The Vibrant Bonebridge – Presenting 11 Cases

Background: Bone anchored hearing devices (BAHD) are implantable hearing aids for patients with conductive, mixed or unilateral hearing loss (UHL). The Vibrant Bonebridge (VB) is a BAHD with a fully-implantable oscillator with the advantages of: no skin-transmission dampening-effect, cochlear-proximity, discrete appearance and wide range of sound frequencies. Disadvantages are surgical complexity and implant`s size. The first VB implantation in Israel was conducted in 2015, at the Kaplan Medical center.

Objective: Presenting our experience with the VB.

Methods: Retrospective case-series of all patients implanted with the VB between the years 2015 to 2017.

Results: 11 patients, ages 12 to 53, were implanted. Pre-implantation otologic history was cholesteatoma (4/11), aural atresia\microtia (2/11), chronic otitis media (2/11), CHARGE syndrome (1/11), UHL and Mondini malformation (1/11) and meningitis (1/11). Pre-implantation surgeries were: mastoidectomy (5/11), ear-reconstruction (2/11) and tympanoplasty (1/11). Hearing loss patterns pre-implantation were: mixed (4/11), conductive (6/11) and UHL (1/11). The Pure Tone Average for 0.5, 1 and 2 KHz pre-implantation were 63(±13.3) and 18.8(±15.3) dB for air and bone-conduction respectively. Implantation sites were: retrosigmoid (3/11), sinudural-angle (4/11) and supratemporal (4/11). There were no surgery related adverse events or infections. Post-implantation speech reception threshold without and with activation of the VB were 56.7(±8.2) and 20.8(±8) dB respectively. 3 patients suffered from surgical-site pain. 2 patients underwent expalntations of the VB due to pain (1) and skin-protrusion (1). Of the remaining 9, 8 report using the VB daily for more than 8 hours.

Conclusion: The VB is an effective solution for the right indications. Patients favor the VB`s appearance, but lack of dampening-effect, cholear-proximity and range of sound frequencies amplification are also advantages. Complications were pain and implant-protrusion, causing explantation in 2/11 patients.