Surgical approaches to position the Vibrant Soundbridge in conductive and mixed hearing loss

The criteria for treatment of patients with a Vibrant Soundbridge (VSB) were recently extended to care for patients with conductive as well as mixed hearing loss. Although patients undergo appropriate middle ear surgery, hearing restoration sometimes remains inadequate. These patients with unsuccessful conventional hearing rehabilitation and a variety of middle ear conditions can be fitted with the active middle ear implant VSB. This article describes the surgical techniques in such cases for the application of the VSB and the positions of its active part—the floating mass transducer.