The Hannover Coupler: Controlled Static Prestress in Round Window Stimulation With the Floating Mass Transducer

Müller, Mathias; Salcher, Rolf; Lenarz, Thomas; Maier, Hannes

doi:10.1097/mao.0000000000001484

Cited by 16 publications

(28 citation statements)

References 13 publications

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“…Its layout [11] is based on the preceding HC prosthesis design [10]. Different from the preceding prototype, the HCv2 spring is now part of the prosthesis frame to increase robustness.…”

Section: Methodsmentioning

confidence: 99%

“…Like in the previous HC version [10] the prosthesis tip is spherical with a diameter ( d = 0.5 mm) that is well below the typical diameter of the RW membrane [5]. The spring at the prosthesis back, however, is a redesign of the previous HC prototype.…”

Section: Methodsmentioning

confidence: 99%

“…Details of the TB preparation and the measurement setup are described in an earlier publication [10]. …”

Section: Methodsmentioning

confidence: 99%

“…In a previous study of our group [10] we could demonstrate the feasibility of a novel prosthesis for the FMT termed “Hannover Coupler” (HC) that allows for RW stimulation at controlled static RW preloads. Stimulation with the HC showed improved stapes footplate (SFP) displacement at frequencies ≥ 1 kHz at an optimal RW load of 4 mN.…”

Section: Introductionmentioning

confidence: 99%

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Redesign of the Hannover Coupler: Optimized Vibration Transfer from Floating Mass Transducer to Round Window

Müller

Salcher

Prenzler

et al. 2018

BioMed Research International

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Introduction In order to reduce the large variations in clinical outcomes of patients with implanted MED-EL Floating Mass Transducer (FMT) at the round window (RW), several approaches were proposed to optimize FMT-RW coupling. Our previous study showed improved FMT-RW coupling by applying static RW loads utilizing the “Hannover Coupler” (HC) FMT-prosthesis but also demonstrated insufficient low frequency performance. Hence, a redesigned HC version (HCv2) was investigated in this study. Methods Experiments were performed in ASTM F2504-05 compliant fresh human temporal bones. The HCv2 is a FMT-prosthesis redesigned from a previous prototype to specifically improve low frequency performance. Stapes footplate (SFP) displacements in response to acoustic stimulation of the tympanic membrane and to FMT-RW stimulation at varying static force (0–100 mN) were measured by Laser-Doppler vibrometry. Results SFP displacements were highly dependent on the applied RW load and had a global maximum at 15 mN when averaged at speech relevant frequencies (0.5–4 kHz). SFP responses at frequencies ≤ 1 kHz were up to 25 dB higher than responses achieved with the previous HC version. Conclusion Optimizing the HC prosthesis design resulted in improved SFP responses to RW stimulation especially at lower frequencies (≤1 kHz).

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“…Its layout [11] is based on the preceding HC prosthesis design [10]. Different from the preceding prototype, the HCv2 spring is now part of the prosthesis frame to increase robustness.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…Details of the TB preparation and the measurement setup are described in an earlier publication [10]. …”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Redesign of the Hannover Coupler: Optimized Vibration Transfer from Floating Mass Transducer to Round Window

Müller

Salcher

Prenzler

et al. 2018

BioMed Research International

Self Cite

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“…Besides these known causes, manipulations at the round window membrane and around the round window niche in round window vibroplasty with or without a coupler can also cause acoustic damage and efflux of perilymph. Another imaginable cause could be that the preload of the FMT to the round window membrane disturbs tone perception, but this is rather unlikely as it mainly affects low frequencies and requires significant forces [21]. …”

Section: Discussionmentioning

confidence: 99%

The Impact of Two-Stage Subtotal Petrosectomy and Round Window Vibroplasty on Bone Conduction Thresholds

Prenzler

Gruber

Lenarz

et al. 2018

ORL

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Objective: To evaluate possible increases in bone conduction (BC) hearing thresholds in patients undergoing subtotal petrosectomy (SP) with fat obliteration and blind sac closure of the outer ear canal and subsequent round window vibroplasty. Patients and Interventions: Between 1997 and 2013, 43 patients (45 ears) with combined hearing loss and recurrent chronic otitis or status post formation of a radical cavity underwent SP around 6 months prior to implantation of a Vibrant Soundbridge^TM. Pure tone audiograms (0.5, 1, 1.5, 2, 3, 4, and 6 kHz) prior to SP, after SP, prior to implantation, after implantation, and at first fitting around 5 weeks after implantation were collected and statistically analyzed. Results: The comparison between BC thresholds before SP and at first fitting showed an overall decline during the two-step procedure between 2.8 and 6 dB that was significant (p < 0.05, Student t test) at 2, 3, 4, and 6 kHz. Conclusion: In some cases, SP is the only way to eradicate chronic otitis and to achieve a suitable environment for the implantation of active middle ear implants. The present data demonstrate a relatively small but significant decline in BC thresholds throughout the whole procedure. Knowledge of its extent is mandatory for a correct indication for later implantation of a Vibrant Soundbridge^TM.

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The Hannover Coupler V2: Audiological outcomes of a round window coupler for the Vibrant Soundbridge

Knölke

Murawski

Wardenga

et al. 2022

Laryngoscope Investig Oto

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Introduction:The Hannover Coupler version 2 (HC2) was designed to (1) adapt the coupler geometry to the round window (RW) niche (2) to stabilize the floating mass transducer, and (3) to control static coupling forces to the RW. First audiological outcomes with a custom-made HC2 are reported here.Material and Methods: Ten patients were enrolled in our site-initiated, prospective study. To assess audiological outcomes up to 6 months, preoperative and postoperative hearing thresholds, word recognition score (WRS) at 65 dB SPL and the speech recognition threshold in quiet and noise were performed. The effective gain (EG) and the coupling efficiency were calculated.Results: One revision surgery had to be performed during the study period and a significant, but clinically not relevant bone conduction thresholds change was observed at 4 and 6 kHz at 6-month follow-up. At 6 months, the median WRS (n = 10) improved significantly from 0% to 80%. The median speech reception threshold in noise improved significantly from 11.6 to À2.4 dB SNR, and in quiet significantly from 79.6 to 44.4 dB SPL. The average EG of À1.3 dB indicated a closure of the air bone gap. The determined average coupling efficiency of 23.3 dB was within the acceptance range suggested by the manufacturer. Conclusion:For patients with mixed hearing loss and multiple ear surgeries, the HC2 provided good and stable speech recognition results exceeding published results of RW coupling without a coupler or coupling with the RW soft coupler.

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The Hannover Coupler: Controlled Static Prestress in Round Window Stimulation With the Floating Mass Transducer

Abstract: The coupling between FMT and RW membrane was improved by the application of static RW preloads as indicated by increased SFP amplitudes to RW stimulation.

Cited by 16 publications

References 13 publications

Redesign of the Hannover Coupler: Optimized Vibration Transfer from Floating Mass Transducer to Round Window

Redesign of the Hannover Coupler: Optimized Vibration Transfer from Floating Mass Transducer to Round Window

The Impact of Two-Stage Subtotal Petrosectomy and Round Window Vibroplasty on Bone Conduction Thresholds

The Hannover Coupler V2: Audiological outcomes of a round window coupler for the Vibrant Soundbridge

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