Purpose: To evaluate the complication rate in adult subjects with open cavities that were implanted with the Vibrant Soundbridge implant, using the round window (RW) vibroplasty procedure.
Methods: From 2009 to 2014, 21 adult subjects with mixed hearing loss, all with sequel from open tympanoplasty surgery, underwent RW vibroplasty (RW-VPL). Surgical complications were recorded and a standard minimal approach was used as a basis for all the cases that needed revision.
Results: The mean follow-up was 42 months (range 12-76). Complications occurred in nearly half of the cases and included: cable extrusion (23.8%), hardware failure (14.3%), profound hearing loss (9.5%), and inadequate RW coupling (9.5%). A minimal endaural approach (MEA) was used in the majority of the cases (86.7%), while the extended endaural approach was adopted for those patients requiring explantation with or without replacement (14.3%).
Conclusions: RW-VPL can be considered a possible option for the rehabilitation of auditory impairment derived from an open tympanoplasty procedure due to cholesteatoma. The procedure may lead to minor/major complications that may require a surgical revision. By adopting an MEA, it has been possible to manage all the situations in which functionality of the device is worth being preserved.
Keywords: Active middle ear implant; Mixed hearing loss; Open tympanoplasty; Revision surgery; Round window coupling.