Intraoperative Auditory Brainstem Response Measurements via the Vibrant Soundbridge Active Middle Ear Implant: Comparison of Two Methods.

Abstract

The Vibrant Soundbridge (VSB) active middle ear implant can be used to treat adults and children with hearing loss. Intraoperative measurements based on auditory brainstem response (ABR) allow the determination of the implant's performance. Two methods for stimulus presentation during ABR measurements via VSB will be compared. ABRs were measured in patients implanted with a VSB using a standard ABR system. The stimulus was transmitted directly to the VSB using a new transmission unit (AcoustiAP, MED-EL) and for comparison via a standard audio processor coupled to a wireless streaming device. The study included 10 subjects with mild-to-profound sensorineural, conductive, or mixed hearing loss. As opposed to the wireless method, the AcoustiAP transmits the ABR stimulus without additional signal processing. Therefore, only minor distortions of the transmitted signal are to be expected. There was no significant difference between the performance of the two methods (mean wave V amplitudes 313 [75.2] vs. 301 [88.2] nVpp). In addition, the new system allowed for a more stable connection to the implant system. The AcoustiAP is a valuable tool for performing ABR measurements in patients during VSB implantation using standard equipment, as it allows for easier and more controlled measurements of the coupling efficiency of the implant.