Loads and Coupling Modalities Influence the Performance of the Floating Mass Transducer as a Round Window Driver.

Hypothesis: High loads forcing the floating mass transducer (FMT) of a single active middle ear implant toward the round window membrane (RWM) affect the backward stimulation of the cochlea. Background: Various factors influence the backward stimulation of the cochlea. We investigated the effects of various loads applied to the FMT together with different coupling techniques at the fully exposed RWM on the vibration transmission. Methods: Experimental study on temporal bones with the FMT linked to a load cell mounted on a translation stage moving it against the fully exposed RWM with increasing loads up to 200 mN by itself, with interposed perichondrium, cartilage or connected to the round window coupler. Cochlear stimulation is measured by the volume velocities of the stapes footplate using LASER-Doppler-vibrometry. Results: Loads ranging from 5 to 20 mN induce the highest volume velocities of the stapes footplate. Increasing loads decrease the transmission of vibration in the low-frequency range but enhance the transmission of high frequencies. The interposition of perichondrium and cartilage proved to be advantageous. Conclusion: The load applied to the FMT distinctly affects the backward stimulation of the cochlea. Although increasing loads have inverse effects on the transmission of low and high frequencies, high loads lead to an overall decrease of cochlear stimulation. Out of the applied coupling techniques interposed perichondrium and cartilage allow for the most efficient stimulation. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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