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Complications after round window vibroplasty.

Maurizio Barbara1,2, Luigi Volpini3, Edoardo Covelli3

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Round window vibroplasty (RW-VPL) in adults with open cavities following tympanoplasty shows a high complication rate, including device issues and hearing loss. Surgical revisions were often necessary, but a minimal endaural approach (MEA) helped manage complications.

Keywords:
Active middle ear implantMixed hearing lossOpen tympanoplastyRevision surgeryRound window coupling

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Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Biomedical Engineering

Background:

  • Open tympanoplasty cavities, often resulting from cholesteatoma, can present challenges for hearing rehabilitation.
  • Traditional hearing implant options may be unsuitable for these complex cases.

Purpose of the Study:

  • To assess the complication rate of round window vibroplasty (RW-VPL) in adult patients with open cavities after tympanoplasty.
  • To evaluate the effectiveness of surgical approaches in managing complications associated with RW-VPL.

Main Methods:

  • A cohort of 21 adult patients with mixed hearing loss and open tympanoplasty cavities underwent RW-VPL between 2009 and 2014.
  • Surgical complications were systematically recorded, and a minimal approach was used for revisions.

Main Results:

  • The mean follow-up period was 42 months.
  • Complications occurred in approximately 50% of cases, including cable extrusion (23.8%), hardware failure (14.3%), profound hearing loss (9.5%), and inadequate round window coupling (9.5%).
  • A minimal endaural approach (MEA) was employed in 86.7% of cases, with an extended approach for explantation or replacement.

Conclusions:

  • RW-VPL is a potential option for hearing rehabilitation in patients with open tympanoplasty cavities.
  • The procedure carries a risk of minor and major complications requiring surgical intervention.
  • Employing an MEA facilitates the management of complications while preserving device functionality.