Speech performance and subjective satisfaction of middle ear implant in congenital aural atresia

OBJECTIVES: To evaluate the safety, speech performance in noise and subjective satisfaction of patients with congenital aural atresia (CAA) implanted with the active middle ear implant. METHODS: This retrospective study included 13 patients (15 ears) implanted with middle ear implants with different methods of floating mass transducer attachment. In 6 ears, the floating mass transducer (FMT) was coupled with the short process of incus; in 8 ears, a clip coupler was used; and in one ear, a round window coupler was used. Patients were assessed preoperatively, and at one, three, and six months postoperatively. The assessment included Pure Tone Average (PTA4), Speech Reception Threshold (SRT) and Speech Discrimination Score (SDS). The Speech Spatial and Qualities of Hearing scale (SSQ12) was also used to evaluate levels of satisfaction. RESULTS: The mean aided PTA4 using Vibrant Sound Bridge (VSB) was 26.44 4.03 dB HL compared to 61.88 ±1.53 dB HL unaided. The SDS improved significantly (p = 0.002) from 51% (± 9.17%) to 94.60% (± 4.43%). Furthermore, there was a significant improvement in SDS in noise (p = 0.008) and SSQ12 responses (p < 0.0001). CONCLUSIONS: Patients with hearing loss due to CAA can substantially benefit from VSB, with highly satisfactory subjective results and a negligible rate of complications.