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Related Experiment Video

Updated: Jan 13, 2026

Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and Its Application in the Postoperative Fitting Process
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Experimental comparison between forward and reverse Vibrant Soundbridge cochlear stimulation.

Lukas Graf1, David Stauske2, Mohammad Ghoncheh3

  • 1Department of ENT, Basel University Hospital, Basel, Switzerland.

Hearing Research
|January 11, 2026
PubMed
Summary
This summary is machine-generated.

Forward coupling methods for the Vibrant Soundbridge implant offer superior mechanical performance compared to reverse stimulation. Direct stapes coupling demonstrates better outcomes than round window or incus coupling for hearing restoration.

Keywords:
CouplersHearing implantsReverse cochlear stimulationVibrant Soundbridge

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Area of Science:

  • Biomedical Engineering
  • Otolaryngology
  • Auditory Implants

Background:

  • Various couplers connect the Vibrant Soundbridge actuator to middle ear structures.
  • Biomechanical distinctions between forward and reverse cochlear stimulation are proposed as more meaningful than current clinical indications.

Purpose of the Study:

  • To evaluate the biomechanical performance of common Vibrant Soundbridge couplers.
  • To compare forward and reverse cochlear stimulation methods using temporal bone experiments.

Main Methods:

  • Experiments were conducted on 20 cadaveric temporal bones across two research labs.
  • Laser Doppler velocity measurements on the stapes were used to compare coupling methods.
  • Correction factors for reverse stimulation were calculated by measuring intracochlear pressure differences.

Main Results:

  • Reverse stimulation requires a frequency-dependent correction factor, decreasing with higher frequencies.
  • Forward stimulation showed a 15-22 dB advantage below 2000 Hz and a 7 dB advantage above 2000 Hz compared to reverse stimulation.
  • The stapes head coupler performed 7-25 dB better than the round window coupler.

Conclusions:

  • Forward coupling, including direct stapes coupling, is mechanically superior to reverse stimulation for the Vibrant Soundbridge.
  • The stapes head coupler is a highly effective coupling method, outperforming round window and matching incus couplers.