Implantation of the Vibrant Soundbridge in a Case of Bilateral Malformation of the Middle and External Ear

Patient: Female, 13-year-old Final Diagnosis: Bilateral congenital external and middle ear malformation Symptoms: Hearing loss Medication: — Clinical Procedure: — Specialty: Otolaryngology OBJECTIVE: Congenital defects/diseases BACKGROUND: Here we present a case of Vibrant Soundbridge implantation in a 13-year-old girl with bilateral aural atresia of the external ear canal. In this instance, we attached the device’s floating mass transducer (FMT) to a mobilizable complex of the incus and malleus, which functionally connected to the short process of the incus. CASE REPORT: The article presents a case study of a patient with a congenital defect of the middle and external ear and conductive hearing loss, who was referred for middle ear implantation. Tonal audiometry revealed bilateral moderate to severe hearing loss with a 30 to 50 dB air-bone gap. After making a sufficiently wide antromastoidectomy, it became apparent that implantation of the MedEl Bonebridge hearing aid was not possible because of an overhanging dura. The short process of the incus was then visualized and, by drilling the bone laterally and anteriorly, the incus and malleus were found to have formed a conglomerate, firmly fused to the anterior wall of a rather small tympanic cavity. By removing the bony adhesion, mobility of the ossicular chain was restored. The MedEl Vibrant Soundbridge could then be implanted by attaching its FMT to the incus-like conglomerate. CONCLUSIONS: Restoration of ossicular chain mobility was achieved, and the patient’s hearing was improved by implanting the Vibrant Soundbridge hearing aid. Speech audiometry 1 month later showed improved hearing. Implantation of the Vibrant Soundbridge following ossiculoplasty may be a feasible solution in cases of bilateral congenital defect of the middle and external ear.