Safe explantation of a Vibrant Soundbridge with incus short process coupler: Case report and literature review

Grégoire, Anaïs [UCL] Hox, Valérie [UCL]

We describe the first reported case of explantation of a Vibrant Soundbridge (VSB) with the floating mass transducer (FMT) fixed to the incus short process that was implanted 2 years before. The patient had good hearing results on the conversational frequencies but complained about insufficient amplification of low and high frequencies, discomfort, and blurred hearing. Our team along with technical specialists from Med-El analyzed and tried to solve his problems through multiple fitting sessions, computed tomography scan (which was normal), and revision surgery to exclude displacement of the FMT and eliminate excessive fibrosis surrounding it, all without success. Finally, the patient decided to be explanted. We removed the FMT from the short process of the incus without major complications. The hearing thresholds remained globally stable, except at 250 Hz (a decrease of 10 dB). This case is the first description of FMT removal from the short process of the incus as this coupler has only been available since 4 years. We reviewed the literature to look at the reported complications of the VSB and the revision surgery rates, especially when the FMT is fixed on the incus.