Round-Window Vibroplasty: Systematic Review and Meta-Analysis of Audiological Effectiveness With Different...

Area of Science:

• Otolaryngology
• Biomedical Engineering
• Audiology

Background:

• Active middle ear implants offer a therapeutic option for hearing loss, with Round-window (RW) Vibroplasty enabling direct coupling to the RW membrane.
• Systematic review and meta-analysis are crucial for synthesizing evidence on novel surgical techniques like RW Vibroplasty.

Approach:

• A comprehensive literature search was conducted across PubMed, Cochrane Library, and Embase.
• Two independent reviewers screened publications and extracted data on audiological and safety outcomes from 61 studies.
• Meta-analyses and meta-regression evaluated surgical and demographic parameters influencing audiological results, with adverse events analyzed qualitatively.

Key Points:

• Fourteen surgical coupling parameter combinations were identified, with 23 publications contributing to meta-analyses.
• RW Vibroplasty without a dedicated coupler and using fascia as an interponate yielded significantly better aided sound-field thresholds.
• No significant differences were observed for functional gain or word recognition scores; however, 32 revisions were reported due to coupling efficacy loss.

Conclusions:

• Existing literature on RW Vibroplasty is characterized by undersampled studies and low evidence levels.
• Meta-analyses provide a summary of audiological and safety outcomes, highlighting the importance of coupling modality selection.
• Standardized intraoperative measurements and diligent patient follow-up are essential for optimizing RW coupling efficacy.