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Year: 2013  Vol. 17   Num. Suppl. 1  - Print:
II Hearing 2013 - Oral Presentation
Luiz Fernando Manzoni Lourencone, Ademir Antonio Comerlatto Junior, Eduardo Boaventura Oliveira, José Carlos Jorge, Rubens Vuono Brito Neto

OBJECTIVES: To describe the surgical techniques and outcomes in simultaneous bilateral auditory implantation of the Vibrant Soundbridge®, a middle-ear hearing aid, in patients with microtia and ear atresia. CASE REPORT: A DCN, male, 18 years of age, was a carrier of the gene for bilateral congenital aural atresia and presented with moderate conductive hearing loss and an air-bone gap of 50 dB. The patient had not adapted satisfactorily to arc vibration due to discomfort caused by pressure on the mastoid. Before this, an auditory prosthesis of the middle ear was considered as an alternative, specifically, the Vibrant SoundBridge®. The computed tomography of the bilateral temporal bones showed a presence of the supply-structure of the stapes, a fusion of the malleus and incus in an aerated attic, and a facial nerve in the normal position. The internal ear without alterations presented with patent windows of the cochlea. The patient underwent simultaneous bilateral surgery with tympanomastoidectomy, ample opening of the attic, and withdrawal of the atrophic bone. The fixed malleus and incus and exposition of the supply-structure of the stapes were withdrawn from both sides. The bobbin of the internal unit was connected to the titanium prosthesis specific for this purpose (PORP) and encased in the stapes. In the comparative audiogram, free-field average auditory thresholds of 20 dB in the frequencies of 500 Hz to 4000 Hz were recorded; there was high patient and family satisfaction. CONCLUSION: Although surgery for ear atresia is complex, the restoration of hearing with implantable middle ear prostheses is effective, and with favorable anatomical conditions, can be performed bilaterally in the same surgical procedure.



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