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An alternative approach to mixed hearing loss in otosclerosis: stapes surgery combined with an active middle-ear implant

  • H R F Powell (a1), I Pai (a1), H Ghulam (a1) and D Jiang (a1)



To report a novel management strategy for mixed hearing loss in advanced otosclerosis.


A 50-year-old male was referred to St Thomas’ Hearing Implant Centre with otosclerosis; he was no longer able to wear conventional hearing aids because of recurrent otitis externa. The patient underwent short process incus vibroplasty (using the Med-El Vibrant Soundbridge device), followed at a suitable interval (six weeks) by stapes surgery. The main outcome measures were: pure tone audiometry, functional gain and monosyllabic word recognition scores.


Post-operative pure tone audiometry showed a reduction of the mean air–bone gap from 55 dB HL to 20 dB HL. The residual mixed hearing loss was rehabilitated with the Vibrant Soundbridge, with an average device gain of 32 dB. The monosyllabic word recognition scores in quiet at 65 dB improved from 37 to 100 per cent when using the Vibrant Soundbridge at six months after switch-on of the device.


Stapedotomy in conjunction with incus short process vibroplasty (i.e. inner-ear vibroplasty) is a safe and promising procedure for managing advanced otosclerosis with mixed hearing loss in selected patients.


Corresponding author

Address for correspondence: Prof Dan Jiang, Hearing Implant Centre, 2nd floor Lambeth Wing, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK E-mail:


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Presented at the 6th International Congress on Bone Conduction Hearing and Related Technologies, 17−20 May 2017, Nijmegen, the Netherlands.



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An alternative approach to mixed hearing loss in otosclerosis: stapes surgery combined with an active middle-ear implant

  • H R F Powell (a1), I Pai (a1), H Ghulam (a1) and D Jiang (a1)


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