Wils Irina, Geerardyn Alexander, Fierens Guy, Putzeys Tristan, Denis Kathleen, Verhaert Nicolas
Department of Neurosciences, Research Group Experimental Oto-rhino-laryngology, KU Leuven, Leuven, B3000, Belgium.
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, B3000, Belgium.
Sci Rep. 2024 Dec 2;14(1):29943. doi: 10.1038/s41598-024-81505-9.
Bone conduction implants enable patients to hear via vibrations transmitted to the skull. The main constraint of current bone conduction implants is their maximum output force level. Stimulating closer to the cochlea is hypothesized to increase efficiency and improve force transfer, addressing this limitation. This study evaluated stimulation at four positions in human cadaveric specimens: the cochlear promontory, the posterior wall of the outer ear canal, the lateral semi-circular canal, and the standard Bone-Anchored Hearing Aid (Baha) location. To assess potential hearing sensation, three objective measures were simultaneously recorded. For intracochlear pressure and promontory velocity, stimulating at the lateral semi-circular canal and promontory results in the highest response, with a gain of up to 20 dB. Ear canal pressure shows less conclusive results, with significant differences at only a few frequencies. These findings suggest that stimulation closer to the cochlea offers higher efficiency, which could benefit patients needing higher output force levels than currently available or those eligible for electro-vibrational stimulation, e.g. a cochlear implant combined with a bone conduction device.
骨传导植入物使患者能够通过传递到颅骨的振动来听到声音。当前骨传导植入物的主要限制是其最大输出力水平。据推测，在更靠近耳蜗的位置进行刺激可提高效率并改善力的传递，从而解决这一限制。本研究评估了在人类尸体标本中的四个位置进行刺激的情况：耳蜗岬、外耳道后壁、外侧半规管以及标准骨锚式助听器（Baha）的位置。为了评估潜在的听觉感受，同时记录了三种客观测量指标。对于耳蜗内压力和岬部速度，在外侧半规管和岬部进行刺激会产生最高的反应，增益可达20分贝。耳道压力的结果不太明确，仅在少数频率上存在显著差异。这些发现表明，更靠近耳蜗的刺激具有更高的效率，这可能使需要比目前更高输出力水平的患者或适合电振动刺激的患者（例如，将耳蜗植入物与骨传导装置相结合的患者）受益。
