Case report of the first patient with electro-mechanical stimulation of the inner ear: The Vibrant Soundbridge combined with a FLEX20 cochlear implant

Background Previous studies in the field of cochlear implantation have proven that the use of electro-acoustic stimulation systems in patients with low frequency residual hearing results in improved speech perception scores compared to electric only stimulation. Unfortunately, many patients cannot use these systems because of inflammatory responses to the external ear piece of the system. In these cases, the substitution of low frequency acoustic stimulation through an external ear piece by mechanical stimulation with a middle ear implant could be a way to take advantage of the remaining residual hearing. Case We report on a patient who was bilaterally implanted with a MED-EL Vibrant Soundbridge. After 12 years, her hearing loss had progressed such that she was acoustically indicated for electro-acoustic stimulation. Since she could not wear an external ear piece due to medical reasons, she was then implanted with a cochlear implant in addition to her middle ear implant on the right-hand side, hence benefitting from electro-mechanical stimulation in the right ear. For the follow-up period of 12 month her hearing loss was found stable, and speech perception results were satisfying. Conclusion The ipsilateral use of a Vibrant Soundbridge in addition to a cochlear implant was found to be a feasible and save option for providing electro-mechanical auditory stimulation. Speech performance results comparable to electro-acoustic stimulation patients can be expected for patients with substantial low frequency residual hearing.