Wagner Luise, Hönig Elisabeth, Fröhlich Laura, Plontke Stefan, Rahne Torsten
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Halle (Saale), Martin-Luther-University Halle-Wittenberg, Germany.
Otol Neurotol. 2019 Jun;40(5):e482-e487. doi: 10.1097/MAO.0000000000002201.
Audio processor magnets used in transcutaneous active hearing implants vary in retention force. We hypothesized that a range of optimal magnetic retention forces could be derived, based on objective in-situ measurements of individual retention forces.
The magnetic force required to retain the proper placement of transcutaneous active hearing implants varies among patients. Currently, audiologists rely on personal experience in deciding which magnet to use. Insufficient force causes frequent loss of the single-unit processors or external coils of behind-the-ear devices, and excessive force causes pain and skin irritations.
We experimentally determined magnetic retention force as a function of the distance between two magnets for different processor-implant magnet combinations. In addition, we studied individual in situ retention forces in 100 patients with hearing devices. Skin status was evaluated by a physician and assessed by patient self-reporting and a questionnaire.
Force-distance functions showed that different magnet strengths had differential effects only at distances less than 6 mm. Examiner and patient skin status assessments and comfort scores showed that optimal retention force range was 0.23 to 0.4 N.
We found that the currently available magnet types restrict the range of feasible skin flap thicknesses to a maximum of 6 mm. Further we conclude that retention forces between 0.23 and 0.4 N could provide the appropriate trade-off between the risk of losing device fixation and of causing skin irritations. We recommend measuring the retention force in all patients.
经皮有源听力植入设备中使用的音频处理器磁体在保持力方面存在差异。我们假设,基于对个体保持力的客观原位测量,可以得出一系列最佳磁保持力。
保持经皮有源听力植入设备正确位置所需的磁力在患者之间有所不同。目前,听力学家依靠个人经验来决定使用哪种磁体。磁力不足会导致耳后设备的单单元处理器或外部线圈频繁丢失,而磁力过大则会导致疼痛和皮肤刺激。
我们通过实验确定了不同处理器-植入磁体组合的磁保持力与两个磁体之间距离的函数关系。此外,我们研究了100名佩戴听力设备患者的个体原位保持力。由医生评估皮肤状况,并通过患者自我报告和问卷调查进行评估。
力-距离函数表明,不同的磁体强度仅在距离小于6毫米时具有不同的影响。检查者和患者的皮肤状况评估以及舒适度评分表明,最佳保持力范围为0.23至0.4牛。
我们发现,目前可用的磁体类型将可行的皮瓣厚度范围限制在最大6毫米。此外,我们得出结论,0.23至0.4牛之间的保持力可以在设备固定丢失风险和引起皮肤刺激之间提供适当的权衡。我们建议对所有患者测量保持力。