Complications after round window vibroplasty

Purpose: To evaluate the complication rate in adult subjects with open cavities, implanted with the Vibrant Soundbridge (VSB) implant, using the round window (RW) vibroplasty procedure. Methods: From 2010 to 2018, 21 adult subjects with mixed hearing loss, all with sequel from open tympanoplasty surgery, underwent RW vibroplasty. Surgical complications were recorded and a standard minimal approach was used as basis for all the cases that needed revision. Results: 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 EA was adopted for those patients requiring explantation with or without replacement (14.3%). Conclusions: Round window vibroplasty (RW-VPL) can be considered a possible option for the rehabilitation of the 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 a minimal EA it has been possible to manage all the situations in which functionality of the device is worth being preserved.