Anpassung der Geometrie implantierbarer Hörgerätekomponenten an das menschliche Felsenbein

Maassen, Marcus M.; Lehner, R.; Müller, Gerd; Reischl, G; Lüdtke, Rainer; Leysieffer, H.; Zenner, H. P.

doi:10.1007/s001060050163

Cited by 9 publications

(7 citation statements)

References 5 publications

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“…Die grundlegenden Abschätzungen und Berechnungen des hier beschriebenen Funktionsmodells haben gezeigt, daß eine Positionierung des Wandlergehäuses in der Paukenhöhle aufgrund des minimal notwendigen Durchmessers des Membranverbunds nur bei ungewöhnlich hoher Pauke möglich ist [29]. Grundsätzlich wurde daher von folgendem Prinzip ausgegangen: das Wandlergehäuse selbst wird in der Mastoidhöhle so implantiert, daß die mit der Gehäusemembran fest verbundene, mechanisch steife Koppelstange in das Mittelohr reicht und direkt oder über geeignete Koppelelemente mechanisch mit einem Gehörknöchelchen bei intakter Ossikelkette verbunden werden kann.…”

Section: Prinzipielle Klinische Funktionsaspekteunclassified

Ein implantierbarer piezoelektrischer Hörgerätewandler für Innenohrschwerhörige

Leysieffer

Baumann²,

Müller³

et al. 1997

HNO

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Implantable hearing aids can form the basis of new surgical techniques for dealing with hearing problems originating in the inner ear, provided they are fully implantable. Accordingly, a comprehensive, interdisciplinary, combined project was initiated at the ENT clinic of the University of Tübingen which was to conclude with operations to improve hearing via fully implantable hearing aids. A novel electromechanical transducer for implantable hearing aids based on the piezoelectric principle is described. Unlike the piezoelectric transducers reported so far, this transducer does not rely on the bimorphic principle but on a circle-shaped, heteromorphic combination system consisting of a piezoceramic disc and metal membrane. The transducer can be hermetically sealed and is designed for implantation into the mastoid. Transfer of mechanical oscillations to an ossicle in the middle ear is effected by a directly fixed coupling rod or via suitable coupling elements. The transducer is highly tuned with a resonance frequency at the upper end of the spectral transfer range (greater than 10 kHz). Below this resonance and down to low frequencies, the frequency response of elongation is smooth with amplitudes of around 20 nm. At low and middle frequencies of up to 1 kHz, these vibration amplitudes correspond to sound-pressure levels of around 90 dB SPL. At higher frequencies of up to 10 kHz, the output level increases to about 130 dB SPL. Nonlinear distortions are also very small at the highest levels (less than 0.1%) throughout the whole transfer range. Electric power consumption at maximum levels is in the range of a few microwatts and is therefore significantly lower than that of electromagnetic systems. Particularly, this makes it possible to use the transducer in fully implantable hearing aids for rehabilitation of sensorineural hearing loss.

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Section: Prinzipielle Klinische Funktionsaspekteunclassified

Ein implantierbarer piezoelektrischer Hörgerätewandler für Innenohrschwerhörige

Leysieffer

Baumann²,

Müller³

et al. 1997

HNO

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“…Der entscheidende Sprung gegenüber Teilimplantaten wäre der Wegfall der die Kranken erheblich belastenden Stigmatisierung durch ein Hörgerät wie auch durch einen äußerlich sichtbaren Anteil eines partiellen Implanteats (P-CAI). Versuche von Maniglia et al [ [22]. Als Teil des Tübinger CAI [16] ist das Mikrophon für Innenohrschwerhörige ausgebildet und zusammen mit dem Wandler beim Menschen implantiert worden [40].…”

Section: Aktive Elektronische Hörimplantate Für Mittel-und Innenohrscunclassified

“…Diese Teilmodule wurden in mehrere Entwicklungsstufen an die chirurgische Anatomie des Ohrs angepaßt [12, 21,22] und in Tierversuchen [14,29] evaluiert.Der Wandler wurde weiterhin probeweise bei Patienten intraoperativ an die Ossikelkette probeweise angekoppelt [39]. Darüber hinaus erfolgten im Rahmen einer klinischen Studie Akutimplantationen von Wandler und Mikrophon bei Patienten mit und ohne Innnenohrhörverlusten [40].…”

Section: Aktive Elektronische Hörimplantate Für Mittel-und Innenohrscunclassified

Aktive elektronische Hörimplantate für Mittel- und Innenohrschwerhörige - eine neue Ära der Ohrchirurgie

Hp¹,

Leysieffer²

1997

HNO

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The perspectives for active hearing implants lie in the treatment of patients with sensorineural hearing loss (SNHL). The majority of patients with SNHL suffer from a cochlea amplifier (CA) failure which is discernible by a positive recruitment and loss of otoacoustic emissions (OAE). Therefore, the electronic implant is expected to partially replace functions of the CA. Thus, the implant is thought to function as a CAI (cochlea amplifier implant). An approved implant for routine use is not yet available. Clinical studies have thus far only used the high energy consuming (HEC), narrow-band, electromagnetic floating-mass transducer, as well as the Maniglia-HEC implant. The high energie consuming, yet broadband Canadian Fredrickson implant is soon to be used in humans. Of the piezoelectrical implants, a German CAI (Tübingen implant) at present consisting of a piezoelectrical transducer and a microphone has thus far been acutely implanted in first patient. It is a low energy consuming (LEC), broad-band implantable system for patients with sensorineural hearing loss. Routine surgical treatment of patients with sensorineural hearing loss with a CAI will only be achieved if complete implants (with transducer, microphones, batteries, and control unit) are made available. They combine distinct acoustic superiority with invisibility (end of stigmatization), an open ear canal, and hopefully, the end of feedback whistling. Among the implants mentioned, the German CAI is the only LEC implant. Its energy requirements are so low that with today's technologie implantable batteries (e.g., in pacemakers), the additional implantation of an energy carrier seems feasible. Since the implantable microphone is already available in the German system, the only essential part missing for a totally implantable CAI is the implantable control unit.

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“…Sensorineural hearing loss · Cochlea amplifier implant · Implantable hearing aid · Electronic hearing implant · TICA des Ohrs angepaßten [17,18] …”

Section: Introductionunclassified

Erste Implantationen eines vollständig implantierbaren elektronischen Hörsystems bei Patienten mit Innenohrschwerhörigkeit

Zenner

Maassen

Plinkert

et al. 1998

HNO

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For the majority of patients with sensorineural hearing loss (SNHL) many available hearing aids often do not achieve satisfactory results. For these patients partially implantable hearing devices have been developed, allowing distortion-free hearing and speech intelligibility that may be superior to conventional hearing aids. The external parts of partial implants, however, may result in a patient's stigmatization. Furthermore, they do not use the acoustic properties of the external auditory canal. Recently, we published the successful development of the first totally implantable hearing device for the treatment of SNHL (HNO 46 [1998] 853-863). Here we report the first implantations of this unique, totally implantable electronic hearing system in patients with SNHL: Implex TICA LZ 3001. The implant microphone is implanted subcutaneously in the outer ear canal near the ear drum. The signal is processed by a digitally programmable multichannel audioprocessor located subcutaneously on the bony skull behind the ear. A piezoelectric transducer is coupled to the body of the incus and drives the ossicular chain by vibratory actions. Energy is provided by an implantable battery. Implanted patients describe hearing as being distortion-free and transparent. Speech intelligibility and the hearing of music are improved. Patients may achieve better speech discrimination, especially in the presence of background noise. The aid can be used during sports, including swimming. To our knowledge, this is the first report of the implantation of a totally implantable electronic hearing system in patients. These results encourage further implantations of the totally implantable hearing system in the course of an ongoing clinical study.

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Anpassung der Geometrie implantierbarer Hörgerätekomponenten an das menschliche Felsenbein

Cited by 9 publications

References 5 publications

Ein implantierbarer piezoelektrischer Hörgerätewandler für Innenohrschwerhörige

Ein implantierbarer piezoelektrischer Hörgerätewandler für Innenohrschwerhörige

Aktive elektronische Hörimplantate für Mittel- und Innenohrschwerhörige - eine neue Ära der Ohrchirurgie

Erste Implantationen eines vollständig implantierbaren elektronischen Hörsystems bei Patienten mit Innenohrschwerhörigkeit

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