Vibrant Soundbridge surgery in patients with severe external otitis: complications of a transcanal approach
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Published on: February 16, 2022
Joost W Zwartenkot1, Jef J S Mulder, Ad F M Snik
1Department of Otorhinolaryngology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. j.zwartenkot@kno.umcn.nl
Objective:
To evaluate the transcanal surgical implantation of the semi-implantable Vibrant Soundbridge (VSB) device in patients with severe external otitis.
Study Design:
Retrospective analysis.
Methods:
Long-term postoperative complications and postoperative hearing thresholds were evaluated in 13 adults with bilateral sensorineural hearing loss (average of between 40 and 55 dB HL) and therapy-resistant external otitis after implantation of the VSB by a transcanal surgical method.
Results:
Postoperative audiometry findings were comparable with those reported after the transmastoidal posterior tympanotomy approach. In 2 patients, the chorda tympani was intentionally sacrificed to maximize the size of the facial recess. Seven postoperative complications occurred in 6 patients (46%) during a mean follow-up period of 51 months: extrusion of the conducting wire into the ear canal (n=5), collapse of the cartilaginous part of the ear canal (n=1), and tympanic membrane perforation (n=1). In the revision operations that added additional layers of fascia for the patients with wire extrusions, repeated extrusion occurred in 3 of 4 cases.
Conclusion:
The transcanal approach for the implantation of the VSB has led to postoperative complications different from those reported after the transmastoidal posterior tympanotomy approach. External otitis should be considered as a contraindication for VSB surgery by the transcanal approach.
