Fully implantable hearing aid in the incudostapedial joint gap

Effects of Astragaloside IV on Hearing, Inflammatory Factors, and Intestinal Flora in Mice Exposed to Noise

Long-term exposure to noise can cause irreversible hearing loss. Considering that there is no effective drug treatment, it is important to seek preventive treatment for noise-induced hearing loss (NIHL). Although astragaloside IV (AS-IV) protects against NIHL by reducing serum inflammatory factors, there is scarce information on the regulation of inflammatory factors by AS-IV to prevent NIHL. We investigated the hearing thresholds and relationship between the serum levels of inflammatory cytokines and intestinal microbiota of c57bl/6j mice exposed to noise (103 dB SPL 4 h·d-1) for 7 days, treated with or without AS-IV. Our results revealed a lower hearing threshold and lower serum levels of TNF-α, TNF-γ, IL-6, IL-1β, and IFN-γ in the mice treated with AS-IV. Additionally, AS-IV increased the abundance levels of the phylum Firmicutes, class Bacillus, order Lactobacillus, and family Lactobacillus (p < 0.05), and decreased those of the phylum Bacteroidetes and order Bacteroidales (p < 0.05). Lactobacillus and Bacilli negatively correlated with TNF-α, TNF-γ, and IL-1β; Erysipelotrichaceae negatively correlated with INF-γ; and Clostridiales positively correlated with IL-1β. In conclusion, AS-IV reduces the elevation of hearing thresholds in mice, preventing hearing loss in mice exposed to noise, and under the intervention of AS-IV, changes in the levels of inflammatory factors correlate with intestinal flora. We suggest that AS-IV improves intestinal flora and reduces inflammation levels in c57bl/6j mice exposed to noise.

A microelectromechanical system (MEMS) capacitive accelerometer-based microphone with enhanced sensitivity for fully implantable hearing aid: a novel analytical approach

The present work proposes a novel, compact, intuitively simple and efficient structure to improve the sensitivity of a microelectromechanical system (MEMS) capacitive accelerometer using an arrangement of microlever as a displacement amplifier. The accelerometer is proposed to serve as a microphone in the fully implantable cochlear prosthetic system which can be surgically implanted at the middle ear bone structure. Therefore, the design parameters such as size, weight and resonant frequency require deliberation. The paper presents a novel analytical model considering the impact of the mechanical amplification along with the width of the microlever and the capacitive fringe effects on the performance of the sensor. The design is simulated and verified using COMSOL MULTIPHYSICS 4.2. The accelerometer is designed within a sensing area of 1 mm2 and accomplishes a nominal capacitance of 4.85 pF and an excellent sensitivity of 5.91 fF/g.

Sensor-actuator component for a Floating Mass Transducer-based fully implantable hearing aid

We propose a novel system based on the Floating Mass Transducer (FMT) to be used as the active component of a fully implantable, Vibrant Soundbridge-like middle ear implant. The new system replaces the external microphone used in the currently available design with an implantable piezoelectric sensor that is inserted into the incudostapedial joint and picks up the vibrations transmitted to the long process of the incus. The FMT is coupled to the round window of the cochlea. We characterize the system by measuring the gain in intracochlear sound pressure using laser Doppler vibrometry at a surgically installed "third window" into the cochlea of six temporal bones. Closed-loop feedback oscillations limit the system's available output. We show that using an adaptive control algorithm, a mean functional gain of up to 40 dB is achieved, which is similar to Soundbridge functional gain. The concept matches the FMT's one-point fixation philosophy and offers several advantages over other designs, namely an easy and time-efficient surgery, reversibility of implantation, and natural hearing for the prospective patient.

Static and dynamic forces in the incudostapedial joint gap

Dynamic pressure at the tympanic membrane is transformed and subsequently transferred through the ossicular chain in the form of forces and moments. The forces are primarily transferred to the inner ear. They are transferred partly to the stapedial annular ligament which exhibits non-linear behavior and stiffens for larger static forces. In unventilated middle ears, static pressure is additionally transferred to the ossicles. The purpose of this study was to measure the force inside the ossicular chain as a physiological parameter. We determined the forces which act for dynamic sound transmission and for static load on the ossicular chain. The study is the first one which introduces these forces. The static forces have direct impact on clinically relevant questions for middle ear reconstructions with passive or active prosthesis. The dynamic forces have an impact on the development of middle ear sensors. Quasi-static forces in the incudostapedial joint (ISJ) gap were measured with two different sensor types in 17 temporal bones. The sensing elements, a single crystal piezo and a strain gauge element for validation, were bonded to a thin flexible titanium plate and encapsulated in a titanium housing to allow the acquisition of the applied force signal inside the ossicular chain. Dynamic forces were measured in 11 temporal bones with the piezo sensor. We measured a static force of 23 mN in the ISJ after sensor insertion. The mean force for dynamic physiological acoustic excitation from 250 Hz to 6 kHz was 26 μN/Pa. If the tympanic membrane is loaded with a static pressure, the static force in the ISJ increases up to 1 N for a maximum static pressure load scenario of 30 kPa.

Sensitivity enhancement of a folded beam MEMS capacitive accelerometer-based microphone for fully implantable hearing application

The present work attempts to enhance the sensitivity of a folded beam microelectromechanical systems (MEMS) capacitive accelerometer by optimising the device geometry. The accelerometer is intended to serve as a microphone in the fully implantable hearing application which can be surgically implanted in the middle ear bone structure. For the efficient design of the accelerometer as a fully implantable biomedical device, the design parameters such as size, weight and resonant frequency have been considered. The geometrical parameters are varied to obtain the optimum sensitivity considering the design constraints and the stability of the structure. The optimised design is simulated and verified using COMSOL MULTIPHYSICS 4.2. The stability of the device is ensured using eigenfrequency analysis. Optimised results of the device geometry are presented and discussed. The accelerometer has a sensing area of 1 mm2 and attains a nominal capacitance of 5.3 pF and an optimum sensitivity of 6.89 fF.