Third window vibroplasty: an alternative in surgical treatment of tympanosclerotic obliteration of the oval and round window niche.

Objective: To describe a new technique in surgical treatment of obliterative tympanosclerosis by applying a floating mass transducer (FMT) to a third window.

Patient: A 64-year-old woman with a severe combined hearing loss due to tympanosclerosis received a third window vibroplasty.

Intervention: A mastoidectomy and a posterior tympanotomy via the large facial recess were performed. The promontory was exposed by a transcanal approach. The third window was performed anterior inferior to the round window. The membranous cochlea was left intact. The FMT was gently pushed into the perichondrium-coated cochlear window. All other surgical steps were the same as in conventional FMT application.

Results: Preliminary data of this report reveal that vibroplasty with coupling of the FMT directly to a third window leads to similar audiological results compared with the conventional coupling of the FMT on the round window niche.

Conclusion: The presented case demonstrates the applicability of a third window vibroplasty in obliterative tympanosclerosis. Further studies will show if our assumption of a reduced risk for inner ear trauma is justified or not.