European Results With Totally Implantable Carina Placed on the Round Window

Abstract

These results show that this option is valid for patients with a fixed footplate and unsuccessful previous surgeries or patients who cannot benefit from a stapedotomy for anatomic reasons. In some cases, access to the round window membrane could represent a limitation. However, these promising initial results establish the need for further works with regard to 3 issues: 1) clinical data studies are needed, including a greater number of patients to confirm these preliminary results; 2) a long-term follow-up must be performed to detect any possible cochlear adverse effects, in particular, on the basilar membrane; 3) the effect of fascia interposition and tip size has to be evaluated in experimental studies.

Measurement of Basilar Membrane Motion During Round Window Stimulation in Guinea Pigs

“…Generally, two curves in Figure 6(C) had the same shape and were parallel across frequencies, suggesting that the BM response to round window stimulation was essentially similar in nature to that of forward or acoustic stimulation in the ear canal. This finding supports the clinical outcomes reported in the literature (Colletti et al 2006;Cuda et al 2009;Martin et al 2009). …”

“…According to their results, improvements in postoperative aided thresholds were achieved for all patients. Improved pure-tone threshold or speech recognition scores after FMT stimulation on the RWM have also been reported in other clinical studies (Cuda et al 2009;Linder et al 2009;Martin et al 2009;Streitberger et al 2009;Rajan et al 2011).…”

Implantable Hearing Devices

“…The fully implantable Otologics Carina includes an internal magnet, battery, signal processor, receiver coil, and connector all housed in an electronics capsule, as well as a microphone and the transducer system [23,26]. There are multiple transducer types with the selection of a transducer type dependent on where the transducer is to be placed, determined by the patient's middle ear anatomy [26,27].…”

“…There are multiple transducer types with the selection of a transducer type dependent on where the transducer is to be placed, determined by the patient's middle ear anatomy [26,27]. The receiver coil allows for transcutaneous programming of the device and recharging of the battery.…”

“…The microphone placement can be in the temporalis region, the retroauricular region, or on the mastoid tip, avoiding areas that are prone to tissue thickness changes and contraction effects of the temporalis and sternocleidomastoid muscles [26,27]. Just as there are many available transducer tips, there are also many configurations for transducer placement.…”