Complications after round window vibroplasty

  • Maurizio BarbaraEmail author
  • Luigi Volpini
  • Edoardo Covelli
  • Martina Romeo
  • Chiara Filippi
  • Simonetta Monini



To evaluate the complication rate in adult subjects with open cavities that were implanted with the Vibrant Soundbridge implant, using the round window (RW) vibroplasty procedure.


From 2009 to 2014, 21 adult subjects with mixed hearing loss, all with sequel from open tympanoplasty surgery, underwent RW vibroplasty (RW-VPL). Surgical complications were recorded and a standard minimal approach was used as a basis for all the cases that needed revision.


The mean follow-up was 42 months (range 12–76). Complications occurred in nearly half of the cases and included: cable extrusion (23.8%), hardware failure (14.3%), profound hearing loss (9.5%), and inadequate RW coupling (9.5%). A minimal endaural approach (MEA) was used in the majority of the cases (86.7%), while the extended endaural approach was adopted for those patients requiring explantation with or without replacement (14.3%).


RW-VPL can be considered a possible option for the rehabilitation of auditory impairment derived from an open tympanoplasty procedure due to cholesteatoma. The procedure may lead to minor/major complications that may require a surgical revision. By adopting an MEA, it has been possible to manage all the situations in which functionality of the device is worth being preserved.


Open tympanoplasty Round window coupling Active middle ear implant Mixed hearing loss Revision surgery 


  1. 1.
    Beltrame AM, Martini A, Prosser S, Giarbini N, Streitberger C (2009) Coupling the Vibrant Soundbridge to cochlea round window: auditory results in patients with mixed hearing loss. Otol Neurotol 30:194–201CrossRefGoogle Scholar
  2. 2.
    Colletti V, Soli SD, Carner M, Colletti L (2006) Treatment of mixed hearing losses via implantation of a vibratory transducer on the round window. Int J Audiol 45(10):600–608CrossRefGoogle Scholar
  3. 3.
    Lassaletta L, Calvino M, Sánchez-Cuadrado I, Pérez-Mora RM, Muñoz E, Gavilán J (2015) Pros and cons of round window vibroplasty in open cavities: audiological, surgical, and quality of life outcomes. Otol Neurotol 36:944–952CrossRefGoogle Scholar
  4. 4.
    Mojallal H, Schwab B, Hinze AL, Giere T, Lenarz T (2015) Retrospective audiological analysis of bone conduction versus round window vibratory stimulation in patients with mixed hearing loss. Int J Audiol 54:391–400CrossRefGoogle Scholar
  5. 5.
    Barbara M, Volpini L, Ciotti M, Filippi C, Covelli E, Monini S, D’Ambrosio F (2015) Cone beam computed tomography after round window vibroplasty: do the radiological findings match the auditory outcome? Acta Otolaryngol 135:369–375CrossRefGoogle Scholar
  6. 6.
    Perez R, Adelman C, Chordekar S, de Jong MA, Sohmer H (2014) The mechanism of direct stimulation of the cochlea by vibrating the round window. J Basic Clin Physiol Pharmacol 25:273–276CrossRefGoogle Scholar
  7. 7.
    Zwartenkot JW, Mulder JJS, Snik AFM, Mylanus EAM (2016) Active middle ear implantation: longterm medical and technical follow-up, implant survival and complication. Otol Neurotol 37:513–519CrossRefGoogle Scholar
  8. 8.
    Böheim K, Mlynski R, Lenarz T, Schlögel M, Hagen R (2012) Round window vibroplasty: long-term results. Acta Otolaryngol 132:1042–1048CrossRefGoogle Scholar
  9. 9.
    Colletti V, Mandalà M, Colletti L (2012) Electrocochleography in round window Vibrant Soundbridge implantation. Otolaryngol Head Neck Surg 146:633–640CrossRefGoogle Scholar
  10. 10.
    Verhaert N, Mojallal H, Schwab B (2013) Indications and outcome of subtotal petrosectomy for active middle ear implants. Eur Arch Otorhinolaryngol 270:1243–1248CrossRefGoogle Scholar
  11. 11.
    Linder T, Schlegel C, DeMin N, van der Westhuizen S (2009) Active middle ear implants in patients undergoing subtotal petrosectomy: new application for the Vibrant Soundbridge device and its implication for lateral cranium base surgery. Otol Neurotol 30:41–47CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.NESMOS Department, Medicine and PsychologySapienza UniversityRomeItaly
  2. 2.ENT Clinic Sant’Andrea University HospitalRomeItaly

Personalised recommendations