Revision of active middle ear implants (AMEI): causes, surgical issues and rehabilitative transition at a single implanting center

This report describes the design of a new piezoelectric transducer for round window (RW)-driven middle ear implants. The transducer consists of a piezoelectric element, gold-coated copper bellows, silicone elastomer (polydimethylsiloxane, PDMS), metal cylinder (tungsten), and titanium housing. The piezoelectric element is fixed to the titanium housing and mechanical resonance is generated by the interaction of the bellows, PDMS, and tungsten cylinder. The dimensions of PDMS and the tungsten cylinder with output characteristics suitable for compensation of sensorineural hearing loss were derived by mechanical vibrational analysis (equivalent mechanical model and finite element analysis (FEA)). Based on the results of FEA, the RW piezoelectric transducer was implemented, and bench tests were performed under no-load conditions to confirm the output characteristics. The transducer generates an average displacement of 219.6 nm in the flat band (0.1–1 kHz); the resonance frequency is 2.3 kHz. To evaluate the output characteristics, the response was compared to that of an earlier transducer. When driven by the same voltage (6 Vp), the flat band displacement averaged 30 nm larger than that of the other transducer, and no anti-resonance was noted. Therefore, we expect that the new transducer can serve as an output device for hearing aids, and that it will improve speech recognition and treat high-frequency sensorineural hearing loss more effectively.

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Bone Resorption Induced by Middle-Ear Implants

Archives of Otolaryngology - Head and Neck Surgery ◽

10.1001/archotol.1986.03780060047006 ◽

1986 ◽

Vol 112 (6) ◽

pp. 635-641 ◽

Cited By ~ 10

Author(s):

M. D. McGinn ◽

R. A. Chole ◽

S. P. Tinling

Keyword(s):

Bone Resorption ◽

Middle Ear ◽

Middle Ear Implants

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Hydroxylapatite Ossicular Replacement Prostheses: A Four-Year Experience

Otolaryngology ◽

10.1177/019459989210600312 ◽

1992 ◽

Vol 106 (3) ◽

pp. 261-269 ◽

Cited By ~ 32

Author(s):

Robert A. Goldenberg

Keyword(s):

Surgical Technique ◽

Middle Ear ◽

Control Group ◽

Hearing Results ◽

Extrusion Rate ◽

Hearing Result ◽

Ossicular Replacement ◽

Middle Ear Implants

Between 1987 and 1991, I have used 215 hydroxylapatite middle ear implants, in various styles, for hearing reconstruction. The first such implants were composed entirely of hydroxylapatite. Because of intraoperative difficulties in shaping and trimming these prostheses, hybrid prostheses using Plasti-Pore were developed. For each of four implant designs (incus, incus-stapes, PORP, and TORP), the head is constructed from hydroxylapatite and the shaft from Plasti-Pore. Extrusion rate for the hybrid prostheses is low (4.3%). Hearing results from 47 patients with the hybrid hydroxylapatite prostheses, 140 patients with total hydroxylapatite prostheses, and 75 control group patients with homograft bone or Plasti-Pore prostheses were compared. A “successful” hearing result was achieved in 51.1%, 51.4%, and 60.0% of the three groups, respectively. Surgical technique for use of the new hybrid hydroxylapatite prostheses is described.

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Safe magnetic resonance scanning of patients with metallic middle ear implants

Clinical Otolaryngology ◽

10.1111/j.1365-2273.2006.01326.x ◽

2006 ◽

Vol 31 (6) ◽

pp. 508-510 ◽

Cited By ~ 4

Author(s):

D.C. Wild ◽

K. Head ◽

D.A. Hall

Keyword(s):

Magnetic Resonance ◽

Middle Ear ◽

Middle Ear Implants ◽

Magnetic Resonance Scanning

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Middle Ear Implants

Hearing ◽

10.1201/b19201-18 ◽

2015 ◽

pp. 107-112

Author(s):

Neil Donnelly

Keyword(s):

Middle Ear ◽

Middle Ear Implants

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Middle Ear Implants

Scott-Brown’s Otorhinolaryngology Head and Neck Surgery ◽

10.1201/9780203731017-95 ◽

2018 ◽

pp. 1169-1176

Author(s):

Maarten J.F. de Wolf ◽

Richard M. Irving

Keyword(s):

Middle Ear ◽

Middle Ear Implants

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Comparative study of efficiency and characteristics of FMT and DRT installed in human cadavers for round-window stimulation

Scientific Reports ◽

10.1038/s41598-021-95456-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Dong Ho Shin ◽

Jong Hoon Kim ◽

Peter Gottlieb ◽

Yona Vaisbuch ◽

Sunil Puria ◽

...

Keyword(s):

Middle Ear ◽

Hearing Aids ◽

Round Window ◽

Standard Of Care ◽

Acoustic Hearing ◽

Middle Ear Implants ◽

Human Cadavers ◽

Limited Frequency ◽

Output Characteristics ◽

Temporal Bones

AbstractAcoustic hearing aids generate amplified sound in the ear canal, and they are the standard of care for patients with mild to moderate sensorineural hearing loss. However, because of their limited frequency bandwidth, gain, and feedback, there is substantial room for improvement. Active middle ear implants, which directly vibrate the middle ear and cochlea, are an alternative approach to conventional acoustic hearing aids. They provide an opportunity to improve sound quality and speech understanding with amplification rehabilitation. For floating-mass type and direct-rod type (DRT) middle ear transducers, a differential floating-mass transducer (DFMT) and a tri-coil bellows transducer (TCBT), respectively, were fabricated to measure the output characteristics in four human temporal bones. Both were fabricated to have similar output forces per unit input and were placed in four human temporal bones to measure their output performances. The TCBT resulted in higher output than did the DFMT throughout the audible frequency range, and the output was more prominent at lower frequency ranges. In this study, we showed that DRT was a more effective method for round window stimulation. Because of its frequency characteristics and vibration efficiency, this implantation method can be utilized as a driving solution for middle ear implants.

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