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Background <p>Vibrant Soundbridge (VSB) has shown effective hearing rehabilitation for patients with conductive, mixed, or sensorineural hearing loss. However, optimal floating mass transducer (FMT) coupling is critical for device performance. This study investigates the utility of intraoperative auditory brainstem response (ABR) for assessing coupling efficiency and guiding surgical decision-making, particularly in patients with normal bone conduction.</p> Methods <p>This retrospective cohort study included VSB patients with complete audiometric data. Coupling efficiency was assessed by comparing postoperative Vibrogram and intraoperative ABR thresholds with preoperative bone conduction (BC pre-op) thresholds (PTA3 at 1, 2, and 4&#xa0;kHz). Segmented regression with breakpoint estimation was used to model the relationship between BC pre-op and ABR thresholds, accounting for variability at lower BC values.</p> Results <p>Thirty-six patients (mean age 23 ± 18 years) were evaluated. Postoperative functional gain averaged 32.6 ± 11.9 dB HL, with speech discrimination improvement by 22.3 ± 10.1%. ABR thresholds correlated moderately with Vibrogram thresholds (<i>r</i> = 0.481, <i>p</i> = 0.003). Vibrogram–BC differences (mean = 15.9 ± 13.3 dB) were consistently lower than ABR–BC (mean = 34.8 ± 14.8 dB; t(34) = 8.74, <i>p</i> &lt; 0.001). Segmented regression identified a breakpoint at 18.3 dB (SE = 7.1). Below this value, the slope was non-significant (-0.21, <i>p</i> = 0.483), and mean ABR–BC difference was 39.84 dB. In contrast, above this value, a proportional relationship was observed (slope = 0.659) with difference of 21.67 dB.</p> Conclusion <p>Intraoperative ABR provides adjunctive physiological information that may inform surgical judgment. However, its interpretation should account for preoperative BC thresholds, particularly in patients with normal BC levels.</p>

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Intraoperative ABR in Vibrant Soundbridge Surgery: Influence of Bone-Conduction Thresholds

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月23日

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  • Asma Alahmadi,
  • Anas Ibrahim,
  • Nourah Shahadah,
  • Medhat Yousef,
  • Farid Alzhrani

摘要

Background

Vibrant Soundbridge (VSB) has shown effective hearing rehabilitation for patients with conductive, mixed, or sensorineural hearing loss. However, optimal floating mass transducer (FMT) coupling is critical for device performance. This study investigates the utility of intraoperative auditory brainstem response (ABR) for assessing coupling efficiency and guiding surgical decision-making, particularly in patients with normal bone conduction.

Methods

This retrospective cohort study included VSB patients with complete audiometric data. Coupling efficiency was assessed by comparing postoperative Vibrogram and intraoperative ABR thresholds with preoperative bone conduction (BC pre-op) thresholds (PTA3 at 1, 2, and 4 kHz). Segmented regression with breakpoint estimation was used to model the relationship between BC pre-op and ABR thresholds, accounting for variability at lower BC values.

Results

Thirty-six patients (mean age 23 ± 18 years) were evaluated. Postoperative functional gain averaged 32.6 ± 11.9 dB HL, with speech discrimination improvement by 22.3 ± 10.1%. ABR thresholds correlated moderately with Vibrogram thresholds (r = 0.481, p = 0.003). Vibrogram–BC differences (mean = 15.9 ± 13.3 dB) were consistently lower than ABR–BC (mean = 34.8 ± 14.8 dB; t(34) = 8.74, p < 0.001). Segmented regression identified a breakpoint at 18.3 dB (SE = 7.1). Below this value, the slope was non-significant (-0.21, p = 0.483), and mean ABR–BC difference was 39.84 dB. In contrast, above this value, a proportional relationship was observed (slope = 0.659) with difference of 21.67 dB.

Conclusion

Intraoperative ABR provides adjunctive physiological information that may inform surgical judgment. However, its interpretation should account for preoperative BC thresholds, particularly in patients with normal BC levels.