Influence of Floating-Mass Transducer Coupling Efficiency for Active Middle-Ear Implants on Speech Recognition

Otol Neurotol. 2017 Jul;38(6):809-814. doi: 10.1097/MAO.0000000000001412.

Abstract

Objective: The efficiency of vibroplasty (coupler-floating mass transducer [FMT] assembly) can be monitored by direct stimulation of the inner ear through the active middle-ear implant system and comparison of the vibroplasty in vivo threshold and the postoperative bone-conduction pure-tone threshold. The aim of this study was to compare the vibroplasty in vivo threshold with the postoperative speech recognition in patients with a high preoperative maximum word recognition score.

Study design: Retrospective cohort study of German-speaking patients implanted with a vibrating ossicular prosthesis (VORP) 502 or VORP 503 and high preoperative maximum word recognition score between the years of 2011 and 2015.

Setting: Multicenter study of four German centers.

Patients: Twenty-three active middle-ear implant users.

Intervention: Rehabilitative.

Main outcome measures: Bone-conduction pure-tone and vibroplasty thresholds, postoperative aided word recognition score (WRS) at 65 dB SPL (sound pressure level) and preoperative maximum WRS with Freiburg monosyllabic words.

Results: The mean postoperative aided WRS at 65 dB SPL was 82%. An increasing difference between vibroplasty thresholds and bone-conduction thresholds was associated with a higher discrepancy between the unaided maximum WRS and the postoperative aided WRS. Only if this difference was less than 20 dB, an articulation index of 0.5 (WRS = 75%) or more was achieved.

Conclusions: Audiological outcome after vibroplasty depends on the coupling efficiency reflected by the vibroplasty threshold.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Auditory Threshold / physiology
  • Bone Conduction / physiology
  • Cohort Studies
  • Female
  • Hearing Loss, Mixed Conductive-Sensorineural / rehabilitation*
  • Hearing Loss, Mixed Conductive-Sensorineural / surgery
  • Humans
  • Male
  • Middle Aged
  • Ossicular Prosthesis*
  • Retrospective Studies
  • Speech Perception / physiology*
  • Transducers
  • Treatment Outcome