scholarly journals Round Window Stimulation of the Cochlea

2021 ◽  
Vol 12 ◽  
Author(s):  
Herman A. Jenkins ◽  
Nathaniel Greene ◽  
Daniel J. Tollin
Keyword(s):  
Hearing Loss ◽  
Mechanical Stimulation ◽  
Round Window ◽  
Ossicular Chain ◽  
External Ear ◽  
Ear Canal ◽  
Hearing Rehabilitation ◽  
Mixed Hearing Loss ◽  
Conductive Mechanism ◽  
Stimulation Of

Mixed hearing loss associated with a sensorineural component and an impaired conductive mechanism for sound from the external ear canal to the cochlea represents a challenge for rehabilitation using either surgery or traditional hearing amplification. Direct stimulations of the ossicular chain and the round window (RW) membrane have allowed an improved hearing in this population. The authors review the developments in basic and clinical research that have allowed the exploration of new routes for inner ear stimulation. Similar changes occur in the electrophysiological measures in response to auditory stimulation through the traditional route and direct mechanical stimulation of the RW. The latter has proven to be very effective as a means of hearing rehabilitation in a group of patients with significant difficulties with hearing and communication.

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.

Round Window Stimulation for Conductive and Mixed Hearing Loss

2014 ◽  
Vol 35 (9) ◽  
pp. 1601-1608 ◽  
Author(s):  
Margaret T. Dillon ◽  
Rhonda S. Tubbs ◽  
Marcia C. Adunka ◽  
English R. King ◽  
Todd A. Hillman ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Round Window ◽  
Mixed Hearing Loss

scholarly journals Cochlear Implantation in Patients with Keratitis-Ichthyosis-Deafness Syndrome: A Report of Two Cases

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Birgul Gumus ◽  
Armagan Incesulu ◽  
Mehmet Ozgur Pinarbasli
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Cochlear Implantation ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
External Ear ◽  
Ear Canal ◽  
External Ear Canal ◽  
Brainstem Response ◽  
Visual Disturbances

Background.Keratitis-ichthyosis-deafness (KID) syndrome is a syndrome which presents with hearing loss and visual and keratinization disorders. In such patients, hearing aids cannot be effectively used in the rehabilitation of hearing loss because of the frequent blockage of the external ear canal with epithelial debris and due to dry and tense skin of the external ear canal. Moreover, severe or profound hearing loss also limits the benefits gained from the conventional hearing aids. On the other hand, cochlear implantation is a method that has been used in limited cases in the literature.Case Report.This study presents the results of cochlear implantation applied in our clinic to two children who had been diagnosed with KID. Audiological assessments before and after the cochlear implant operation were performed using pure-tone audiometry, immittance audiometry, and auditory brainstem response (ABR), and the postoperative follow-up was conducted using pure-tone audiometry.Conclusion.Skin problems, visual disturbances, and other additional problems complicate the short-term and long-term rehabilitation after implantation in individuals with KID syndrome. Close monitoring should be exercised due to possible skin complications that may develop during the postoperative period. The families and rehabilitation teams should be warned about the possible visual disturbances and skin complications.

Fully implantable hearing device with transducer on the round window as a treatment of mixed hearing loss

2009 ◽  
Vol 36 (3) ◽  
pp. 353-358 ◽  
Author(s):  
Stéphane Tringali ◽  
Nick Pergola ◽  
Paul Berger ◽  
Christian Dubreuil
Keyword(s):  
Hearing Loss ◽  
Round Window ◽  
Mixed Hearing Loss ◽  
Hearing Device

scholarly journals Contralateral Occlusion Test (COT): the effect of external ear canal occlusion with aging

CoDAS ◽  
2019 ◽  
Vol 31 (3) ◽  
Author(s):  
Luís Roque Reis ◽  
Luís Castelhano ◽  
Filipe Correia ◽  
Pedro Escada
Keyword(s):  
Hearing Loss ◽  
Tuning Fork ◽  
Age Groups ◽  
Sound Field ◽  
External Ear ◽  
Ear Canal ◽  
Occlusion Test ◽  
External Ear Canal ◽  
Hearing Thresholds ◽  
And Gender

ABSTRACT Purpose This study aimed to evaluate the effects of complete external ear canal occlusion on hearing thresholds with aging. The goal was to decide which tuning fork is more appropriate to use for the contralateral occlusion test (COT), in individuals of different ages. Methods Forty-two normal hearing subjects between 21 and 67 years were divided into three age groups (20-30 years, 40-50 years, and 60-70 years). Participants underwent sound field audiometry tests with warble tones, with and without ear canal occlusion. Each ear was tested with the standard frequencies (250, 500, 1000, and 2000 Hz). The contralateral ear was suppressed by masking. Results Hearing thresholds showed an increase as the frequency increased from 20.85 dB (250 Hz, 20-30 years group) to 48 dB (2000 Hz, 60-70 years group). The threshold differences between occlusion and no occlusion conditions were statistically significant and increased ranging from 11.1 dB (250 Hz, 20-30 years group) to 32 dB (2000 Hz, 20-30 years group). We found statistically significant differences for the three age groups and for all evaluations except to 500 Hz difference and average difference. The mean hearing loss produced by occlusion at 500 Hz was approximately 19 dB. We found no statistically significant differences between right and left ears and gender for all measurements. Conclusion We conclude that the use of the 512 Hz tuning fork is the most suitable for COT, and its use may allow clinicians to distinguish mild from moderate unilateral conductive hearing loss.

scholarly journals Vibrant Soundbridge and Bone Conduction Hearing Aid in Patients with Bilateral Malformation of External Ear

2015 ◽  
Vol 20 (01) ◽  
pp. 034-038 ◽  
Author(s):  
Maria Mondelli ◽  
Thais Mariano ◽  
Heitor Honório ◽  
Rubens Brito
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Bone Conduction ◽  
External Ear ◽  
Vibrant Soundbridge ◽  
Mixed Hearing Loss ◽  
Bone Conduction Hearing ◽  
Bone Conduction Hearing Aid

Introduction Hearing loss is the most common clinical finding in patients with malformation of the external ear canal. Among the possibilities of treatment, there is the adaptation of hearing aids by bone conduction and the adaptation of implantable hearing aids. Objective To assess speech perception with the use of Vibrant Soundbridge (VBS - MED-EL, Innsbruck, Austria) associated with additional amplification in patients with bilateral craniofacial malformation. Method We evaluated 11 patients with bilateral malformation over 12 years with mixed hearing loss or bilateral conductive. They were using the Softband (Oticon Medical, Sweden) and bone conduction hearing aid in the ear opposite the one with the VSB. We performed the evaluation of speech perception using the Hearing in Noise Test. Results Participants were eight men and three women with a mean of 19.5 years. The signal / noise ratio presented significant results in patients fitted with VSB and bone conduction hearing aid. Conclusion The results of speech perception were significantly better with use of VBS combined with bone conduction hearing aids.

Outcome of 22 cases of perforated tympanic membrane caused by otomycosis

2001 ◽  
Vol 115 (11) ◽  
pp. 879-880 ◽  
Author(s):  
William B. Hurst
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Externa ◽  
Residual Hearing ◽  
External Ear ◽  
Ear Canal ◽  
Trichloracetic Acid ◽  
External Ear Canal ◽  
Discrete Area ◽  
Perforated Tympanic Membrane

Twenty-two cases of perforated tympanic membrane due to fungal otitis externa were observed over a five-year period.The diagnosis of fungal otitis externa was made on clinical grounds due to the obvious presence of fungal bloom in the external ear canal. Some perforations were noted at the first treatment after the fungal debris had been removed from the external ear canal using a microscope. Other perforations were observed to develop over a few days. Initially, a discrete area of the tympanic membrane appeared white and opaque. As time progressed the white area disintegrated, forming a perforation. Once the otitis externa had resolved most perforations healed spontaneously. Two that were observed to develop during treatment required a myringoplasty. Another one closed significantly but a tiny persistent perforation required cauterization with trichloracetic acid to encourage it to close over completely. The only residual hearing loss was in a case with almost total disintegration of the tympanic membrane requiring a myringoplasty.Treatment of fungal otitis externa for the patients in this series was aural toilet using suction under a microscope and insertion of a gauze wick saturated in a combination of hydrocortisone, clotrimazole, framycetin and gramicidin.

Conductive hearing loss: investigation of possible inner ear origin in three cases studies

2002 ◽  
Vol 116 (11) ◽  
pp. 942-945 ◽  
Author(s):  
Hamad Al Muhaimeed ◽  
Yousry El Sayed ◽  
Abdulrahman Rabah ◽  
Abdulrahman Al-Essa
Keyword(s):  
Hearing Loss ◽  
Inner Ear ◽  
Conductive Hearing Loss ◽  
Round Window ◽  
The Third ◽  
Conductive Deafness ◽  
Mixed Hearing Loss ◽  
Stapedial Reflex ◽  
Conductive Hearing ◽  
Inner Ear Disorders

This is a report of three cases of mixed hearing loss that resulted from inner ear disorders. Two cases were unilateral and the third was bilateral. The diagnosis was based on the findings of normal middle and external ears in association with the absence of round window reflexes. The contralateral stapedial reflex was present in the two unilateral cases. This is the first documentation of conductive deafness due to inner ear abnormality. This diagnosis should be considered in cases of conductive hearing loss if the middle and external ears are normal. More studies are needed to establish the pathophysiology of this entity.

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