Round Window Vibroplasty in Infants and Children with Atretic Ear

Abstract

Objectives: Evaluate long-term safety and outcome of round window vibroplasty (RWVPL) by the placement of the floating mass transducer (FMT) on the round window membrane in infants and children with congenital aural atresia (CAA). Methods: External auditory canal and middle ear malformation, accompanied by more or less severe conductive or mixed hearing impairment characterize children and infants with CAA. Several atresiaplasty procedures have been proposed without evidence of long-term air-bone gap closure despite initial satisfactory outcome. Prospective study at atertiary referral center. Seven infants and 10 children with CAAwere judged not to be candidates for air and bone conductive hearing aids and their parents declined bone-anchored hearing aids. Intervention: RW implantation with the Med-El VSB. Main outcome measures: Pure tone audiogram and free-field speech testing, free-field Auditory Brainstem Response (ABR). Results: Significant improvements were observed in pure-tone threshold and speech perception immediately after surgery and at follow-up intervals (12 to 60 months) in older children ( P <0.01). In infants and younger children free-field ABRs showed a significant shift of the mean air conduction threshold from 110 dB sound pressure level (SPL) preoperatively to 40 dB SPL ( P < 0.05) and 30 dB SPL ( P < 0.01), respectively postoperatively and at the last follow-up. No complications or instances of device extrusion were observed in this series of patients. Conclusions: RWVPL offers a safe, viable and improved treatment option for infants and children with CAA.