The vibrant soundbridge (VSB) middle ear implant: hearing and quality of life (QOL) outcomes in patients with mixed and conductive hearing loss (CHL)

    Research output: ThesisDoctoral Thesis

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    Abstract

    Background and aims
    The vibrant soundbridge (VSB) implant offers a solution for people who suffer hearing losses that cannot be corrected using conventional hearing aids (CHAs). Although the VSB implant can assist with perception of speech in quiet and noise, whether it delivers benefits that are comparable to those from CHAs was not known prior to this work.
    The specific aims of this work were therefore:

    To determine if the round window application of the vibrant soundbridge (VSB-RW) provide comparable results to CHAs for speech perception in quiet and in noise.

    To determine if the VSB-RW application improves quality of life (QOL) outcomes and specifically tinnitus perception.

    To determine if stapes or incus vibroplasty is comparable to round window (RW) vibroplasty with regard to coupling and outcomes.

    To investigate the effect of different floating mass transducer (FMT) attachment points on hearing outcomes.

    Methods
    Speech in quiet and speech in noise performance was measured in 18 patients undergoing RW placement of the FMT for mixed or conductive hearing loss (CHL). Their performance was evaluated in comparison to the subjects wearing a CHA (Aim 1). QOL outcomes were measured using the tinnitus reaction questionnaire (TRQ) and the abbreviated profile of hearing aid benefit (APHAB) in 10 of these patients (Aim 2). The effect of different FMT attachment points was evaluated in 16 patients (Aims 3 and 4).

    Results

    Aim 1 (Chapter 3)
    Subjects attained equivalent performance for speech in quiet with the VSB compared to their pre-operative performance with CHAs.

    Subjects attained improved performance for speech in noise with the VSB compared to their pre-operative performance with hearing aids.

    Aim 2 (Chapter 4)
    Subjects reported significant improvements in their QOL with improved hearing in background noise (BN) and in reverberant conditions, as well as in their overall ease of communication (EC).

    Subjects with tinnitus pre-implantation all experienced a reduction in tinnitus following implantation with the VSB.

    Aims 3 and 4 (Chapter 5)
    Subjects with FMT placement on the stapes showed the best coupling efficiency, followed by placement at the incus, RW vibroplasty without interposed tissue, and lastly RW vibroplasty with interposed tissue.
    Preliminary data suggested that different placement of the FMT was not associated with differences in outcomes.

    Conclusions
    In carefully selected patients, the VSB can provide significant hearing benefits including improved hearing in quiet and in BN. Performance in noise was superior to performance using CHAs. Patients experiencing tinnitus pre-implantation reported a reduction in tinnitus perception with VSB use. Our preliminary results suggest that ossicular placement, and in particular the stapes, provides the best coupling efficiency for patients with mixed and conductive losses. However, no differences in hearing outcomes between the different vibroplasty placement groups were apparent.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Awarding Institution
    • The University of Western Australia
    Award date17 Jun 2016
    Publication statusUnpublished - 2016

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