RÉALISATION D'UNE PROTHÈSE D'OREILLE MOYENNE

Nous présentons la conception et la réalisation d'une prothèse complète d'oreille moyenne (remplacement du tympan et de la chaîne ossiculaire). Des considérations de biocompatibilité ont orienté le choix des matériaux. Le tympan artificiel est constitué d'une membrane plane circulaire ou elliptique. Les modes propres de ces membranes sont calculés compte tenu de l'influence des cavités. Les techniques de construction et de caractérisation sont présentées. L'influence de différents paramètres a été étudiée, en particulier le vieillissement et la stérilisation. La réponse des prothèses est comparée à celle de tympans humains. Les résultats cliniques de six implantations sont aussi donnés.We present the design and the realization of a complete middle ear prosthesis (replacement of the eardrum and of the ossicular chain). Biocompatibility considerations have guided the choice of the materials. The artificial eardrum consists of a plane, circular or elliptic membrane. The vibration modes of these membrane have been worked out, considering the influence of the cavities. The characterization and construction technique is detailed. The influence of different parameters has been studied, in particular the aging and the sterilization. The response of the prosthesis is compared to that of the human eardrum. The clinical results of six implantations are also presented

Does the bone-anchored hearing aid have a complementary effect on audiological and subjective outcomes in patients with unilateral conductive hearing loss?

Item does not contain fulltextOBJECTIVES: To study the effect of a bone-anchored hearing aid (BAHA) in patients with unilateral conductive hearing loss. STUDY DESIGN: Prospective evaluation on 18 subjects. METHODS: Aided and unaided binaural hearing was assessed in the sound field using a sound localization test and a speech recognition in noise test with spatially separated sound and noise sources. The patients also filled out a disability-specific questionnaire. PATIENTS: 13 out of the 18 subjects had normal hearing on one side and acquired conductive hearing loss in the other ear. The remaining 5 patients had a unilateral air-bone gap and mild symmetrical sensorineural hearing loss. RESULTS: Sound localization with the BAHA improved significantly. Speech recognition in noise with spatially separated speech and noise sources also improved with the BAHA. Fitting a BAHA to patients with unilateral conductive hearing loss had a complementary effect on hearing. Questionnaire results showed that the BAHA was of obvious benefit in daily life. CONCLUSIONS: The BAHA proved to be a beneficial means to optimize binaural hearing in patients with severe (40-60 dB) unilateral conductive hearing loss according to audiometric data and patient outcome measures