Intraoperative real-time monitoring of VSB transmission efficiency

Introduction When coupling the Vibrant Soundbridge (VSB) to the middle ear structures, there may be uncertainty intraoperatively as to whether sufficient sound transmission can be achieved. In particular, a no longer intact ossicular chain, middle ear malformations but also poor overview can represent major challenges here. A system for intraoperative real-time monitoring of VSB transmission efficiency has been developed and implemented in the clinical routine. In our video contribution, the basics, the structure, the implementation and the evaluation of the measurements are presented.

Material & Methods The system consists of several components: a BERA system with stimuli specially optimized for the changed transit times serves as the signal generator. At this a miniTek system is connected, which transmits the signal wirelessly to the speech processor. The latter forwards the signal transcutaneously to the VSB. Via adhesive electrodes, the BERA measurement is carried out in the usual way. Intraoperatively, measurements are taken at various stimulation levels until optimum coupling is achieved by reaching the previously audiometrically determined bone conduction threshold without a transmission deficit.

Results The system has been in routine use for 4 years and has been applied in more than 80 operations. The measurements have proven to be very robust. The setup of the measurement setup is associated with little effort and does not lead to any significant operating time extension.

Discussion Intraoperative real-time monitoring of VSB transmission efficiency can be a helpful tool for the surgeon to achieve a high quality of hearing rehabilitations with the VSB even in difficult hearing situations.

Poster-PDF A-1132.PDF

Publication History

Article published online:
10 June 2020