Lehner R, Maassen M M, Leysieffer H, Plester D, Zenner H P
Universitätsklinik für Hals-Nasen-Ohrenheilkunde Tübingen.
HNO. 1998 Jan;46(1):27-37. doi: 10.1007/s001060050193.
Development and short-term implantation results of the Tübingen implantable hearing aid (TI = Tübingen implant) have been presented. The TI is designed for patients with sensorineural hearing loss due to a malfunction of the cochlear amplifier. This can be identified by the presence of positive recruitment and the absence of TEOAE (transitory evoked otoacoustic emissions). The Tübingen implant functions in two ways: it allows electronic amplification of the auditory signal and electromechanical signal transduction into a micromechanical vibratory stimulus. There are two paths by which vibratory stimulus reaches the cochlea: (1) directly through a perforation in the stapes foot plate into the perilymph or (2) via the ossicular chain. Made of pure titanium, the casing of the helium-tight welded transducer includes the piezoelectric actuator. An implantable manipulator device is designed for transducer positioning and anchoring in the mastoid cavity. Usually, the transducer probe tip is directly coupled to the body of the incus. This functions without a special coupling device by utilization of an Erbium-YAG laser. Special anatomical situations or the loss of incus and/or stapes suprastructure, however, requires coupling of the vibratory signal to other points of the ossicular chain or to the perilymph. A major problem, however, was an intraoperative, irreversible link between the titanium probe tip and coupling elements. To overcome this problem, the coupling elements were made of gold. A crimp technique was developed, allowing the surgeon to induce cold deformation of the gold. The cold deformation technique (crimp) results in an irreversible coupling between the titanium probe tip and the golden coupling element.
图宾根植入式助听器（TI = 图宾根植入体）的研发及短期植入结果已被公布。TI专为因耳蜗放大器故障导致感音神经性听力损失的患者设计。这可通过阳性重振的存在和瞬态诱发耳声发射（TEOAE）的缺失来识别。图宾根植入体有两种工作方式：它能对听觉信号进行电子放大，并将机电信号转换为微机械振动刺激。振动刺激通过两条路径到达耳蜗：（1）直接通过镫骨底板的穿孔进入外淋巴，或（2）经由听骨链。氦气密封焊接换能器的外壳由纯钛制成，包括压电致动器。一种可植入的操纵装置被设计用于将换能器定位并固定在乳突腔中。通常，换能器探头尖端直接与砧骨主体相连。这通过使用铒钇铝石榴石激光在无需特殊耦合装置的情况下发挥作用。然而，特殊的解剖情况或砧骨和/或镫骨上部结构的缺失，需要将振动信号耦合到听骨链的其他点或外淋巴。然而，一个主要问题是钛探头尖端与耦合元件在术中形成了不可逆的连接。为克服这个问题，耦合元件由金制成。开发了一种压接技术，使外科医生能够使金产生冷变形。冷变形技术（压接）导致钛探头尖端与金耦合元件之间形成不可逆的连接。
