Department of Otolaryngology, Head and Neck Surgery, University Hospital Zürich, Zürich, Switzerland.
Department of Otolaryngology, Head and Neck Surgery, University of Zürich, Zürich, Switzerland.
Audiol Neurootol. 2021;26(4):287-294. doi: 10.1159/000512600. Epub 2021 Mar 1.
The Vibrant Soundbridge (MED-EL Medical Electronics, Austria) is an active middle ear implant with a floating mass transducer (FMT) for patients with conductive, sensorineural, or mixed hearing loss. While the FMT is vertically aligned above the stapes head (SH) with the current Vibroplasty Clip coupler (MED-EL Medical Electronics), the new SH coupler was developed to mount the FMT on the inferior side of the stapes and to fit in the reduced middle ear space after canal-wall-down mastoidectomy.
Using 11 human cadaveric temporal bones (TBs), placements of the new SH couplers on the stapes were examined, and effective stimuli to the cochlea were evaluated by measuring piston-like motion of the stapes footplate with a current of 1 mA on the FMT. The results were assessed in comparison with the Vibroplasty Clip coupler.
The new SH coupler showed perfect coupling on the stapes in 9 out of 11 TBs. A small gap between the SH and the plate of the connection link part was unavoidable in 2 TBs but had negligible effect on vibrational motion of the stapes. Vibrational motion of the stapes with the new SH coupler was reduced at frequencies above 3 kHz compared to the corresponding motion with the current Vibroplasty Clip coupler, but the relative attenuation over all 11 cadaveric temporal bones was <10 dB.
The new SH coupler provides an alternative with more stable fixation when placement of the current Vibroplasty Clip coupler is limited due to insufficient space after canal-wall-down mastoidectomy, while still delivering effective stimuli to the cochlea.
Vibrant Soundbridge（MED-EL Medical Electronics，奥地利）是一种带有浮动质量换能器（FMT）的主动中耳植入物，适用于传导性、感音神经性或混合性听力损失患者。当前的 Vibroplasty Clip 耦合器（MED-EL Medical Electronics）将 FMT 垂直对准镫骨头部（SH）上方，而新的 SH 耦合器则用于将 FMT 安装在镫骨的下侧，并适应经完壁式乳突切开术后缩小的中耳空间。
使用 11 个人体颞骨（TB）标本，检查新的 SH 耦合器在镫骨上的放置情况，并通过在 FMT 上施加 1 mA 电流测量镫骨底板的活塞样运动，评估对耳蜗的有效刺激。将结果与 Vibroplasty Clip 耦合器进行比较。
在 11 个 TB 中，有 9 个的新 SH 耦合器在镫骨上实现了完美耦合。在 2 个 TB 中，SH 和连接环节板之间存在微小间隙是不可避免的，但对镫骨的振动运动几乎没有影响。与当前的 Vibroplasty Clip 耦合器相比，新的 SH 耦合器的镫骨振动在 3 kHz 以上的频率下降低，但在所有 11 个尸体颞骨中，相对衰减小于 10 dB。
当经完壁式乳突切开术后空间不足，当前的 Vibroplasty Clip 耦合器的放置受到限制时，新的 SH 耦合器提供了一种更稳定的固定替代方案，同时仍能向耳蜗提供有效的刺激。
