scholarly journals A Vibrant Soundbridge aktív középfül-implantátum történeti áttekintése és sebészi alkalmazásának lehetőségei

2021 ◽  
Vol 162 (40) ◽  
pp. 1619-1626
Author(s):  
Tamás Tóth ◽  
Imre Gerlinger ◽  
T. Barbara Bölcsföldi ◽  
György Kellényi ◽  
Adrienne Németh ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Round Window ◽  
Bone Conduction ◽  
Surgical Techniques ◽  
Sensorineural Hearing ◽  
Vibrant Soundbridge ◽  
Hearing Rehabilitation ◽  
Active Middle Ear Implant ◽  
Mixed Hearing Loss

Összefoglaló. A Vibrant Soundbridge aktív középfül-implantátum vezetéses, sensorineuralis és kevert típusú halláscsökkenés esetén is megoldást jelenthet a beteg hallásrehabilitációja során. Sensorineuralis halláscsökkenés esetén akkor indikálható, ha a légvezetéses hallásküszöb nem haladja meg a 80–85 dBHL-t a 3–4 kHz frekvenciákon, vezetéses, illetve kevert típusú halláscsökkenés esetén pedig akkor, ha a csontvezetéses hallásküszöb nem haladja meg a 45–65 dBHL-t a 0,5–4 kHz közti frekvenciatartományban. Az implantátum beültetését eleinte tisztán sensorineuralis halláscsökkenés esetén végezték, és csupán egyféleképpen történhetett: a rezgéskeltő rendszer oldalán lévő rögzítőcsipeszt rá kellett applikálni az incus hosszú nyújtványára. Azokra az esetekre, amikor a rezgéskeltő rögzítése nem kivitelezhető, különböző rögzítőelemeket (coupler) fejlesztettek ki. Az incusra való rögzítés hosszúnyújtvány-couplerrel, illetve rövidnyújtvány-couplerrel lehetséges. Vezetéses és kevert típusú halláscsökkenés esetén a kerek ablak membránjához is illeszthető a rendszer, előrehaladott otosclerosis esetén pedig a Soundbridge-implantáció stapedotomiával kiegészített változata („power stapes”) hozhat kielégítő halláseredményt. Ezek a technikák meglehetősen megnövelték a sebész szabadságát, így széles körben alkalmazott, megbízható megoldássá váltak. A Pécsi Tudományegyetem Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinikáján az elmúlt évtizedben számos incusvibroplastica történt, de kerekablak-vibroplasticára is több alkalommal sor került. A jelen összefoglaló tanulmányban a Vibrant Soundbridge implantátum technikai fejlődésének történeti áttekintésén felül az alkalmazható műtéti megoldásokat mutatjuk be. Orv Hetil. 2021; 162(40): 1619–1626. Summary. The Vibrant Soundbridge active middle ear implant can provide a reliable solution for hearing rehabilitation of patients with conductive, sensorineural or mixed hearing loss. For sensorineural hearing loss, the air conduction threshold of the patient should not be more increased than 80–85 dBHL at the range of 3–4 kHz, and for conductive and mixed hearing loss, the bone conduction threshold should not be more increased than 45–65 dBHL between 0.5 and 4 kHz. The standard surgical procedure was originally designed for purely sensorineural hearing loss, and the fixation clip of the vibrating transducer needed to be crimped onto the long process of the incus. In many cases, it is impossible to crimp the vibrator onto the incus. In order to solve such circumstances, fixation clips (couplers) have been developed. There are two options to crimp the device on the incus: applying a long process coupler or a short process coupler. For conductive or mixed hearing loss, a round window soft coupler has been introduced. In advanced otosclerotic cases, a special combined technique of Soundbridge implantation with simultaneous stapedotomy can result in sufficient hearing rehabilitation. These techniques significantly broadened the scale of possibilities for the implantation, therefore, it became a widely utilized, reliable procedure. At the Department of Otorhino-laryngology, Clinical Center, University of Pécs, in addition to a noteworthy amount of incus vibroplasty, several cases of round window vibroplasty have also been performed. The aim of the present study is to summarize the history of development of the Vibrant Soundbridge and to present an overview of the applicable surgical techniques. Orv Hetil. 2021; 162(40): 1619–1626.

Comparison of Alternative Coupling Methods of the Vibrant Soundbridge Floating Mass Transducer

2016 ◽  
Vol 21 (6) ◽  
pp. 347-355 ◽  
Author(s):  
Susan Busch ◽  
Thomas Lenarz ◽  
Hannes Maier
Keyword(s):  
Hearing Loss ◽  
Round Window ◽  
Bone Conduction ◽  
Regression Function ◽  
Ossicular Chain ◽  
Oval Window ◽  
Vibrant Soundbridge ◽  
Active Middle Ear Implant ◽  
Middle Ear Implant ◽  
Relevant Effect

The active middle ear implant Vibrant Soundbridge© provides a variety of coupling modalities of the floating mass transducer (FMT) to various structures of the ossicular chain and the round window. A retrospective analysis was performed on 125 subjects (n = 137 ears) (1) to compare the efficacy of the different FMT coupling modalities with increasing degree of hearing loss, (2) to compare the performance in speech outcome and the effective gain between the coupling types, and (3) to evaluate the risk of additional hearing loss of each coupling procedure. The patients were grouped according to their type of FMT coupling into incus vibroplasty (incus group, n = 59), round window vibroplasty with coupler (RWC group, n = 23), round window vibroplasty without coupler (RW group, n = 22), and oval window vibroplasty with coupler (OWC group, n = 33). For each coupling group, pre- and postoperative thresholds, the results of the Freiburg monosyllable test at 65 dB SPL, and the effective gain across frequencies (0.5-6 kHz) were evaluated. A logistic regression function was used to describe the relationship between word recognition scores (WRS, in % correct) and the mean bone conduction (BC) hearing loss. The surgical procedure had no clinically relevant effect on BC thresholds of patients in each coupling group. The BC pure tone average (PTA4) for 50% WRS predicted by the model function was similar for the incus (48.2 dB nHL), RW (47.8 dB nHL), and OWC (49.0 dB nHL) groups, but higher for the RWC group (67.9 dB nHL). However, the median WRS was 80% or better with no significant differences in speech perception between coupling types (Kruskal-Wallis test, p = 0.229). The effective gain shows an advantage for the incus coupling between 0.5 and 2 kHz over the other coupling types. The performance of the FMT coupling modalities is equally good for patients with a mild-to-moderate hearing loss, but the efficacy of coupling types differs for patients with greater hearing loss (>48 dB BC HL).

Sensorineural hearing loss caused by a high jugular bulb

2000 ◽  
Vol 114 (11) ◽  
pp. 867-869 ◽  
Author(s):  
Atsunobu Tsunoda
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Round Window ◽  
Bone Conduction ◽  
Jugular Bulb ◽  
Sensorineural Hearing ◽  
High Jugular Bulb ◽  
Low Tone ◽  
Round Window Niche ◽  
The Right

A 15 – year – old female presented with sensorineural hearing loss related to a high jugular bulb. She noticed temporary worsening of her right hearing with mild dizziness when her neck was compressed whereas she noticed no change in her left hearing. An audiogram showed temporary worsening of low tone bone – conduction on such occasions. A large jugular bulb covering the right round window was observed through the perforation. Computed tomography (CT) revealed a large jugular bulb obliterating the round window niche. Deterioration of bone conduction during neck compression was thought to be caused by the protrusion of the jugular bulb into the inner ear via the round window. This case suggested the possibility of sensorineural hearing loss due to the jugular bulb. As in the present case, jugular bulb or vein -related ear disorders should be examined by neck compression.

scholarly journals Cochlear Implantation Following Explorative Tympanotomy in Patients With Sudden Sensorineural Hearing Loss: Surgical Features and Audiological Outcomes

2021 ◽  
pp. 014556132110091
Author(s):  
Robin Rupp ◽  
Joachim Hornung ◽  
Matthias Balk ◽  
Matti Sievert ◽  
Sarina Müller ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Connective Tissue ◽  
Sensorineural Hearing Loss ◽  
Cochlear Implantation ◽  
Round Window ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Round Window Membrane ◽  
Hearing Results ◽  
Round Window Niche

Objective: To investigate the anatomical status of the round window niche and hearing outcome of cochlear implantation (CI) after explorative tympanotomy (ExT) with sealing of the round window membrane in patients with sudden sensorineural hearing loss at a tertiary referral medical center. Methods: Between January 1, 2007, and July 30, 2020, 1602 patients underwent CI at our department. Out of these, all patients previously treated by ExT with sealing of the round window membrane because of unilateral sudden hearing loss were included in the study. A retrospective chart review was conducted concerning method of round window membrane sealing, intraoperative findings during CI, postoperative imaging, and hearing results. Results: Twenty one patients (9 females; 8 right ears; 54.3 years [± 12.9 years]) underwent ExT with sealing of the round window membrane with subsequent CI after 26.6 months (± 32.9 mo) on average. During CI, in 76% of cases (n = 16), the round window niche was blocked by connective tissue due to the previous intervention but could be removed completely in all cases. The connective tissue itself and its removal had no detrimental effects on the round window membrane. Postoperative computed tomography scan showed no electrode dislocation. Mean postoperative word recognition score after 3 months was 57.4% (± 17.2%) and improved significantly to 73.1% (± 16.4%, P = .005) after 2 years. Conclusion: Performing CI after preceding ExT, connective tissue has to be expected blocking the round window niche. Remaining tissue can be removed safely and does not alter the round window membrane allowing for a proper electrode insertion. Short- and long-term hearing results are satisfactory. Consequently, ExT with sealing of the round window membrane in patients with sudden sensorineural hearing loss does not impede subsequent CI that can still be performed safely.

scholarly journals Design Study of a Round Window Piezoelectric Transducer for Active Middle Ear Implants

Sensors ◽  
2021 ◽  
Vol 21 (3) ◽  
pp. 946
Author(s):  
Dong Ho Shin
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Middle Ear ◽  
Piezoelectric Transducer ◽  
Round Window ◽  
Piezoelectric Element ◽  
Sensorineural Hearing ◽  
Flat Band ◽  
Middle Ear Implants ◽  
Output Characteristics

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.

scholarly journals Intralabyrinthine Schwannomas: Disease Presentation, Tumor Management, and Hearing Rehabilitation

2019 ◽  
Vol 80 (02) ◽  
pp. 196-202 ◽  
Author(s):  
Baishakhi Choudhury ◽  
Matthew Carlson ◽  
Daniel Jethanamest
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hearing Loss ◽  
Magnetic Resonance ◽  
Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Resonance Imaging ◽  
Hearing Rehabilitation ◽  
Rare Tumors ◽  
Auditory Rehabilitation ◽  
Tumor Management

AbstractIntralabyrinthine schwannomas (ILS) are rare tumors that frequently cause sensorineural hearing loss. The development and increased use of magnetic resonance imaging in recent years have facilitated the diagnosis of these tumors that present with otherwise nondiscriminant symptoms such as tinnitus, vertigo, and hearing loss. The following is a review of the presentation, pathophysiology, imaging, and treatment with a focused discussion on auditory rehabilitation options of ILS.

Hearing Rehabilitation in a Patient with Sudden Sensorineural Hearing Loss in the Only Hearing Ear

2008 ◽  
Vol 19 (03) ◽  
pp. 267-274 ◽  
Author(s):  
David B. Hawkins
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
The Other ◽  
Profound Hearing Loss ◽  
Hearing Rehabilitation ◽  
Aural Rehabilitation ◽  
Product Manager ◽  
Software Product

A case report is presented of a 62-year-old software product manager who had normal hearing in one ear and a congenital profound hearing loss in the other ear and then sustained a sudden sensorineural hearing loss in the only hearing ear. The approach to amplification decisions, cochlear implant evaluation, and rehabilitation options are discussed. Providing aural rehabilitation and continually updating and providing new amplification options and accessories are described. Se presenta un reporte de caso de un gerente de productos de software de 62 años de edad quien tenía audición normal en un oído y un sordera congénita profunda en el otro, y quién súbitamente sufrió una sordera sensorineural súbita en el único oído con audición. Se discute el enfoque de decisiones de amplificación, la evaluación para implante coclear, y las opciones de rehabilitación. Se describen las pautas para proveer rehabilitación aural y para actualizar continuamente y aportar nuevas opciones de amplificación.

scholarly journals The Vibrant Soundbridge

2010 ◽  
Vol 2 (2) ◽  
pp. 143-149
Author(s):  
Ashutosh G Pusalkar
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Aid ◽  
Sensorineural Hearing ◽  
Speech Discrimination ◽  
Vibrant Soundbridge ◽  
Hearing Improvement ◽  
Electronic Engineer

Abstract Till about 15 years ago, the only choice of hearing improvement for moderate sensorineural hearing loss with severe speech discrimination defect was a hearing aid. It was only after Mr. Geoff Ball, an electronic engineer who was suffering from a similar defect, started thinking of an alternative to the conventional hearing aid that the Vibrant Soundbridge came into existence, and with the passage of time the indications for the use of the same have increased.

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