Download 13th International Conference on Cochlear Implants and Other

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Transcript
KN2-15
Systemic review to evaluate the safety, efficacy and economical outcomes of the Vibrant Soundbridge
for the treatment of sensorineural hearing loss (SNHL)
Wollenberg B.
1
1
Universitätsklinikum Schleswig-Holstein, Klinik für Hals-, Nasen-, und Ohrenheilkunde, Lübeck, Germany
Firstly introduced in the late 90's, the active middle ear implant Vibrant Soundbridge is nowadays largely used for
hearing rehabilitation in patients with mild to severe sensorineural hearing loss unable to tolerate conventional
hearing aids. Implantation involves a surgical procedure, which usually requires general anaesthesia. In
experienced hands the implantation is fastly done, safe and highly standardized. Here we present a systematic
review after more than 15 years of Incus Vibroplasty application to determine the efficacy/effectiveness and cost
effectiveness as well as patient satisfaction with the VSB active middle ear implant in the treatment of mild to
severe SNHL. The systematic search of electronic databases resulted in a total of 1640 papers. At the end of a
Cochrane based study search procedure 24 studies remained to be systematically reviewed. It shows that VSB
Implantation is a safe procedure with no loss of threshold during surgery and surgical complications that are
seen during routine middle ear surgery. Explantation rates due to device failure are low compared to other
MEI.The functional gain of VSB is significantly higher compared to conventional hearing aids being used prior to
surgery and as compared to the unaided situation. Speech perception in quiet and noise was difficult to evaluate
as the number of available testing tools outweighs the results. Taken all studies together the VSB was found to
provide a functional gain ranging 25 dB HL to 33 dB HL.Seven different self-assessment scales were used with
the most frequent ones being the APHAB and the Glasgow Benefit Inventory (GBI). In general the VSB is
described as much more comfortable, clearer in sound perception and less events of unease are reported.
Considering the economic benefit of VSB implantation is difficult as there is only little information on economic
impact of MEIs in general. In comparison to Willingness To Pay (WTP) threshold Data middle ear implantation
with the Soundbridge is cost effective.
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