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Active middle ear implants-Enhanced efficiency of oval window stimulation with larger piston size
Mohammad Ghoncheh1, Daniel Schurzig2, David Stauske3
1Department of Otolaryngology and Institute of Audioneurotechnology (VIANNA), Hannover Medical School, Hannover, Germany; Cluster of Excellence Hearing4all, Hannover, Germany.
Hearing Research
|August 28, 2025
Summary
Increasing the surface area of oval window couplers (OWCs) significantly enhances sound transmission efficiency for otosclerosis treatment. This study demonstrates larger OWCs provide greater output, though leakage must be considered.
Area of Science:
- Biomedical Engineering
- Otolaryngology
- Auditory Implants
Background:
- Direct piston-stimulation of the oval window (OW) via middle ear implants is a treatment for otosclerosis.
- Current treatments involve stapedotomy or stapedectomy.
- Investigating enhanced transmission efficiency in OW stimulation is crucial for improving hearing restoration.
Purpose of the Study:
- To experimentally determine if increasing the surface area of the actuated piston enhances transmission efficiency in oval window (OW) stimulation.
- To evaluate the impact of different oval window coupler (OWC) sizes on intracochlear pressure differences.
- To develop a numerical model for estimating the output of floating mass transducers (FMTs).
Main Methods:
- Utilized 14 fresh-frozen human cadaveric temporal bones for OWC evaluation.
- Measured intracochlear pressure differences (PSV - PST) using different OWCs (0.38 mm², 1.26 mm², 3.06 mm²).
- Employed a piezoelectric transducer for OWC actuation post-stapedectomy and developed a numerical model for FMT output estimation.
Main Results:
- Larger OWCs (medium and large) demonstrated significantly higher average pressure differences (18 dB and 8 dB, respectively) compared to the small OWC across frequencies (p < 0.05).
- Numerical simulations indicated smaller output differences, highlighting the impact of volume leakage at open gaps post-stapedectomy.
- Significant differences in piston diameters confirmed the influence of OWC size on transmission efficiency.
Conclusions:
- Increasing the surface area of the oval window coupler (OWC) proportionally enhances output efficiency for active stimulation.
- Volume leakage at open oval window gaps is a significant factor influencing transmission efficiency.
- Findings support the use of larger OWCs to improve sound transmission in otosclerosis treatment.
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