Active Middle Ear Implant Application in Case of Stapes Fixation

Devèze, Arnaud; Koka, Kanthaiah; Tringali, S.; Jenkins, Herman A.; Tollin, Daniel J.

doi:10.1097/mao.0b013e3181edb6d1

Cited by 34 publications

(25 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Responses were overlayed onto the 95% confidence interval for H Stap , and the mean ± standard deviation of responses observed for H SV and H ST reported previously (23,35). Several specimens showed frequencies that lie outside of these bands in one or more response; however these deviations are relatively small, thus may be expected based upon normal physiological variability, and should not affect the results since all analyses are relative to baseline measurements (29,30,36). Transfer function phase was likewise calculated, and baseline responses are shown superimposed on normal responses observed in the literature (23,35) in Figure 1B.…”

Section: Resultsmentioning

confidence: 96%

See 1 more Smart Citation

Cochlear Implant Electrode Effect on Sound Energy Transfer Within the Cochlea During Acoustic Stimulation

Greene

Mattingly²,

Jenkins³

et al. 2015

Otology &Amp; Neurotology

Self Cite

View full text Add to dashboard Cite

Hypothesis Cochlear implants (CI) designed for hearing preservation will not alter mechanical properties of the middle and inner ear as measured by intracochlear pressure (PIC) and stapes velocity (Vstap). Background CIs designed to provide combined electrical and acoustic stimulation (EAS) are now available. To maintain functional acoustic hearing, it is important to know if a CI electrode can alter middle or inner ear mechanics, as any alteration could contribute to elevated low-frequency thresholds in EAS patients. Methods Seven human cadaveric temporal bones were prepared, and pure-tone stimuli from 120Hz–10kHz were presented at a range of intensities up to 110 dB SPL. PIC in the scala vestibuli (PSV) and tympani (PST) were measured with fiber-optic pressure sensors concurrently with VStap using laser Doppler vibrometry. Five CI electrodes from two different manufacturers, with varying dimensions were inserted via a round window approach at six different depths (16–25 mm). Results The responses of PIC and VStap to acoustic stimulation were assessed as a function of stimulus frequency, normalized to SPL in the external auditory canal (EAC), in baseline and electrode inserted conditions. Responses measured with electrodes inserted were generally within ~5 dB of baseline, indicating little effect of cochlear implant electrode insertion on PIC and VStap. Overall, mean differences across conditions were small for all responses, and no substantial differences were consistently visible across electrode types. Conclusions Results suggest that the influence of a CI electrode on middle and inner ear mechanics is minimal, despite variation in electrode lengths and configurations.

show abstract

Section: Resultsmentioning

confidence: 96%

“…A canal-wall-up mastoidectomy and extended facial recess approach was performed to visualize the incus, stapes, and round window (30). The cochlear promontory near the oval and round windows was thinned with a small diamond burr in preparation for pressure sensor insertion into the scala vestibuli (SV) and scala tympani (ST).…”

Section: Methodsmentioning

confidence: 99%

Cochlear Implant Electrode Effect on Sound Energy Transfer Within the Cochlea During Acoustic Stimulation

Greene

Mattingly²,

Jenkins³

et al. 2015

Otology &Amp; Neurotology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Temporal bone preparation was similar to methods described previously by our laboratory [13,14], as well as other authors [10]. The specimens were thawed in warm water, and inspected for any damage.…”

Section: Methodsmentioning

confidence: 99%

Effects of Skin Thickness on Cochlear Input Signal Using Transcutaneous Bone Conduction Implants

Mattingly¹,

Greene²,

Jenkins³

et al. 2015

Otology &Amp; Neurotology

Self Cite

View full text Add to dashboard Cite

Hypothesis Intracochlear sound pressures (PIC) and velocity measurements of the stapes, round window, and promontory (VStap/RW/Prom) will show frequency dependent attenuation using magnet-based, transcutaneous bone-conduction implants (TCBCI) in comparison to direct-connect, skin-penetrating implants (DCBCI). Background TCBCIs have recently been introduced as alternatives to DCBCIs. Clinical studies have demonstrated elevated high-frequency thresholds for TCBCIs as compared to DCBCIs; however, little data exists examining the direct effect of skin thickness on the cochlear input signal using TCBCIs. Methods Using seven cadveric heads, PIC was measured in the scala vestibuli and tympani with fiber-optic pressure sensors concurrently with VStap/RW/Prom via laser Doppler vibrometry. Ipsilateral titanium implant fixtures were placed and connected to either a DCBCI or TCBCI. Soft tissue flaps with varying thicknesses (no flap, 3, 6, and 9 mm) were placed successively between the magnetic plate and sound processor magnet. A bone-conduction transducer coupled to custom software provided pure tone stimuli between 120 to 10240 Hz. Results Stimulation via the DCBCI produced the largest response magnitudes. The TCBCI showed similar PSV/ST and VStap/RW/Prom with no intervening flap, and a frequency-dependent, non-linear reduction of magnitude with increasing flap thickness. Phase shows a comparable dependence on transmission delay as the acoustic baseline, and the slope steepens at higher frequencies as flap thickness increases suggesting a longer group delay. Conclusions Proper soft tissue management is critical to optimize the cochlear input signal. The skin thickness related effects on cochlear response magnitudes should be taken into account when selecting patients for a TCBCI.

show abstract

“…In the case where the SFP is obscured, vibration responses of the RW of the cochlea can be determined by LDV instead [12, 13]. However, due to the complex vibration pattern of the RW at frequencies >1.5 kHz, this method is reliable only within one experiment and if the measurement site on the RW is unchanged [12, 14, 15].…”

Section: Introductionmentioning

confidence: 99%

Differential Intracochlear Sound Pressure Measurements in Human Temporal Bones with an Off-the-Shelf Sensor

Großöhmichen

Salcher

Püschel

et al. 2016

BioMed Research International

View full text Add to dashboard Cite

The standard method to determine the output level of acoustic and mechanical stimulation to the inner ear is measurement of vibration response of the stapes in human cadaveric temporal bones (TBs) by laser Doppler vibrometry. However, this method is reliable only if the intact ossicular chain is stimulated. For other stimulation modes an alternative method is needed. The differential intracochlear sound pressure between scala vestibuli (SV) and scala tympani (ST) is assumed to correlate with excitation. Using a custom-made pressure sensor it has been successfully measured and used to determine the output level of acoustic and mechanical stimulation. To make this method generally accessible, an off-the-shelf pressure sensor (Samba Preclin 420 LP, Samba Sensors) was tested here for intracochlear sound pressure measurements. During acoustic stimulation, intracochlear sound pressures were simultaneously measurable in SV and ST between 0.1 and 8 kHz with sufficient signal-to-noise ratios with this sensor. The pressure differences were comparable to results obtained with custom-made sensors. Our results demonstrated that the pressure sensor Samba Preclin 420 LP is usable for measurements of intracochlear sound pressures in SV and ST and for the determination of differential intracochlear sound pressures.

show abstract

Active Middle Ear Implant Application in Case of Stapes Fixation

Abstract: Driving the oval window with an AMEI in a scenario of stapes fixation was demonstrated to be feasible, with performance comparable to traditional AMEI coupling to the incus or stapes. These possibilities offer new perspectives to treat mixed hearing loss in case of fixed footplate.

Cited by 34 publications

References 56 publications

Cochlear Implant Electrode Effect on Sound Energy Transfer Within the Cochlea During Acoustic Stimulation

Cochlear Implant Electrode Effect on Sound Energy Transfer Within the Cochlea During Acoustic Stimulation

Effects of Skin Thickness on Cochlear Input Signal Using Transcutaneous Bone Conduction Implants

Differential Intracochlear Sound Pressure Measurements in Human Temporal Bones with an Off-the-Shelf Sensor

Contact Info

Product

Resources

About