## Alternative Fixation of an Active Middle Ear Implant at the Short Incus Process

Please always quote using this URN: urn:nbn:de:bvb:20-opus-196823
• Introduction: Since 1996, the preferred approach for positioning the active middle-ear implant Vibrant Soundbridge© is a mastoidectomy and a posterior tympanotomy. With this device, placement of the floating mass transducer (FMT) on the long incus process is the standard method for treatment of mild-to-severe sensorineural hearing loss in the case of normal middle-ear anatomy. The aim of this study was to determine the vibrational effectiveness of FMT placement at the short incus process. Materials and Methods: An extended antrotomy and aIntroduction: Since 1996, the preferred approach for positioning the active middle-ear implant Vibrant Soundbridge© is a mastoidectomy and a posterior tympanotomy. With this device, placement of the floating mass transducer (FMT) on the long incus process is the standard method for treatment of mild-to-severe sensorineural hearing loss in the case of normal middle-ear anatomy. The aim of this study was to determine the vibrational effectiveness of FMT placement at the short incus process. Materials and Methods: An extended antrotomy and a posterior tympanotomy were performed in 5 fresh human temporal bones. As a control for normal middle-ear function, the tympanic membrane was stimulated acoustically and the vibration of the stapes footplate and the round-window (RW) membrane were (sequentially) measured by laser Doppler vibrometry. Vibration responses for coupling of an FMT to the long incus process (standard coupling) were compared to those for coupling to the short incus process. Results: Apart from narrow frequency bands near 3 and 9 kHz for the stapes footplate and RW membrane, respectively, the velocity responses presented no significant differences between standard coupling of the FMT and coupling to the short incus process. Conclusion: Coupling the FMT to the short incus process may be a viable alternative in cases where the surgical approach is limited to an extended antrotomy. A reliable technique for attachment to the short incus process has yet to be developed.

Author: Sebastian P. Schraven, Ernst Dalhoff, Daniela Wildenstein, Rudolf Hagen, Anthony W. Gummer, Robert Mlynski urn:nbn:de:bvb:20-opus-196823 Journal article Medizinische Fakultät / Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen English Audiology and Neurotology 1420-3030 1421-9700 2014 19 1 1-11 Audiology and Neurotology 2014;19(1):1–11. DOI: 10.1159/000354981 https://doi.org/10.1159/000354981 https://pubmed.ncbi.nlm.nih.gov/24192762 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit Laser Doppler vibrometer; active middle-ear implant; floating mass transducer; incus; middle-ear surgery 2021/08/19 2013/10/26 This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively. Deutsches Urheberrecht