolaryngol 132:1042–1048
Huber AM, Mlynski R, Müller J et al (2012) A new vibroplasty coupling technique as a treatment for conductive and mixed hearing losses. Otol Neurotol 33:613–617
Brito R, Monteiro TA, Leal AF et al (2012) Complicações em 550 cirurgias consecutivas de implante coclear. Braz J Otorhinolaryngol 78:80–85
Truy E, Eshraghi AA, Balkany TJ et al (2006) Vibrant soundbridge surgery. Otol Neurotol 27:887–895
Polanski JF, Soares AD, Dos Santos ZM et al (2016) Active middle-ear implant fixation in an unusual place: clinical and audiological outcomes. J Laryngol Otol 130:404–407
Pankowsky DA, Ziats NP, Topham NS et al (1990) Morphologic characteristics of adsorbed human plasma proteins on vascular grafts and biomaterials. J Vasc Surg 11:599–606
Bonfield TL, Colton E, Anderson JM (1992) Protein adsorption of biomedical polymers influences activated monocytes to produce fibroblast stimulating factors. J Biomed Mater Res 26:457–465
Tang L, Thevenot P, Hu W (2008) Surface chemistry influences implant biocompatibility. Curr Top Med Chem 8:270–280
Collier TO, Anderson JM (2002) Protein and surface effects on monocyte and macrophage adhesion, maturation, and survival. J Biomed Mater Res 60:487–496
Simpson A (2009) Frequency-lowering devices for managing high-frequency hearing loss: a review. Trends Amplif 13:87–106
Li TC, Cooke ID (1995) The value of an absorbable adhesion barrier, Interceed®, in the prevention of adhesion reformation following microsurgical adhesiolysis. Obstet Gynecol Surv 50:190–192
Zwartenkot JW, Mulder JJ, Snik AF et al (2016) Active middle ear implantation: long-term medical and technical follow-up, implant survival, and complications. Otol Neurotol 37:513–519
Acknowledgements
This research was supported by the Ministry of Trade, Industry & Energy (MOTIE, Korea) under Industrial Strategic Technology Development Program (10051518) and Program (10070232).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
All authors declare that they have no conflict of interest.
Research involving human participants and/or animals
Yes (participants).
Informed consent
Yes.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Supplementary material 1 (MP4 91420 kb)
Rights and permissions
About this article
Cite this article
Park, Y.A., Kong, T.H., Chang, J.S. et al. Importance of adhesiolysis in revision surgery for vibrant soundbridge device failures at the short incus process. Eur Arch Otorhinolaryngol 274, 3867–3873 (2017). https://doi.org/10.1007/s00405-017-4715-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-017-4715-4