The Effects of Mass Loading the Ossicles with a Floating Mass Transducer on Middle Ear Transfer Function

Aj, Needham; Jiang, Dan; Bibas, Athanasios; Jeronimidis, G.; Af, O'Connor

doi:10.1097/00129492-200503000-00015

Cited by 67 publications

(62 citation statements)

References 13 publications

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“…In contrast to experimental results in temporal bones that predicted only a decrease in middle ear sound transfer at high frequencies [Needham et al, 2005], we also found significant changes at frequencies ≤ 1.5 kHz, indicating that mechanisms other than pure mass load added to the ossicular chain (approx. weight of the FMT = 25 mg) may play a role.…”

Section: Discussioncontrasting

confidence: 99%

Long-Term Results of Incus Vibroplasty in Patients with Moderate-to-Severe Sensorineural Hearing Loss

et al. 2015

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Objectives: The principal aim of this study was to assess the safety and effectiveness of the middle ear implant Vibrant Soundbridge (VSB) in patients with moderate-to-severe sensorineural hearing loss up to a mean (± standard deviation) duration of 11.1 ± 2.1 years (min. = 8.2, max. = 13.9, n = 16) after the intervention. Design: This was a retrospective, single-subject repeated-measurements study over a long-term period. A total of 104 German-speaking adults (for 122 implants) were included in this study (54 male, 50 female). The mean age at implantation was 54.5 years (min. = 19.0, max. = 80.4). Audiological outcome and speech intelligibility were assessed in all VSB patients at different time points in non-overlapping groups. Results: Bone conduction (BC) thresholds were preserved after the implantation and no indication was found of an increase over time of the small air-bone gaps introduced by the implantation. BC and air conduction thresholds worsened similarly in both implanted and non-implanted ears over time. The decrease in audiological benefit provided by the VSB was moderate and the Word Recognition Score in quiet conditions at 65 dB SPL was still largely improved with the VSB in the longest observed group. Conclusions: These results confirm that the VSB does not affect the integrity of the inner/middle ear and is still beneficial in long-term follow-up.

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Section: Discussioncontrasting

confidence: 99%

Long-Term Results of Incus Vibroplasty in Patients with Moderate-to-Severe Sensorineural Hearing Loss

et al. 2015

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“…4B] in the case of control experiments with their commercially obtained electromechanical transducer [denoted by them as implantable middle-ear hearing device A (IMEHD-A); the manufacturer was not identified, but as explained below it was probably an FMT]. The present results and those of Rosowski et al [2007] are at variance with the results of Needham et al [2005], who report a statistically significant loading effect of the FMT (MED-EL) which systematically increases with frequency and which for the usual incus location amounts to 8 dB at the highest measured frequency of 5 kHz (their fig. 7, position 1).…”

Section: Acoustic Responsescontrasting

confidence: 38%

Alternative Fixation of an Active Middle Ear Implant at the Short Incus Process

et al. 2013

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Introduction: Since 1996, the preferred approach for positioning the active middle-ear implant Vibrant Soundbridge© is a mastoidectomy and a posterior tympanotomy. With this device, placement of the floating mass transducer (FMT) on the long incus process is the standard method for treatment of mild-to-severe sensorineural hearing loss in the case of normal middle-ear anatomy. The aim of this study was to determine the vibrational effectiveness of FMT placement at the short incus process. Materials and Methods: An extended antrotomy and a posterior tympanotomy were performed in 5 fresh human temporal bones. As a control for normal middle-ear function, the tympanic membrane was stimulated acoustically and the vibration of the stapes footplate and the round-window (RW) membrane were (sequentially) measured by laser Doppler vibrometry. Vibration responses for coupling of an FMT to the long incus process (standard coupling) were compared to those for coupling to the short incus process. Results: Apart from narrow frequency bands near 3 and 9 kHz for the stapes footplate and RW membrane, respectively, the velocity responses presented no significant differences between standard coupling of the FMT and coupling to the short incus process. Conclusion: Coupling the FMT to the short incus process may be a viable alternative in cases where the surgical approach is limited to an extended antrotomy. A reliable technique for attachment to the short incus process has yet to be developed.

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“…However, they currently provide either limited hearing gain or they may induce an additional hearing impairment [Needham et al, 2005] when the system is inactive. Furthermore, treatment of severe mixed hearing loss is the difficult part.…”

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confidence: 99%

A Novel Implantable Hearing System with Direct Acoustic Cochlear Stimulation

et al. 2008

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A new implantable hearing system, the direct acoustic cochlear stimulator (DACS) is presented. This system is based on the principle of a power-driven stapes prosthesis and intended for the treatment of severe mixed hearing loss due to advanced otosclerosis. It consists of an implantable electromagnetic transducer, which transfers acoustic energy directly to the inner ear, and an audio processor worn externally behind the implanted ear. The device is implanted using a specially developed retromeatal microsurgical approach. After removal of the stapes, a conventional stapes prosthesis is attached to the transducer and placed in the oval window to allow direct acoustical coupling to the perilymph of the inner ear. In order to restore the natural sound transmission of the ossicular chain, a second stapes prosthesis is placed in parallel to the first one into the oval window and attached to the patient’s own incus, as in a conventional stapedectomy. Four patients were implanted with an investigational DACS device. The hearing threshold of the implanted ears before implantation ranged from 78 to 101 dB (air conduction, pure tone average, 0.5–4 kHz) with air-bone gaps of 33–44 dB in the same frequency range. Postoperatively, substantial improvements in sound field thresholds, speech intelligibility as well as in the subjective assessment of everyday situations were found in all patients. Two years after the implantations, monosyllabic word recognition scores in quiet at 75 dB improved by 45–100 percent points when using the DACS. Furthermore, hearing thresholds were already improved by the second stapes prosthesis alone by 14–28 dB (pure tone average 0.5–4 kHz, DACS switched off). No device-related serious medical complications occurred and all patients have continued to use their device on a daily basis for over 2 years.

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The Effects of Mass Loading the Ossicles with a Floating Mass Transducer on Middle Ear Transfer Function

Abstract: The floating mass transducer produces a measurable reduction of the stapes displacement in the temporal bone model. The effect is more prominent at high frequencies.

Cited by 67 publications

References 13 publications

Long-Term Results of Incus Vibroplasty in Patients with Moderate-to-Severe Sensorineural Hearing Loss

Long-Term Results of Incus Vibroplasty in Patients with Moderate-to-Severe Sensorineural Hearing Loss

Alternative Fixation of an Active Middle Ear Implant at the Short Incus Process

A Novel Implantable Hearing System with Direct Acoustic Cochlear Stimulation

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