■ OBJECTIVES: High frequency sensorineural hearing loss can be rehabilitated by the Vibrant Sound Bridge (VSB) middle ear implant in those patients, who are dissatisfied after a conventional hearing aid fitting. The adequately servicable hearing for VSB implantation is limited for certain speech discrimination range, frequency range of the hearing loss and some motivation drives.

■ METHODS: Seven patients were VSB implanted during the last 5 years in Hungary. The surgical approach and exposure of the middel ear (posterior tympanotomy) essentially followed the surgical guide suggested by the manufacturer. The conductor link has been introduced into the mastoidectomy cavity through a tunnel which provides with better fixation and hiding. The surgical points important in the proper fitting of the FMT are: (i) large hole in the posterior wall of the tympanic cavity with preservation of the fibrocartilagenous ring of the drum; (ii) safe crimping of the FMT onto the lenticular process of the incus, crimp-by-crimp if necessary, (iii) good orientation of the body of FMT.

■ RESULTS: All seven patients benefitted from implant use. A 15 yrs old teenager was the youngest patient in the series. In this particular case the VSB hearing rehabilitation was convincingly supportive in socialization. A blind patient showed the best speech discrimination score improvement. Best functional gains were obtained at 2000 and 3000 Hz (45 dB SPL).

■ CONCLUSIONS: VSB implantation is a reliable method for hearing rehabilitation even in those cases when low frequencies arealso involved in the hearing loss. Motivation should preoperatively be considered for good results.