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Active middle ear implants

Mario Cebulla, Ute Geiger, Rudolf Hagen, Andreas Radeloff
OBJECTIVE: Active middle ear implants are widely used to treat adults and children with sensorineural, conductive, or mixed hearing loss. Currently, there is no adequate method to determine the performance of active middle ear implant systems. DESIGN: The proposed method is based on measuring the auditory brainstem response while stimulating the hearing system via the active middle ear implant (Vibrant Soundbridge(TM), VSB; MEDEL, Austria). The acoustic stimulation was achieved via an optimised chirp stimulus (CE-Chirp), implemented in the Eclipse system (Interacoustics, Denmark)...
April 19, 2017: International Journal of Audiology
Alexander Müller, Parwis Mir-Salim, Nina Zellhuber, Ralf Helbig, Marc Bloching, Tobias Schmidt, Sven Koscielny, Oliver C Dziemba, Stefan K Plontke, Torsten Rahne
OBJECTIVE: The efficiency of vibroplasty (coupler-floating mass transducer [FMT] assembly) can be monitored by direct stimulation of the inner ear through the active middle-ear implant system and comparison of the vibroplasty in vivo threshold and the postoperative bone-conduction pure-tone threshold. The aim of this study was to compare the vibroplasty in vivo threshold with the postoperative speech recognition in patients with a high preoperative maximum word recognition score. STUDY DESIGN: Retrospective cohort study of German-speaking patients implanted with a vibrating ossicular prosthesis (VORP) 502 or VORP 503 and high preoperative maximum word recognition score between the years of 2011 and 2015...
April 5, 2017: Otology & Neurotology
Markus Pirlich, Andreas Dietz, Sylvia Meuret, Mathias Hofer
In case of audiological and/or anatomical limitations in the provision of conventional hearing aids, semi- or fully-implantable hearing systems represent a modern therapy alternative. These hearing systems are divided according to their mode of action into active middle ear implants when stimulating the auditory ossicles or the round window, into bone conduction devices while stimulating the skull directly, into cochlear implants with direct acoustic stimulation to the cochlea with its auditory nerve and finally into auditory brainstem implants by bridging the peripheral auditory structures...
February 2017: Laryngo- Rhino- Otologie
Anaïs Grégoire, Jean-Philippe Van Damme, Chantal Gilain, Benoit Bihin, Pierre Garin
OBJECTIVE: After 20 years of experience with different types of middle ear implants, we analyzed our database about the Vibrant Soundbridge (VSB) to know the rate of complications, the effect on the residual hearing and the audiometric gain in our center. METHOD: The study was retrospective and included all VSB implants bound to the long process of the incus in our tertiary medical center between january 1999 and february 2015. We observed the effect of surgery on residual hearing by comparing bone and air conduction thresholds before and after implantation...
March 9, 2017: Auris, Nasus, Larynx
Søren Hoberg, Christian Danstrup, Bjarke Laursen, Niels Krintel Petersen, Nichlas Udholm, Gintaras Audrius Kamarauskas, Therese Ovesen
OBJECTIVE: To describe cases of complicated middle ear infections in children with cochlear implants (CI), i.e., episodes of acute otitis media (AOM) and acute mastoiditis (AM), resulting in hospitalization. METHODS: A total of 206 children under 16 years (300 implantations) were implanted between 1 January 2008 and 31 December 2014 at the West Danish CI Center, Department of Otorhinolaryngology Head and Neck Surgery, Aarhus, Denmark. By means of two prospective local databases, episodes of AOM or AM and demographics were retrieved including biochemistry, microbiology, length of follow- up, and variable treatment modalities (intravenous (IV) antibiotics, revision mastoidectomy, and insertion of ventilation tubes)...
February 24, 2017: Cochlear Implants International
Susan Busch, Thomas Lenarz, Hannes Maier
The active middle ear implant Vibrant Soundbridge© provides a variety of coupling modalities of the floating mass transducer (FMT) to various structures of the ossicular chain and the round window. A retrospective analysis was performed on 125 subjects (n = 137 ears) (1) to compare the efficacy of the different FMT coupling modalities with increasing degree of hearing loss, (2) to compare the performance in speech outcome and the effective gain between the coupling types, and (3) to evaluate the risk of additional hearing loss of each coupling procedure...
January 10, 2017: Audiology & Neuro-otology
Philippe P Lefebvre, Javier Gisbert, Domenico Cuda, Stéphane Tringali, Arnaud Deveze
OBJECTIVE: To summarise treatment outcomes compared to surgical and patient variables for a multicentre recipient cohort using a fully implantable active middle ear implant for hearing impairment. To describe the authors' preferred surgical technique to determine microphone placement. STUDY DESIGN: Multicentre retrospective, observational survey. SETTING: Five tertiary referral centres. PATIENTS: Carina recipients (66 ears, 62 subjects) using the current Cochlear® Carina® System or the legacy device, the Otologics® Fully Implantable Middle Ear, with a T2 transducer...
2016: Audiology & Neuro-otology
Simonetta Monini, Alessandra Bianchi, Rita Talamonti, Francesca Atturo, Chiara Filippi, Maurizio Barbara
CONCLUSIONS: The satisfaction rate of the subjects with an auditory implant appears strictly related to the resulting auditory improvement, and the surgical variables would play a prevailing role in respect to the esthetic factors. OBJECTIVES: To assess the rate of satisfaction in subjects who underwent the surgical application of an auditory device at a single Implanting Center Unit. METHOD: A series of validated questionnaires has been administered to subjects who underwent the surgical application of different auditory devices...
December 5, 2016: Acta Oto-laryngologica
Karl-Ludwig Bruchhage, Anke Leichtle, Rainer Schönweiler, Ingo Todt, Wolf-Dieter Baumgartner, Henning Frenzel, Barbara Wollenberg
Introduced in the late 90s, the active middle ear implant Vibrant Soundbridge (VSB) is nowadays used for hearing rehabilitation in patients with mild to severe sensorineural hearing loss (SNHL) unable to tolerate conventional hearing aids. In experienced hands, the surgical implantation is fast done, safe and highly standardized. Here, we present a systematic review, after more than 15 years of application, to determine the efficacy/effectiveness and cost-effectiveness, as well as patient satisfaction with the VSB active middle ear implant in the treatment of mild to severe SNHL...
April 2017: European Archives of Oto-rhino-laryngology
Theodore R McRackan, Jayne B Ahlstrom, William B Clinkscales, Ted A Meyer, Judy R Dubno
OBJECTIVE: To compare word recognition scores for adults with hearing loss measured using earphones and in the sound field without and with hearing aids (HA). STUDY DESIGN: Independent review of presurgical audiological data from an active middle ear implant (MEI) FDA clinical trial. SETTING: Multicenter prospective FDA clinical trial. PATIENTS: Ninety-four adult HA users. INTERVENTIONS/MAIN OUTCOMES MEASURED: Preoperative earphone, aided word recognition scores, and speech intelligibility index...
December 2016: Otology & Neurotology
Jeon Mi Lee, Jinsei Jung, In Seok Moon, Sung Huhn Kim, Jae Young Choi
OBJECTIVES/HYPOTHESIS: We compared the audiologic benefits of active middle ear implants with those of passive middle ear implants with hearing aids in mixed hearing loss, and also compared the outcomes of stapes vibroplasty with those of round window vibroplasty. STUDY DESIGN: Retrospective chart review. METHODS: Thirty-four patients with mixed hearing loss due to chronic otitis media were treated with a middle ear implant. Of these, 15 were treated with a passive middle ear implant (conventional ossiculoplasty with a partial ossicular replacement prosthesis), nine with an active middle ear implant coupling to the stapes, and 10 with an active middle ear implant coupling to the round window...
August 25, 2016: Laryngoscope
Tina L Samuels, Justin Yan, Pawjai Khampang, Alexander MacKinnon, Wenzhou Hong, Nikki Johnston, Joseph E Kerschner
OBJECTIVE: Toll-like receptor signaling activated by bacterial otitis media pathogens in the middle ear has been shown to play a key role in OM susceptibility, pathogenesis and recovery. Recent studies implicate microRNA 146 (miR-146) in regulation of inflammation via negative feedback of toll-like receptor signaling (TLR) in a wide variety of tissues, however its involvement in otitis media is unknown. METHODS: Human middle ear epithelial cells were stimulated with proinflammatory cytokines, interleukin 1 beta or tumor necrosis factor alpha, for two to twenty-four hours...
September 2016: International Journal of Pediatric Otorhinolaryngology
Thomas Zahnert, Hubert Löwenheim, Dirk Beutner, Rudolf Hagen, Arneborg Ernst, Hans-Wilhelm Pau, Thorsten Zehlicke, Hilke Kühne, Natascha Friese, Anke Tropitzsch, Jan-Christoffer Lüers, Robert Mlynski, Ingo Todt, Karl-Bernd Hüttenbrink
OBJECTIVE: To evaluate the safety and effectiveness of round window (RW), oval window (OW), CliP and Bell couplers for use with an active middle ear implant. METHODS: This is a multicenter, long-term, prospective trial with consecutive enrollment, involving 6 university hospitals in Germany. Bone conduction, air conduction, implant-aided warble-tone thresholds and Freiburger monosyllable word recognition scores were compared with unaided preimplantation results in 28 moderate-to-profound hearing-impaired patients after 12 months of follow-up...
June 29, 2016: Audiology & Neuro-otology
Annekatrin Coordes, Linda Jahreiss, Uwe Schönfeld, Minoo Lenarz
After stapes surgery, patients with mixed or moderate hearing loss have limited possibilities for hearing improvement. We are reporting on a patient who underwent stapedotomy bilaterally 20 years ago and had sensorineural and mixed hearing loss. Recurrent otitis externa prevented the use of hearing aids. This patient was treated bilaterally with the Vibrant Soundbridge (Med-El, Innsbruck, Austria) successively. The Schuknecht piston stapes prostheses remained in situ. The Floating Mass Transducer (FMT; Med-El) was coupled to the round window (RW) and provided good acoustic reinforcement bilaterally...
February 2017: Laryngoscope
Johannes Schnabl, Astrid Wolf-Magele, Stefan Marcel Pok, Lena Hirtler, Gertraud Heinz, Georg M Sprinzl
OBJECTIVE: Magnetic resonance imaging (MRI) has become an essential tool of modern medical imaging and disease diagnosis. In November 2014, a new MRI-conditional (up to 1.5 T) generation of an active middle ear implant (AMEI) was released to the market.The aim of the study was to test the MRI compatibility of the new implant system in a clinical-anatomical study. DESIGN: Experimental cadaver head model. SETTING: Temporal bone laboratory...
August 2016: Otology & Neurotology
Viktor Koci, Josef Seebacher, Viktor Weichbold, Patrick Zorowka, Astrid Wolf-Magele, Georg Sprinzl, Kurt Stephan
CONCLUSIONS: Patients, who are bilaterally supplied with active middle ear implants, perform slightly better in sound localization tasks than when unilaterally aided or unaided. OBJECTIVES: To investigate the impact of bilateral use of active middle ear implants on sound source localization in the horizontal plane in patients with a sloping moderate-to-severe hearing loss. METHODS: Ten adults supplied with Med-EL Vibrant Soundbridge systems (VSB) in both ears participated in the study...
July 2016: Acta Oto-laryngologica
Danni Wang, Shouqin Zhao, Qingguo Zhang, Yi Li, Xiaobo Ma, Ran Ren
OBJECTIVES: To report an integrating surgical method of Vibrant SoundBridge (VSB) implant and auricle reconstruction. METHODS: 4 cases of congenital bilateral external/middle ear malformation were enrolled. All of them were diagnosed as bilateral bony atresia and grade III microtia. Stapes vibroplasty was performed for all subjects in one operation with auricle reconstruction stage 3. The clinical information and hearing outcomes were analyzed. RESULTS: Satisfied aesthetic outcomes were confirmed by sculptured outline and symmetric shape on both sides...
July 2016: International Journal of Pediatric Otorhinolaryngology
Kh M Diab, N A Daikhes, Yu B Suleimanov, D S Kondratchikov, K D Yusifov, A R Siraeva
The objective of the present study was to improve the effectiveness of cochlear implantation (CI) in the patients presenting with cochlear-vestibular abnormalities based on the development and practical application of the algorithm for the insertion of an electrode arrayinto the spiral (Rosenthal's) canal of the cochlea taking into consideration the specific anatomical features of the middle and inner ears. The study included 25 patients with congenital malformations of the inner ear and bilateral grade IV sensorineural loss of hearing or deafness selected for CI...
2016: Vestnik Otorinolaringologii
S Volkenstein, J P Thomas, S Dazert
The majority of patients with moderate to severe hearing loss can be supplied with conventional hearing aids depending on severity and cause for hearing loss in a satisfying way. However, some patients either do not benefit enough from conventional hearing aids or cannot wear them due to inflammatory reactions and chronic infections of the external auditory canal or due to anatomical reasons. For these patients there are fully- and semi-implantable middle ear and bone conduction implants available. These devices either directly stimulate the skull (bone conduction devices), middle ear structures (active middle ear implants) or the cochlea itself (direct acoustic stimulation)...
May 2016: Laryngo- Rhino- Otologie
Antoniu Oreste Gostian, David Pazen, Magdalene Ortmann, Andreas Anagiotos, David Schwarz, Karl Bernd Hüttenbrink, Dirk Beutner
HYPOTHESIS: High loads forcing the floating mass transducer (FMT) of a single active middle ear implant toward the round window membrane (RWM) affect the backward stimulation of the cochlea. BACKGROUND: Various factors influence the backward stimulation of the cochlea. We investigated the effects of various loads applied to the FMT together with different coupling techniques at the fully exposed RWM on the vibration transmission. METHODS: Experimental study on temporal bones with the FMT linked to a load cell mounted on a translation stage moving it against the fully exposed RWM with increasing loads up to 200 mN by itself, with interposed perichondrium, cartilage or connected to the round window coupler...
June 2016: Otology & Neurotology
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