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Influence of Floating-Mass Transducer Coupling Efficiency for Active Middle-Ear Implants on Speech Recognition
Alexander Müller1, Parwis Mir-Salim, Nina Zellhuber
1*ORL Department Friedrichshain Clinic, Vivantes Hearing Center, Berlin †Department of Otorhinolaryngology, Head and Neck Surgery and Communication Disorders, HELIOS-Clinic Berlin-Buch ‡Department of Otorhinolaryngology, Institute of Phoniatry/Pedaudiology, Jena University Hospital, Friedrich-Schiller-University Jena, Jena §Department of Otorhinolaryngology, Head & Neck Surgery, University Medicine of Greifswald, Greifswald ||Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Halle (Saale), Martin Luther University Halle-Wittenberg, Halle, Germany.
The efficiency of active middle-ear implants, specifically vibroplasty, is linked to the coupling efficiency. A difference of less than 20 dB between vibroplasty and bone-conduction thresholds is crucial for achieving good speech recognition outcomes.
Area of Science:
- Audiology
- Biomedical Engineering
- Otolaryngology
Background:
- Active middle-ear implants (AMEIs) offer solutions for hearing loss.
- Vibroplasty, a component of AMEIs, uses a coupler-floating mass transducer (FMT) assembly.
- Assessing vibroplasty efficiency is key to optimizing hearing rehabilitation.
Purpose of the Study:
- To compare in vivo vibroplasty thresholds with postoperative speech recognition.
- To evaluate the relationship between vibroplasty efficiency and word recognition scores (WRS) in patients with high preoperative WRS.
Main Methods:
- Retrospective cohort study of 23 German-speaking patients with AMEIs (VORP 502 or VORP 503).
- Data collected between 2011 and 2015 from four German centers.
- Measured bone-conduction pure-tone thresholds, vibroplasty thresholds, and postoperative aided WRS at 65 dB SPL.
Main Results:
- The mean postoperative aided WRS was 82%.
- A larger difference between vibroplasty and bone-conduction thresholds correlated with a greater WRS discrepancy.
- An articulation index of 0.5 or higher (WRS ≥ 75%) was achieved only when this difference was < 20 dB.
Conclusions:
- Postoperative audiological outcomes with vibroplasty are dependent on coupling efficiency.
- Vibroplasty threshold serves as an indicator of this coupling efficiency.
- Optimizing FMT assembly is critical for successful hearing outcomes with AMEIs.