Totally implantable middle ear device for rehabilitation of sensorineural hearing loss: preliminary experience with the Esteem®, Envoy

Barbara, Maurizio; Manni, Vanessa; Monini, Simonetta

doi:10.1080/00016480802593505

Cited by 34 publications

(28 citation statements)

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“…Recently, active middle ear implants (AMEI) have been developed to overcome these problems [Kasic and Fredrickson, 2001;Jenkins et al, 2004Jenkins et al, , 2007Jenkins et al, , 2008. The floating mass transducer of the Vibrant Soundbridge from Med-El (Innsbruck, Austria), the Middle Ear Transducer TM from Otologics LLC (Boulder, Colo., USA) and the Esteem 2 (Envoy Medical, St. Paul, Minn., USA) are three commercially available AMEI for the treatment of moderate-to-severe sensorineural hearing loss in adults [Kasic and Fredrickson, 2001;Sterkers et al, 2003;Jenkins et al, 2004Jenkins et al, , 2007Jenkins et al, , 2008; Barbara et al, 2009]. Some of these devices have been applied in conductive or mixed hearing loss therapy [Colletti et al, 2006;Siegert et al, 2007;Venail et al, 2007;Hüttenbrink et al, 2008;Tringali et al, 2008Tringali et al, , 2009Beltrame et al, 2009;Lefebvre et al, 2009;Martin et al, 2009] but none are currently FDA approved for this application.…”

Section: Introductionmentioning

confidence: 99%

Round Window Membrane Implantation with an Active Middle Ear Implant: A Study of the Effects on the Performance of Round Window Exposure and Transducer Tip Diameter in Human Cadaveric Temporal Bones

Tringali

Koka²,

Devèze

et al. 2010

Audiol Neurotol

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Objectives: To assess the importance of 2 variables, transducer tip diameter and resection of the round window (RW) niche, affecting the optimization of the mechanical stimulation of the RW membrane with an active middle ear implant (AMEI). Materials and Methods: Ten temporal bones were prepared with combined atticotomy and facial recess approach to expose the RW. An AMEI stimulated the RW with 2 ball tip diameters (0.5 and 1.0 mm) before and after the resection of the bony rim of the RW niche. The RW drive performance, assessed by stapes velocities using laser Doppler velocimetry, was analyzed in 3 frequency ranges: low (0.25–1 kHz), medium (1–3 kHz) and high (3–8 kHz). Results: Driving the RW produced mean peak stapes velocities (H_EV) of 0.305 and 0.255 mm/s/V at 3.03 kHz, respectively, for the 1- and 0.5-mm tips, with the RW niche intact. Niche drilling increased the H_EV to 0.73 and 0.832 mm/s/V for the 1- and 0.5-mm tips, respectively. The tip diameter produced no difference in output at low and medium frequencies; however, the 0.5-mm tip was 5 and 6 dB better than the 1-mm tip at high frequencies before and after niche drilling, respectively. Drilling the niche significantly improved the output by 4 dB at high frequencies for the 1-mm tip, and by 6 and 10 dB in the medium- and high-frequency ranges for the 0.5-mm tip. Conclusion: The AMEI was able to successfully drive the RW membrane in cadaveric temporal bones using a classical facial recess approach. Stimulation of the RW membrane with an AMEI without drilling the niche is sufficient for successful hearing outputs. However, the resection of the bony rim of the RW niche significantly improved the RW stimulation at medium and higher frequencies. Drilling the niche enhances the exposure of the RW membrane and facilitates positioning the implant tip.

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Section: Introductionmentioning

confidence: 99%

Round Window Membrane Implantation with an Active Middle Ear Implant: A Study of the Effects on the Performance of Round Window Exposure and Transducer Tip Diameter in Human Cadaveric Temporal Bones

Tringali

Koka²,

Devèze

et al. 2010

Audiol Neurotol

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“…The speech processor and non-rechargeable battery are hermetically sealed within titanium casing [18]. The sensor is attached to the incus and acts as the system's microphone, using input from the tympanic membrane [19]. The driver is connected to the stapes.…”

Section: System Componentsmentioning

confidence: 99%

“…Surgery has been reported as having a steep learning curve indicated by the time spent in the operating room, with reports ranging from *4-8 h [16,18,19]. Surgery includes a mastoidectomy and epitymanpanectomy to ensure enough room for the device components.…”

Section: Surgery and Outcomesmentioning

confidence: 99%

Implantable Hearing Devices

Kozlowski

Friedland

2014

Curr Surg Rep

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There are many barriers that prevent the use of traditional acoustic amplification including anatomic and medical conditions and patient preference. Implantable hearing devices typically avoid the use of the ear canal and can overcome many of these barriers. Current options include partially and fully implantable devices, devices that make use of bone conduction, devices that directly couple to the ossicular chain, and those that provide more direct cochlear stimulation. This article reviews the major devices that are currently available or in development providing information regarding clinical indications, device components, the general surgical procedure, and typical outcomes. This review should help the clinician understand device options to fit specific patient anatomy and amplification needs.

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“…Outro modelo de IOM totalmente implantável é o Esteem  (Envoy), no qual a captação do sinal acústico dá-se por um sensor piezoelétrico conectado diretamente à bigorna, e a estimulação é feita por um atuador também piezoelétrico ligado ao estribo. Neste caso, o papel do microfone é desempenhado pelo conjunto formado pela membrana timpânica e o transdutor piezoelétrico, o que proporciona um sinal acústico de maior qualidade devido às propriedades naturais da orelha externa e média (Barbara et al, 2009;Chen et al, 2004). No caso do Esteem, o sistema é alimentado por baterias cuja reposição deve ser feita a cada 5 a 9 anos, dependendo do modelo e variando de um paciente para outro, através de cirurgia ambulatorial (Green, 2011).…”

Section: Implantes De Orelha Médiaunclassified

Implantes cocleares: aspectos tecnológicos e papel socioeconômico

Tefili

Barrault

Ferreira³

et al. 2013

RBEB

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Resumo Introdução: O grande número de defi cientes auditivos faz da perda auditiva um sério problema social, econômico e de saúde pública. Próteses auditivas e implantes cocleares representam os principais dispositivos utilizados como paliativos por pessoas com defi ciência auditiva, sendo que os implantes cocleares são muitas vezes a única opção nos casos de defi ciência auditiva severa e profunda. Nesse artigo discute-se de maneira geral os diferentes aspectos envolvendo implantes cocleares, tanto de âmbito tecnológico como seu papel socioeconômico. Métodos: Baseado em dados do SUS, IBGE e outras fontes, um levantamento qualitativo e quantitativo é feito pela primeira vez especifi camente para a população brasileira. O artigo discute ainda o estado da arte das tecnologias envolvidas no implante coclear, com base em literatura científi ca e informações de fabricantes, bem como as perspectivas para as próximas gerações de implantes cocleares. Conclusão: Há potencial e demanda para evoluções nos implantes atuais. A implantação precoce é benéfi ca para pacientes e sociedade, compensando os custos econômica e socialmente. No entanto, as políticas públicas de reabilitação necessitam se adequar para atender com efi cácia à crescente população afetada pela defi ciência auditiva.Palavras-chave Implante coclear, Processamento de sinais, Defi ciência auditiva severa e profunda, Impacto socioeconômico. Cochlear implants: technological aspects and socioeconomic role

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Totally implantable middle ear device for rehabilitation of sensorineural hearing loss: preliminary experience with the Esteem®, Envoy

Cited by 34 publications

References 1 publication

Round Window Membrane Implantation with an Active Middle Ear Implant: A Study of the Effects on the Performance of Round Window Exposure and Transducer Tip Diameter in Human Cadaveric Temporal Bones

Round Window Membrane Implantation with an Active Middle Ear Implant: A Study of the Effects on the Performance of Round Window Exposure and Transducer Tip Diameter in Human Cadaveric Temporal Bones

Implantable Hearing Devices

Implantes cocleares: aspectos tecnológicos e papel socioeconômico

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