TORP-vibroplasty: a new alternative for the chronically disabled middle ear

Area of Science:

• Otolaryngology
• Biomedical Engineering
• Audiology

Background:

• Chronic middle ear disease often leads to persistent hearing loss, even after multiple surgeries.
• Conventional hearing aids may not fully restore social hearing due to middle ear dysfunction.

Purpose of the Study:

• To evaluate a novel implantable hearing device for patients with severe hearing loss.
• To assess the efficacy of a total ossicular replacement prosthesis-vibroplasty in cases of incurable middle ear dysfunction.

Main Methods:

• Investigated biomechanics and transducer placement in a temporal bone laboratory.
• Developed a titanium clip holder for a Vibrant integrated total ossicular replacement prosthesis assembly.
• Implanted the device in four patients with severe combined hearing loss after revision tympanoplasties.

Main Results:

• Direct footplate transducer placement provided superior high-frequency gain compared to the round window.
• Patients experienced improved speech understanding, exceeding conventional hearing aid performance.
• The device maintained an unoccluded ear canal, independent of middle ear function.

Conclusions:

• Total ossicular replacement prosthesis-vibroplasty is a viable surgical option for recalcitrant middle ear dysfunction.
• The procedure offers a straightforward approach within the tympanic cavity.
• The open ear canal and enhanced acoustic performance present a promising solution for revision surgeries.