The Vibrant Soundbridge: A Global Overview

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Key points

  • The Vibrant Soundbridge is a semi-implantable, active middle ear implant.

  • This device is an effective and safe alternative for the treatment of sensorineural hearing loss.

  • It is used internationally for the treatment of conductive and mixed hearing losses of all types.

  • It is currently under investigation for conductive and mixed loss in the United States.

Implant description

This semi-implantable device (Fig. 1) consists of an externally worn audio processor (AP) and the implanted vibrating ossicular replacement prosthesis (VORP) that consists of the floating mass transducer (FMT) and a receiver stimulator (RS) that are connected via a conductor link. The FMT (Fig. 2) weighs 25 mg and consists of an electromagnetic coil that surrounds a small magnet.

Similar to a cochlear implant, the AP receives the acoustic signal and modulates and converts it to an electric

Vibrant Soundbridge advantages in sensorineural hearing loss

  • Natural sound quality

  • Open ear canal

  • No feedback, distortion, occlusion

  • Improved speech discrimination in noise

  • Improved aesthetics over visible hearing aids

Patient criteria for sensorineural hearing loss

  • Stable moderate to severe SNHL (Fig. 3)

  • No middle ear disease, normal immittance

  • Speech discrimination >50%

  • Healthy scalp at AP site

Indications for sensorineural hearing loss

  • Ear canal problems

  • Side effects from hearing aid use

  • Dissatisfaction with hearing aid sound quality/cosmesis

Surgery for sensorineural hearing loss

The RS is implanted as in cochlear implant surgery (Fig. 4). In the United States (VORP 502; Fig. 5A), the opening of the facial recess must be generous to allow for crimping of the clip of the FMT to the incus long process (Fig. 6). In 2014, the VORP 503 (Fig. 5B) was released in international markets. It features a thinner implant design, fixation wings for self-drilling screws, and a shorter and more robust conductor link. The FMT is without a titanium clip and is placed with one of several

Patient criteria for conductive hearing loss and mixed hearing loss

  • Stable bone conduction thresholds (Fig. 9)

  • Speech discrimination greater than 50%

  • Medically unable to wear acoustic hearing aid

  • Inadequate benefit/functional gain from hearing aid

Surgery for conductive hearing loss and mixed hearing loss

Hearing results in chronic ear surgery often remain unsatisfactory, and amplification with acoustic hearing aids can be insufficient or cause infection. Percutaneous osseointegrated bone-anchored hearing aids, although surgically simple, are frequently rejected by patients, require significant care, and are associated with long-term complications. Expansion of the VSB indications was therefore desirable. Vibrometer studies had demonstrated similar cochlear fluid movement with vibration of the

Summary

The VSB is a versatile device for the treatment of SNHL, CHL, and MHL in patients with normal and abnormal anatomy. In the United States, it is FDA approved for SNHL in patients 18 years and older and has been found to be a safe and effective alternative to traditional hearing aids. Longitudinal studies show safety and device stability. There is a great international body of research with expansion of indications. It is C-marked for SNHL, CHL, and mixed hearing loss down to age 3 in Europe.

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  • Cited by (16)

    • Task force Guideline of Brazilian Society of Otology – hearing loss in children – Part II — Treatment

      2023, Brazilian Journal of Otorhinolaryngology
      Citation Excerpt :

      Initially, the FMT was coupled only to the long process of the incus. Currently, new couplers allow the FMT to be placed on the short process of the incus, stapes superstructure, and round window.96 VSB model 503 supports up to 1.5 Tesla MRI,97 whereas earlier models are incompatible with MRI.

    • Effect of linear electromechanical coupling in nonlinear implanted human middle ear

      2021, Mechanical Systems and Signal Processing
      Citation Excerpt :

      IMEHDs can be used for both conductive and sensorineural hearing loss, therefore they are becoming more and more popular nowadays. A typical IMEHD consists of three parts: a microphone, a signal processor and a vibrating output transducer known as a floating mass transducer (FMT))[20,2,3]. The literature of the subject usually reports clinical studies on the application of IMEHDs in various medical cases [19,22,42,8,16,38,28].

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    Disclosure Statement: None.

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