Application of intraoperative real-time monitoring of the VSB^®transmission efficiency in revision and malformation cases

The intraoperative real-time monitoring of the Vibrant Soundbridge^®(VSB) transmission efficiency by auditory brain stem responses (ABR) is used as a standard instrument at the Univ. ENT Clinic Würzburg since 2014. Especially in complex anatomical conditions, such as revisions and malformation operations, the system can be of great use, since the optimal coupling of the FMT to the middle ear structures can be checked intraoperatively. In the study all VSB^®revisions and implantations of the VSB^®in malformation cases, in which the system was used, were reviewed A retrospective analysis was performed and operation specific as well as postoperative audiological data were extracted. The quality of the measurements was divided into 3 groups and the measured ABR threshold was determined.

The system was used in 14 VSB^®revisions and 11 malformation operations. In most cases, a very good quality of the measurements could be achieved during surgery, the ABR threshold was then at the bone conduction threshold. Consequently, a very good coupling of the FMT to the ossicular chain or the cochlea was achieved. The postoperative audiological findings confirmed the intraoperative results. The effort of the measurements was manageable in the setting applied. In addition, the system enabled a quick threshold determination due to the direct application of the energy to the middle ear structures.

With the newly developed and now routinely used system for measuring VSB^®transmission efficiency, the quality of VSB^®surgery could be significantly improved, especially in complex clinical cases, as intraoperatively the coupling of the FMT can be checked and modified.

Poster-PDF A-1155.PDF

Publication History

Article published online:
10 June 2020