Do We Really Need a Coupler for the Round Window Application of an AMEI?

Objective Implanting active middle ear implants (AMEI) at the round window has become a standard procedure to restore hearing for patients with moderate inner ear or mixed hearing loss. The round window (RW)–Coupler was developed as an alternative coupling aid to fit smaller RW diameters and require less drilling in the RW niche. The question arises whether using the RW-Coupler is useful and a safe procedure compared with the nonuse of the RW-Coupler Materials and Methods Forty-nine German-speaking patients were implanted with either a RW-Coupler attached to an AMEI floating mass transducer (FMT) or without coupler. They were evaluated preoperatively and postoperatively for bone and air conduction thresholds with and without the implant, as well as speech perception tests. Results Bone conduction thresholds remained stable preoperatively and postoperatively. The patient’s functional gain was slightly better with the RW-Coupler. Focusing on the average speech perception performances, both groups presented an improvement of speech perception above 80% at 65 dB HL. Conclusion RW-Coupler-Vibroplasty was found to be a safe procedure, which produced good results in this group of patients with mixed hearing loss.