Anatomic limitations in implantation of middle ear transducer and carina middle ear implants12

Kontorinis, Georgios; Lenarz, Thomas; Schwab, Burkard

doi:10.1002/lary.21140

Cited by 23 publications

(19 citation statements)

References 13 publications

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“…The volumes of middle ear and mastoid air cells are particularly important before the implantation of the MET or Carina. Kontorinis et al [10] measured the distance between the dura and the superior-posterior wall of the external auditory canal (dura-meatal distance) on the incus projection level. As a result, when the dura-meatal distance is less than 5 mm, MET or Carina implantation is not recommended, and when the dura-meatal distance is smaller than 8 mm, the surgery introduces a high risk of complications [10] .…”

Section: Discussionmentioning

confidence: 99%

“…Kontorinis et al [10] measured the distance between the dura and the superior-posterior wall of the external auditory canal (dura-meatal distance) on the incus projection level. As a result, when the dura-meatal distance is less than 5 mm, MET or Carina implantation is not recommended, and when the dura-meatal distance is smaller than 8 mm, the surgery introduces a high risk of complications [10] . If the patient has a history of surgery because of chronic otitis media with or without cholesteatoma, as our patient had, preoperative computed tomography evaluation is particularly important for evaluating recurrent cholesteatoma [11] .…”

Section: Discussionmentioning

confidence: 99%

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A Novel Way of Stimulation of the Inner Ear via Labyrinthotomy with Fully Implantable Active Middle Ear Implant, Carina

Bayazıt¹,

Tutar²,

Tutar³

et al. 2014

Int Adv Otol

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The aim of this case report is to demonstrate the effectiveness of Carina for the treatment of mixed hearing loss by stimulation of the inner ear via the endosteum of the cochlea.The left ear of a 55-year-old man with bilateral mixed hearing loss was implanted with Carina. Due to absence of middle ear ossicles and oval and round windows, the transducer was coupled with the endosteum of the cochlea. A significant improvement was observed in the pure tone average after Carina application. Carina and a conventional hearing aid yielded similar amplification in the low frequencies (250 Hz to 1 kHz). The functional gain with Carina was better than that with the conventional hearing aid in the middle (2 kHz) and high (4 and 6 kHz) frequencies, by 15dB, 5dB, and 25dB, respectively. Speech reception threshold in the free field was 80 dB HL without the hearing aid, 60 dB HL with the hearing aid, and 50 dB HL with Carina. Two-syllable speech discrimination scores increased to 40% and 56% in noise and quiet, respectively. According to International Outcome Inventory for Hearing Aids questionnaire, the patient scored 24 with the hearing aid and 32 with Carina.Stimulation of the inner ear with Carina though the endosteum of the cochlea seems to be an efficient and alternative way to amplify hearing.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Novel Way of Stimulation of the Inner Ear via Labyrinthotomy with Fully Implantable Active Middle Ear Implant, Carina

Bayazıt¹,

Tutar²,

Tutar³

et al. 2014

Int Adv Otol

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“…Despite the technological progress of the conventional hearing aids, the occlusion of the external ear canal, re-current episodes of otitis externa or ear eczema, problems with fitting in patients with radical cavities and signal distortion result in lack of acceptance in many cases (10,11). The active middle ear implants introduced an alternative option for these patients.…”

Section: Discussionmentioning

confidence: 99%

Oval Window Membrane Vibroplasty for Direct Acoustic Cochlear Stimulation

Schwab

Salcher

Maier

et al. 2012

Otology &Amp; Neurotology

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Section: Introductionmentioning

confidence: 96%

“…HRCT was successfully used in a recent study to demonstrate anatomic limitations in MET implantation [12]. This work represents, at the time of this study, the only one focusing on MET imaging aspects without, though, any referral to the transducer's tip or to possible dislocation [12]. On the other hand, the increased use of digital volume tomography (DVT) in dental surgery introduced alternative applications of this relatively new radiological method in Otology and particularly in middle ear surgery and hearing implantation [10,13,14].…”

Section: Introductionmentioning

confidence: 97%

Controlling the position and the dislocation of the middle ear transducer with high-resolution computed tomography and digital volume tomography: implications for the transducers’ design

Kontorinis

Giesemann

Witt³

et al. 2011

Eur Arch Otorhinolaryngol

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A minimal tip dislocation of the middle ear transducer (MET(®), Otologics Ltd) may result in poor hearing performance. Our objective was to examine if a defined MET dislocation can be diagnosed by high-resolution computed tomography (HRCT) or digital volume tomography (DVT). A human cadaver head was sequentially implanted with different MET tips (incus application) including a ceramic tip (T 1c), a titanium tip (T 1t), a new, thinner titanium tip (T 2), and a spherical titanium tip (Ts). HRCT and DVT studies were performed. Afterward, the tips were pulled back 0.5 mm, so that they were not attached to the incus. HRCT and DVT scans were repeated to identify the dislocation. Using the best plain in HRCT images, the dislocation of the transducer could be measured reliably and reproducibly in half of the cases. In particular, the precise positioning and the dislocation could be identified when T 1t and Ts were implanted, with the Ts showing the best visibility. DVT failed in recognizing the dislocation in all cases. The identification of MET tip's dislocation with HRCT depends on the shape, size, and material of the tip. This knowledge is useful for the design of the implants, as determination of the right position of the middle ear transducer may be proven important for the hearing outcome. In some cases, however, surgical exploration may still be required. Although DVT represents a promising imaging method for the otologists, it can barely help when MET dislocation is suspected.

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Anatomic limitations in implantation of middle ear transducer and carina middle ear implants12

Cited by 23 publications

References 13 publications

A Novel Way of Stimulation of the Inner Ear via Labyrinthotomy with Fully Implantable Active Middle Ear Implant, Carina

A Novel Way of Stimulation of the Inner Ear via Labyrinthotomy with Fully Implantable Active Middle Ear Implant, Carina

Oval Window Membrane Vibroplasty for Direct Acoustic Cochlear Stimulation

Controlling the position and the dislocation of the middle ear transducer with high-resolution computed tomography and digital volume tomography: implications for the transducers’ design

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