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Laryngoscope ; 131(5): E1434-E1442, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33210744

RESUMO

OBJECTIVE: The objective of the study was to demonstrate the long-term outcomes of patients implanted with the active middle ear implant (AMEI) Vibrant Soundbridge (VSB) through coupling the floating mass transducer (FMT) to the round window (RW). METHODS: This retrospective study evaluated the short- and long-term clinical performance (audiological outcomes) and safety (revisions/explantations) of the VSB coupled to the RW between 2013 and 2019 at the St. Pölten University Hospital, Austria. For the outcome analysis, the sample was divided into a short-term examination group followed up for less than 12 months (<12 months) and a long-term examination group followed up for more than 12 months (>12 months). Cumulative survival outcomes were separately analyzed for subjects with and without cholesteatoma. RESULTS: 46 patients with an average long-term follow-up period of 31.43 months (13-75 months) were investigated. Complications requiring revision surgery were reported in total in seven patients with cholesteatoma (15.2%) and none in subjects without cholesteatoma (0%). Residual hearing was not affected by VSB surgery. Word understanding on the Freiburger monosyllabic speech test improved significantly at 65 dB (P < .0001) and 80 dB (P < .0001), and these outcomes were stable for long-term follow up. CONCLUSION: The VSB coupled to the RW is a safe implantation method for patients with conductive or mixed hearing loss. Hearing improvement was stable for the long-term follow-up up to 74 months. The revision rates are directly related to the underlying pathology of cholesteatoma (with radical cavity); thus, this special cohort requires additional counseling on potential complications. LEVEL OF EVIDENCE: 4 (Case-series) Laryngoscope, 131:E1434-E1442, 2021.


Assuntos
Colesteatoma da Orelha Média/cirurgia , Perda Auditiva Condutiva/cirurgia , Perda Auditiva Condutiva-Neurossensorial Mista/cirurgia , Substituição Ossicular/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Janela da Cóclea/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Áustria/epidemiologia , Colesteatoma da Orelha Média/complicações , Remoção de Dispositivo/estatística & dados numéricos , Feminino , Seguimentos , Perda Auditiva Condutiva/diagnóstico , Perda Auditiva Condutiva/etiologia , Perda Auditiva Condutiva-Neurossensorial Mista/diagnóstico , Perda Auditiva Condutiva-Neurossensorial Mista/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prótese Ossicular/efeitos adversos , Substituição Ossicular/instrumentação , Substituição Ossicular/métodos , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
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