The International Center for Atresia Microtia Repair
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Device Options

Bone Conduction:

In almost all cases of AM, the inner ear is normally formed and the hearing nerve function is present. The hearing loss produced by lack of an ear canal and eardrum can be ‘bypassed’ with vibrations in the bone surrounding the inner ear which in turn stimulates the hearing nerve. Normal sound thresholds and quality is possible with these technologies. The bone can be stimulated with implanted abutments, vibrating internal devices, vibrating magnets or even via connecting a vibration producing dental appliance to a tooth. At times, this technology is used temporarily until an ear canal can be constructed and in other cases, bone conduction can be used throughout life to provide a hearing solution.

2013 Atresia Microtia Conference Lecture on Bone Conduction Devices:

2013 Atresia Microtia Conference - Balaker from CEI Medical Group on Vimeo.

Non-Surgically Implanted Bone Conduction Hearing Devices

Surface Bone Conduction (non-surgically implanted): some varieties of these hearing devices receive the sound with a microphone and change the signal into vibrations. with these vibrations, the inner ear can be stimulated allowing patient to hear when the normal channel of the ear canal is not present. in this fashion, sound waves can bypass the congenital lack of an ear canal and eardrum and stimulate the normally functioning hearing nerve directly. These devices can be used from several months of age onward. The hearing received may allow for normal speech, language and brain development. Some children use this technology until an ear canal is made while others continue to use this technology throughout life if they are not good candidates for creation of an ear canal.

Soft Band BAHA:

For more information about the BAHA please visit: Cochlear Website

Ponto:

For more information about the Ponto, please visit: Oticon Website


Surgically Implanted Hearing Devices:

BAHA: A surgically implanted abutment is placed in the bone behind and above the ear and allowed to heal for several weeks to months. After healing a processor that receives sound is placed which receives sound, turns it in to a vibration releasing it to the implanted post and through bone vibration is transmitted to the inner ear allowing stimulation of the hearing nerve. As the first technology in the bone conduction classification, more patients have this device worldwide than others.

For more information about the BAHA please visit: Cochlear Website

Ponto: Nearly identical to the BAHA, this device utilizes a surgically implanted abutment is placed in the bone behind and above the ear and allowed to heal for several weeks to months. After healing a processor that receives sound is placed which receives sound, turns it in to a vibration releasing it to the implanted post allowing stimulation of the hearing nerve.

For more information about the Ponto please visit: Oticon Website

Sophono: To place this device, surgeons place an implantable magnet in the bone of the skull under the skin which is held in place with screws. After healing, a hearing aid, which also contains and is held on by magnets, is placed over the implanted magnets. Sounds is transmitted through the skin as vibrations which is transmitted through bone to the hearing nerve producing hearing.

For more information about the Sophono please visit: Sophono Device Site

Vibration Inducing Devices:

These devices are attached to the inner ear by connecting to the middle ear bones or a window to the inner ear both of which allow vibrations to be passed directly to the fluid of the inner ear, stimulating the hearing nerve.

MedEl Vibrant SoundBridge (VSB): This surgically implanted device is located under the scalp with a wire feeding to a small vibrating component which is attached during surgery to the provide vibrations to the inner ear. It offers that advantage of not having anything coming through the skin as the microphone, battery, and speech processor are worn on the scalp to be held in position over the implanted device with magnetic attraction.

Alternative placement of the floating mass transducer in implanting the MED-EL Vibrant Soundbridge (PDF)

For more information about the SoundBridge please visit: MedEl Website

Dr. Geoffrey Ball and Dr. Joseph Roberson worked together early in their training at Stanford University where Dr. Ball went on to become a medical inventor and Dr. Roberson went on to become a surgeon. The roots of this technology traces back to that laboratory where they worked together.

Future:

MedEl BoneBridge: also invented by Dr. Geoff Ball, this device allows bone conduction with completely under the skin location. Nothing comes through the skin and a processor identical to the Vibrant SoundBridge is worn. FDA trials in the USA are expected in the near term. The device is currently being used in Europe with promising results.

Med-El Bone Bridge from CEI Medical Group on Vimeo.

Hearing Aids:

To use a hearing aid, an ear canal must be present. In some patients who have surgery but hearing does not improve as much as desired, a hearing aid can be used to augment the hearing into the normal range. Several types of hearing devices are available and the canal status and outer ear presence or absence determines what type of devices are applicable. New devices allow use of a hearing aid without a tight mold in the ear canal – known as open canal hearing aids. Approximately 10% of patients use this technology and in some cases, the option to use a hearing aid is superior to a surgically implanted hearing device.

For more information about hearing aids please visit: Global Hearing – Hearing Device Center Website

 


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