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Presentation of floating mass transducer and Vibroplasty Couplers on CT and Cone Beam CT

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Various titanium coupling elements, Vibroplasty Couplers, maintaining the attachment of the Floating Mass Transducer (FMT) of the active middle ear implant Vibrant Soundbridge (VSB) to the round window, the stapes suprastructure or the stapes footplate are in use to optimally transfer energy from the FMT to the inner ear fluids. In certain cases it is of interest to radiologically verify the correct position of the FMT coupler assembly. The imaging appearance of FMT connected to these couplers, however, is not well known. The aim of this study was to present the radiological appearance of correctly positioned Vibroplasty Couplers together with the FMT using two different imaging techniques. Vibroplasty Couplers were attached to the FMT of a Vibrant Soundbridge and implanted in formalin fixed human temporal bones. Five FMT coupler assemblies were implanted in different positions: conventionally to the incus, a Bell-Coupler, a CliP-Coupler, a Round Window-Coupler and an Oval Window-Coupler. High spatial resolution imaging with Multi-Detector CT (MDCT) and Cone Beam CT (CBCT) was performed in each specimen. Images were blind evaluated by two radiologists on a visual basis. Middle ear details, identification of FMT and coupler, position of FMT coupler assembly and artefacts were assessed. CBCT showed a better spatial resolution and a higher visual image quality than MDCT, but there was no significant advantage over MDCT in delineating the structures or the temporal bone of the FMT Coupler assemblies. The FMT with its coupler element could be clearly identified in the two imaging techniques. The correct positioning of the FMT and all types of couplers could be demonstrated. Both methods, MDCT and CBCT, are appropriate methods for postoperative localization of FMT in combination with Vibroplasty Couplers and for verifying their correct position. If CBCT is available, this method is recommended due to the better spatial resolution and less metal artifacts.

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Acknowledgments

Vibrant MedEl (Innsbruck, Austria) sponsored this study by providing the titanium coupler elements, the Vibrant Soundbridge implants for experimental use and financially supporting the transport of the specimens from the Department of Anatomy to the imaging facilities. The authors themselves did not receive any financial support from Vibrant MedEl. We thank the Department of Anatomy of the Martin-Luther-University Halle-Wittenberg (Director: Prof. Dr. med. Dr. agr. Bernd Fischer) for providing the specimens, Mrs. Jana Gräfenhain and Mr. Hans-Joachim Heine for their assistance in the Anatomy Lab and radiographers Mrs. A. Winkler and Mrs. M. Beer for their technical support with radiological imaging.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany

    Robert Mlynski

  2. Department of Radiology, University of Halle-Wittenberg, Halle, Germany

    Thi Dao Nguyen & Sabrina Kösling

  3. Department of Otorhinolaryngology, Head and Neck Surgery, Halle Implant Center, University of Halle-Wittenberg, Halle, Germany

    Stefan K. Plontke

Authors
  1. Robert Mlynski
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  2. Thi Dao Nguyen
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  3. Stefan K. Plontke
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  4. Sabrina Kösling
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Correspondence to Robert Mlynski.

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Mlynski, R., Nguyen, T.D., Plontke, S.K. et al. Presentation of floating mass transducer and Vibroplasty Couplers on CT and Cone Beam CT. Eur Arch Otorhinolaryngol 271, 665–672 (2014). https://doi.org/10.1007/s00405-013-2457-5

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  • DOI: https://doi.org/10.1007/s00405-013-2457-5

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