CN112533122B - Fixing support of round window excitation type artificial middle ear actuator - Google Patents
Fixing support of round window excitation type artificial middle ear actuator Download PDFInfo
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- H—ELECTRICITY
- H04—ELECTRIC COMMUNICATION TECHNIQUE
- H04R—LOUDSPEAKERS, MICROPHONES, GRAMOPHONE PICK-UPS OR LIKE ACOUSTIC ELECTROMECHANICAL TRANSDUCERS; DEAF-AID SETS; PUBLIC ADDRESS SYSTEMS
- H04R25/00—Deaf-aid sets, i.e. electro-acoustic or electro-mechanical hearing aids; Electric tinnitus maskers providing an auditory perception
- H04R25/60—Mounting or interconnection of hearing aid parts, e.g. inside tips, housings or to ossicles
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F11/00—Methods or devices for treatment of the ears or hearing sense; Non-electric hearing aids; Methods or devices for enabling ear patients to achieve auditory perception through physiological senses other than hearing sense; Protective devices for the ears, carried on the body or in the hand
- A61F11/04—Methods or devices for enabling ear patients to achieve auditory perception through physiological senses other than hearing sense, e.g. through the touch sense
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- H—ELECTRICITY
- H04—ELECTRIC COMMUNICATION TECHNIQUE
- H04R—LOUDSPEAKERS, MICROPHONES, GRAMOPHONE PICK-UPS OR LIKE ACOUSTIC ELECTROMECHANICAL TRANSDUCERS; DEAF-AID SETS; PUBLIC ADDRESS SYSTEMS
- H04R2460/00—Details of hearing devices, i.e. of ear- or headphones covered by H04R1/10 or H04R5/033 but not provided for in any of their subgroups, or of hearing aids covered by H04R25/00 but not provided for in any of its subgroups
- H04R2460/17—Hearing device specific tools used for storing or handling hearing devices or parts thereof, e.g. placement in the ear, replacement of cerumen barriers, repair, cleaning hearing devices
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Otolaryngology (AREA)
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- Acoustics & Sound (AREA)
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Abstract
The invention discloses a fixed support of a round window excitation type artificial middle ear actuator, which comprises a fixed shell, an elastic support, a positioning device and a supporting rear seat, wherein the fixed shell is provided with a first end and a second end; the elastic supports are symmetrically arranged on two sides of the fixed shell and used for adjusting the pose of the actuator, so that the actuator and the round window film are kept on the same axis; the positioning device is arranged at the top of the rear end of the fixed shell and used for adjusting the position of the supporting rear seat so that the supporting rear seat can be pushed in a one-way stepping manner; the supporting rear seat is arranged at the rear end of the fixed shell and provides support for the actuator, so that initial pressure is kept between the actuator and the round window film; in operation, the actuator is mounted in the stationary housing. The actuator is supported and fixed more stably and reliably through a mechanical structure; this actuator fixed bolster can also monitor the initial pressure between actuator and the circle window membrane simultaneously to can realize the more accurate control of this initial pressure through simple operation clinically, avoid the uncontrollable problem of coupling degree between actuator and the circle window membrane.
Description
Technical Field
The invention relates to an auxiliary fixing device for otology operation. More particularly, the present invention relates to a fixing bracket of a round window excitation type artificial middle ear actuator.
Background
Hearing impairment is one of the common diseases affecting human daily life, and is classified into conductive hearing impairment, sensorineural hearing impairment and mixed hearing impairment according to different mechanisms of hearing impairment. With the continuous deepening of otology research and the rapid development of ear microsurgery, most of patients with conductive hearing impairment can improve the hearing through operations, but for sensorineural hearing impairment, the hearing is generally improved by wearing a traditional hearing aid. However, the conventional hearing aid has the problems of small output gain (unable to compensate for high-degree hearing impairment), accompanying acoustic feedback, blocked auditory canal and the like, many patients are unwilling to wear the hearing aid, and people with external auditory canal infection are even unable to wear the hearing aid. Therefore, many research institutes at home and abroad compete to research the implantable hearing aid device, and the artificial middle ear is one of the devices.
The artificial middle ear is mainly composed of four parts, namely a microphone 101, a signal processing module 102, a power supply 103 and an actuator 107 in a fixed body (as shown in figure 1). The actuator 107, which is implanted in the body and excites the tissues in the ear to achieve hearing compensation, is a central component of the artificial middle ear. In the working process of the artificial middle ear, firstly, an external sound signal is collected by the microphone 101, then, the sound signal collected by the microphone 101 is subjected to noise reduction, amplification, filtering and other processing by the signal processing module 102 and then converted into an electric signal, the electric signal is applied to the actuator 107 to be used as a driving source of the actuator 107, the actuator 107 vibrates under the action of the input driving electric signal, and ear tissues (the tympanic membrane 104, the incus 105, the stapes 106 and the like) coupled with the actuator 107 are driven to vibrate, so that a patient can sense the sound. The artificial middle ear is classified into various types, such as an anvil excitation type, a tympanic excitation type, and an incus long process excitation type, according to the difference in which the actuator 107 drives the human ear tissue. These types of artificial middle ear require the patient's ossicular chain to be intact to provide the excitation tissue for the actuator 107. However, many hearing impaired patients are also accompanied by auditory ossicle diseases such as auditory ossicle corrosion and auditory ossicle malformation. This prevents many patients from using the artificial middle ear described above to compensate for hearing impairment. In view of this problem, studies have been made in recent years at home and abroad on round window excitation type artificial middle ear, in which a round window membrane 109 on a cochlea 108 is directly excited by an actuator 107 to compensate for hearing impairment. The excitation mode directly avoids the ossicular chain of the patient and provides a reliable treatment scheme for the patient with the damaged ossicular chain.
At present, an actuator clinically applied to round window excitation is mainly an actuator of an artificial middle ear Vibrant Sound bridge (vibratory acoustic bridge) of Austrian MED-EL company, namely a suspension vibrator (FMT), the self structure of the actuator is a cylinder, and the actuator is usually placed in a bone groove cut by a round window membrane during operation implantation. In the surgical implantation process of the actuator, a facial recess path is usually adopted, the incision position is positioned behind the ear, and the diameter of the opening is smaller; the middle ear cavity space is narrow and small, and the round window is located deep in the ear. Therefore, the implantation environment of the round window excitation type artificial middle ear actuator is complex, and the operation is difficult.
On the other hand, when the actuator is implanted, in order to facilitate the placement of the suspended vibrator, part of bone materials above and behind the round window niche beside the round window membrane are ground, and then the actuator is placed into the expanded bone groove. Because the suspension vibrator actuator is only a cylinder with smooth periphery and does not have a fixing structure, the suspension vibrator actuator is difficult to form stable support and fixation in a sunken pit-shaped space such as an enlarged round window niche groove.
In order to fix the suspension vibrator in the bone groove and achieve a better round window excitation effect, the actuator 107 is mainly fixed clinically by inserting the fascia 202 at the rear end of the actuator and inserting the fascia 202 around the actuator (see fig. 2). However, this fixing method has the following problems:
first, studies have shown that The initial pressure between The actuator 107 and The round window film 109 is kept at 15-20 mN, which is preferable for Hearing compensation (Maier H, Salcher R, Schwab B, et al. The effect of static force on smooth simulation with The direct acoustic complex simulator [ J ]. Hearing stress, 2013, 301: 115) in The above-mentioned method of fixing The actuator, The magnitude of The initial pressure between The actuator and The round window film is controlled by The doctor through subjective experience at The thickness of The fascia 202 inserted at The rear end of The actuator 107 (see FIG. 2), so that The coupling state between The actuator 107 and The round window film 109 cannot be determined, which generally causes a problem of large individual difference in Hearing compensation effect of The patient after implantation of The actuator 107. In addition, since the contact force between the actuator 107 and the round window membrane 109 cannot be determined, the contact force during the implantation process is too large to perforate the round window membrane 109, which causes further conductive hearing loss.
Secondly, the actuator 107 and the round window film 109 are kept on the same axis, which is beneficial to the vibration transmission of the actuator 107, so that the hearing compensation performance of the actuator 107 can be improved, and the position and posture of the actuator 107 are controlled clinically only by the subjective experience of a doctor to control the thickness of the fascia 202 around the actuator 107, which is not beneficial to the position and posture adjustment of the actuator 107.
Addressing the first problem described above, namely the inability to monitor the initial pressure of the actuator 107 against the round window membrane 109, max. florichi et al (patent application No. 201780021486.9) discloses an actuator coupling device with a compression indicator (as shown in fig. 3). The device is installed by clamping the actuator 107, placing it in the bone groove 601 adjacent to the round window membrane 109, and monitoring the initial pressure exerted by the actuator 107 on the round window membrane 109 by the amount of deformation of the compression indicator 302. Although this patent achieves that the initial pressure of the actuator 107 on the round window membrane 109 can be approximately monitored, it requires that the length of the bone groove 601 next to the round window membrane 109 in which the actuator 107 is placed corresponds to the length of the coupling device 301. Considering that the coupling device 301 compression indicator 302 is compressed within 200 microns when the optimal initial pressure is reached, i.e., the length of the bone groove 601 is required to be no less than 200 microns of the length of the coupling device 301, such a small allowable deviation greatly increases the difficulty of surgically cutting the bone groove 601. Furthermore, when the bone groove 601 in which the actuator 107 is placed is longer than the length of the coupling device 301, it is also necessary to plug the fascia 202 behind the coupling device 301 so that the active end of the actuator 107 contacts the round window membrane 109. The actual thickness of the surgically cut fascia is difficult to control precisely on the order of microns, which prevents the compression indicator 302 from being compressed to the optimal position, and thus prevents the actuator 107 from optimally applying the load to the round window membrane 109.
In addition to the above, the actuator coupling device 301 disclosed by Max Freusch et al (patent application No. 201780021486.9) does not contemplate securing the left and right portions of the device within the bone groove 601. The width of the bone groove 601 for placing the actuator 107 cut by the round window film 109 is larger than the width of the coupling device 301 and is more than 1.5 times of the width. The left and right portions of the coupling device 301 are not fixed in the bone groove 601, which may cause the actuator 107 to deflect or even fall off under long-term high-frequency vibration. Both of these occurrences can degrade the hearing compensation performance of the actuator 107 or even cause the actuator 107 to fail.
Disclosure of Invention
In order to overcome the defects of the prior art, the invention provides a fixing bracket of a round window excitation type artificial middle ear actuator, which enables the round window excitation type actuator to get rid of the current application situation that the actuator is roughly fixed by repeatedly plugging fascia at the rear end of the actuator, and provides more stable and reliable support and fixation for the actuator through a mechanical structure. In addition, this actuator fixed bolster can also monitor the initial pressure between actuator and the round window membrane to can realize the more accurate control of this initial pressure through simple operation clinically, avoid the uncontrollable problem of coupling degree between actuator and the round window membrane.
The invention is realized by the following technical scheme: a fixed support of a round window excitation type artificial middle ear actuator comprises a fixed shell, an elastic support, a positioning device and a supporting rear seat;
the elastic supports are symmetrically arranged on two sides of the fixed shell and used for adjusting the pose of the actuator, so that the actuator and the round window film are kept on the same axis;
the positioning device is arranged at the top of the rear end of the fixed shell and used for adjusting the position of the supporting rear seat so that the supporting rear seat can be pushed in a one-way stepping manner;
the supporting rear seat is arranged at the rear end of the fixed shell and provides support for the actuator, so that initial pressure is kept between the actuator and the round window film;
in use, the actuator is mounted in a fixed housing.
Preferably, the elastic support and the fixed shell are connected in a welding mode; the elastic bracket comprises a front elastic bracket and a rear elastic bracket; the front elastic support is self-adaptively deformed in a bone groove drilled by a surgery beside the round window membrane according to a space structure, and a stable transverse support is formed in the bone groove; the back elastic support is arranged at the back end of the fixed shell, and the back end of the back elastic support is propped against the opposite bone wall of the round window film, so that the back end of the front elastic support is prevented from loosening in the high-frequency vibration process to cause the whole loosening of the actuator.
Preferably, the elastic supports comprise two pairs of front elastic supports and one pair of rear elastic supports; the front elastic support is arc-shaped, and the tail end of the front elastic support is provided with a pointed tooth-shaped structure; the rear elastic support is a bent square thin sheet, and the tail end of the rear elastic support is provided with a pointed tooth-shaped structure.
Preferably, the fixed shell is a hollow cylindrical thin shell structure, and an opening is cut on the lower side of the fixed shell along the axial direction of the fixed shell; and a wire guide groove is cut in the middle of the fixed shell at one side or two sides and is communicated with the lower side opening.
Preferably, the supporting rear seat comprises a cantilever support, a supporting column and a guide rod I, the cantilever support is a circular thin sheet, a plurality of cantilevers are cut in the cantilever support, and the supporting column is located in the middle of the cantilever support; the guide rod I is located on the upper side of the cantilever support, a ratchet is arranged on the upper surface of the guide rod I, and the ratchet is deviated to the rear end of the fixed support.
Preferably, the positioning device is a limiting top cover I which is arranged on the upper side of the rear end of the fixed shell and is connected with the fixed shell in a welding mode; the internal shape and size of the welded limiting top cover I are matched with those of the guide rod I, and the guide rod I and the limiting top cover I form a sliding pair and are pushed along the axial direction of the sliding pair; the front end of the limiting top cover I is provided with a backstop sheet, and the backstop sheet can be matched with the ratchet on the upper surface of the guide rod I.
Preferably, the supporting backseat comprises a cantilever support, a supporting column and a guide rod II; the cantilever support is a circular thin sheet, a plurality of cantilevers are cut in the cantilever support, and the support column is located in the middle of the cantilever support; the guide rod II is positioned on the upper side of the cantilever support, and the upper surface of the guide rod II is provided with a ratchet; a rack groove is formed in the middle of the guide rod II and matched with the adjusting gear;
preferably, the device further comprises a load indicator, wherein the load indicator is a thin sheet parallel to the cantilever and arranged at the rear end of the cantilever and used for monitoring the initial pressure between the actuator and the round window film.
Preferably, the positioning device comprises a limiting top cover II, an adjusting knob and an adjusting gear; the limiting top cover II is arranged on the upper side of the rear end of the fixed shell and is connected with the fixed shell in a welding mode, and the front end of the limiting top cover II is provided with a backstop sheet; the middle position of the adjusting knob is provided with a through hole matched with the adjusting knob.
Preferably, the upper side of the adjusting knob is an S-shaped sheet which is convenient to stir, and the lower side of the adjusting knob is provided with a key slot which is matched with the adjusting gear through a key.
Compared with the prior art, the invention provides a fixing bracket of a round window excitation type artificial middle ear actuator, which has the following beneficial effects:
according to the fixing support, the front elastic support and the rear elastic support are symmetrically arranged on two sides of the fixing support, the front elastic support enables the actuator to adaptively deform on the left side wall and the right side wall of a bone groove drilled by an operation beside a round window membrane according to a spatial structure, so that stable support in the transverse direction (parallel to the direction of the round window membrane) is realized in the bone groove, the problem that the actuator inclines in the bone groove because the left side edge and the right side edge are not fixed is avoided, and the actuator is ensured to form stable support; still push up on the round window membrane is to the face bone wall through back elastic support to prevent that preceding elastic support from getting loose at high-frequency vibration in-process rear end and leading to the whole pine of actuator to take off, provide more reliable and stable support for the actuator. In addition, the deformable characteristic of the front elastic support can be adaptive to bone grooves with different space structures, and the cuspid structure at the tail end of the front elastic support can be adaptive to uneven bone walls.
According to the fixing support, the front elastic supports on the two sides can be deformed in a self-adaptive manner, so that the pose of the actuator can be adjusted to a certain degree during implantation, the actuator and the round window film are kept on the same axis, vibration transmission of the actuator is facilitated, and the hearing compensation performance of the actuator is improved.
The fixing support of the invention enables the actuator to be adjusted in a larger range, and has no special high requirement on the size of a bone groove space for cutting and placing the actuator in the operation, thereby avoiding the problem that the actuator connecting device of the invention of the Max, Freund and the like has higher requirement on the size of the bone groove and reducing the operation difficulty; in addition, the actuator no longer adjusts the initial pressure of the actuator acting on the round window membrane by means of inserting fascia of different thicknesses into its rear end, avoiding the surgical need to cut fascia of a specific thickness, and enabling such initial pressure adjustment to be more accurate, so that the initial pressure is optimal.
The fixing support has the function of monitoring the initial pressure, can solve the problem that the initial pressure between the actuator and the round window membrane is uncontrollable, and is beneficial to solving the problem that the individual difference of the hearing compensation effect of a patient is large after the actuator is implanted.
The actuator adopts a translational propulsion mode to establish the contact between the coupling rod and the round window membrane in the implantation process, thereby avoiding the problem of damage to the round window membrane caused by relative rotation between the coupling rod and the round window membrane.
In order to facilitate the adjustment of the initial pressure of the actuator on the round window membrane, the upper end of the round window membrane is provided with a large adjusting knob which is matched with a gear rack mechanism to realize the adjustment. The adjusting knob can be rotated by using common surgical instruments such as forceps and the like clinically, so that the initial pressure between the actuator and the round window membrane is easy to adjust for surgery.
Description of the drawings:
FIG. 1 is a schematic diagram of the working principle of an artificial middle ear;
FIG. 2 is a schematic view of the fixing of a round window excitation actuator in a clinical setting;
FIG. 3 is a schematic view of an actuator coupling device with a compression indicator as disclosed in Max, Freusch et al;
FIG. 4 is a schematic structural view of an assembly according to a first embodiment of the present invention;
FIG. 5 is a schematic diagram of an exploded structure of a first embodiment of the present invention;
figure 6 is a schematic view of the embodiment of the present invention in an enlarged round window niche slot;
FIG. 7 is a schematic structural view of an assembly according to a second embodiment of the present invention;
fig. 8 is an exploded view of the second embodiment of the present invention.
In the figure: 101. microphone 102, signal processing module 103, power supply 104, tympanic membrane 105, incus 106, stapes 107, actuator 108, cochlea 109, round window membrane 201, round window membrane facing bony wall 202, fascia 301, actuator coupling device 302, compression indicator 401, elastic support 402, fixed housing 403, positioning device 404, support backseat 501, anti-retropulsion piece 502, cantilever support 503, support post 504, guide bar i, 505, front elastic support 506, rear elastic support 507, limit cap i, 601, bone slot surgically drilled beside round window membrane 602, coupler 603, lead wire 801, adjustment knob 802, adjustment gear 803, guide bar ii, 804, rack slot 805, load indicator 806, limit cap ii.
The specific implementation mode is as follows:
in order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention. It is to be understood that the embodiments described are only a few embodiments of the present invention, and not all embodiments. All other embodiments, which can be obtained by a person skilled in the art without any inventive step based on the embodiments of the present invention, belong to the scope of the present invention.
Example one
Referring to fig. 4, a fixing bracket of a round window excitation type artificial middle ear actuator comprises a fixing shell 402, an elastic bracket 401, a positioning device 403 and a supporting rear seat 404. Referring to fig. 5 and 6, the fixed housing 402 carries the actuator 107 therein, and has a plurality of elastic supports 401 symmetrically disposed on both sides of the outer portion thereof. The elastic support 401 comprises a front elastic support 505 and a rear elastic support 506, and the front elastic support 505 can be adaptively deformed according to a spatial structure in a bone groove 601 surgically drilled beside the round window membrane 109, so that a stable support is formed in the bone groove 601; the rear elastic support 506 is arranged at the rear end of the fixed shell 402 and the rear end of the rear elastic support is pressed against the opposite bone wall 201 of the round window film 109, so that the rear end of the front elastic support 505 is prevented from loosening during high-frequency vibration to prevent the whole actuator 107 from loosening. The positioning device 403 is disposed on the top of the rear end of the fixed housing 402, and can adjust the position of the supporting rear seat 404 through the guiding rod i 504 of the supporting rear seat 404, so that the supporting rear seat 404 can be pushed forward in a one-way stepping manner. The support rear seat 404 further comprises a cantilever bracket 502, a support column 503 is arranged in the middle of the cantilever bracket 502, and the support column 503 supports the actuator 107 against the rear end thereof; during the forward pushing of the supporting backseat 404, the actuator 107 and the round window membrane 109 generate a reaction force after being coupled to deform the cantilever 502, so that a certain initial pressure is maintained between the actuator 107 and the round window membrane 109.
Referring to fig. 4 and 5, the elastic support 401 includes two pairs of front elastic supports 505 and one pair of rear elastic supports 506. The elastic support 401 and the fixed shell 402 are connected by welding. The front elastic support 505 is arc-shaped, and the end thereof is provided with a pointed tooth-shaped structure. The rear elastic support 506 is a bent square thin sheet, and the tail end of the rear elastic support is provided with a pointed tooth-shaped structure.
Referring to fig. 4 and 5, the stationary housing 402 is a hollow cylindrical thin shell structure, and an opening is cut in the lower side thereof in the axial direction thereof. A wire guide groove is cut in the middle of the fixed housing 402 at a single side or both sides, and is communicated with the lower opening.
Referring to fig. 4 and 5, the support rear base 404 includes a cantilever bracket 502, a support pillar 503, and a guide bar i 504. The cantilever support 502 is a circular thin plate with several cantilevers cut into it and the support post 503 is located in the middle. The guide rod I504 is located on the upper side of the cantilever support 502, a ratchet is arranged on the upper surface of the guide rod I504, and the ratchet is deviated to the rear end of the fixed support.
Referring to fig. 4 and 5, the positioning device 403 is a limiting top cover i 507, which is disposed on the upper side of the rear end of the fixed housing 402 and is connected to the fixed housing 402 by welding. The internal shape and the size of the welded limiting top cover I507 are matched with those of the guide rod I504, and the guide rod I504 and the limiting top cover I507 form a sliding pair and can be pushed along the axial direction of the sliding pair. The front end of the limiting top cover I507 is provided with a backstop sheet 501, and the backstop sheet 501 can be matched with a ratchet on the upper surface of the guide rod I504.
The working principle and the working process are as follows:
fig. 6 is a schematic view of the fixing bracket and the actuator 107 implanted in the bone groove 601 drilled by the surgery beside the round window membrane 109. The using method comprises the following steps: the fixed bracket is assembled according to fig. 4, the coupler 602 is installed on the actuator 107, then the actuator 107 is inserted from the front end of the fixed housing 402, and because the lower side of the fixed housing 402 has an opening, by adjusting the opening degree of the fixed housing 402, the actuators 107 with different diameters reported in the current literature can be placed in the fixed housing 402, and the wires 603 of the actuators 107 can move to the wire guide groove through the opening of the lower side of the fixed housing 402.
During the operation implantation, the actuator 107 and the fixing bracket are implanted in a direction approximately perpendicular to the round window membrane 109, in the process, the fixing housing 402 is clamped by forceps or other operation instruments and is inserted into the bone groove 601 drilled by the operation beside the round window membrane 109, at the moment, the front elastic bracket 505 is self-adaptively deformed to abut against the bone walls on two sides of the bone groove 601 drilled by the operation beside the round window membrane 109, so that stable transverse support is formed, and then the rear elastic bracket 506 abuts against the opposite bone wall 201 of the round window membrane 109, so that the rear end of the front elastic bracket 505 is prevented from loosening to cause the integral loosening of the actuator 107 in the high-frequency vibration process. At the same time, the actuator 107 can be made to be substantially coaxial with the round window film 109 by pulling the fixed housing 402.
Then, the rear end of the guide rod I504 is abutted by forceps or other surgical instruments, so that the supporting rear seat 404 is pushed forwards, and the forward stepping movement of the supporting rear seat 404 is ensured by the backstop sheet 501 of the limiting top cover I507. When the supporting backseat 404 is pushed forward to a certain extent, the actuator 107 contacts with the round window film 109, and the supporting backseat 404 is pushed continuously, the round window film 109 can generate a reaction force to the actuator 107 to deform the cantilever 502, and when the rear end of the actuator 107 is close to the outer edge ring of the cantilever 502, the initial pressure of the actuator 107 to the round window film 109 is close to 20 mN. Thus, monitoring of the initial pressure can be achieved by observing the proximity of the rear end of the actuator 107 to the outrigger 502 during the procedure.
In addition, when it is desired to remove the actuator 107 subsequently, forceps or other surgical instruments are only required to break the front elastic support 505 to remove the actuator 107 and the fixed support.
Example two
Referring to fig. 7 and 8, the support rear seat 404 includes a cantilever bracket 502, a support post 503, a guide bar ii 803, and a load indicator 805. The cantilever support 502 is a circular thin plate with several cantilevers cut into it and the support post 503 is located in the middle. The guide rod II 803 is positioned on the upper side of the cantilever support 502, and the upper surface of the guide rod II is provided with a ratchet; in addition, a rack groove 804 is formed in the middle of the guide rod II 803 to be matched with the adjusting gear 802. The load indicator 805 is a thin plate parallel to the cantilever 502 and is located at the rear end of the cantilever 502 to monitor the initial pressure between the actuator 107 and the round window membrane 109.
Referring to fig. 7 and 8, the positioning device 403 comprises a limit cap ii 806, an adjusting knob 801 and an adjusting gear 802. The limiting top cover II 806 is arranged on the upper side of the rear end of the fixed shell 402 and is connected with the fixed shell 402 in a welding mode, and the front end of the limiting top cover II is provided with a backstop sheet 501; in addition, a through hole is formed at the middle position to be matched with the adjusting knob 801. The upper side of the adjusting knob 801 is an S-shaped sheet convenient to shift, and the lower side of the adjusting knob is provided with a key slot matched with the adjusting gear 802 through a key.
In the second embodiment, forceps or other medical instruments are used to pull the adjusting knob 801, so that the supporting backseat 404 moves forward. When the supporting backseat 404 is pushed forward to a certain extent, the actuator 107 contacts with the round window film 109, and the supporting backseat 404 is pushed continuously, the round window film 109 generates a reaction force to the actuator 107 to deform the cantilever 502, and when the cantilever 502 contacts the load indicator 805, the initial pressure of the actuator 107 to the round window film 109 is close to 20 mN. Thus, monitoring of the initial pressure may be achieved by observing the proximity of the outriggers 502 and the load indicators 805 at the time of surgery.
Other technical schemes are the same as the first embodiment.
The above is the preferred embodiment of the present invention, and it should be noted that: it will be apparent to those skilled in the art that various modifications and adaptations can be made without departing from the principles of the invention and these are intended to be within the scope of the invention.
Claims (10)
1. The utility model provides a fixed bolster of artifical middle ear actuator of round window excitation formula which characterized in that: comprises a fixed shell (402), an elastic bracket (401), a positioning device (403) and a supporting rear seat (404);
the elastic supports (401) are symmetrically arranged on two sides of the fixed shell (402) and used for adjusting the pose of the actuator, so that the actuator and the round window film are kept on the same axis;
the positioning device (403) is arranged at the top of the rear end of the fixed shell (402) and used for adjusting the position of the supporting rear seat (404) so that the supporting rear seat (404) can be pushed in a one-way stepping manner;
the supporting rear seat (404) is arranged at the rear end of the fixed shell (402) and provides support for the actuator, so that initial pressure is kept between the actuator and the round window membrane;
in operation, the actuator is arranged in the fixed shell (402); elastic support (401) include in the bone inslot that the operation was drilled out beside the round window membrane according to spatial structure self-adaptation deformation, preceding elastic support (505) of stable horizontal support is formed to the bone inslot to and locate fixed shell (402) rear end and its rear end top on the opposite face bone wall of round window membrane, prevent preceding elastic support (505) at high-frequency vibration in-process rear end pine and lead to the whole back elastic support (506) that takes off of actuator.
2. The fixing bracket of the round window excitation type artificial middle ear actuator as claimed in claim 1, wherein: the elastic support (401) and the fixed shell (402) are connected in a welding mode.
3. The fixing bracket of the round window excitation type artificial middle ear actuator as claimed in claim 2, wherein: the elastic supports (401) comprise two pairs of front elastic supports (505) and one pair of rear elastic supports (506); the front elastic support (505) is arc-shaped, and the tail end of the front elastic support is provided with a pointed tooth-shaped structure; the rear elastic support (506) is a bent square sheet, and the tail end of the rear elastic support is provided with a pointed tooth-shaped structure.
4. The fixing bracket of the round window excitation type artificial middle ear actuator as claimed in claim 1, wherein: the fixed shell (402) is a hollow cylindrical thin shell structure, and an opening is cut on the lower side of the fixed shell along the axial direction of the fixed shell; the middle part of the fixed shell (402) is cut with a wire groove at one side or two sides, and the wire groove is communicated with the lower side opening.
5. The fixing bracket of the round window excitation type artificial middle ear actuator as claimed in claim 1, wherein: the supporting rear seat (404) comprises a cantilever support (502), a supporting column (503) and a guide rod I (504), the cantilever support (502) is a circular sheet, a plurality of cantilevers are cut in the cantilever support, and the supporting column (503) is located in the middle of the cantilever support; the guide rod I (504) is located on the upper side of the cantilever support (502), a ratchet is arranged on the upper surface of the guide rod I (504), and the ratchet is deviated to the rear end of the fixed support.
6. The fixing bracket of the round window excited artificial middle ear actuator as claimed in claim 5, wherein: the positioning device (403) is a limiting top cover I (507), is arranged on the upper side of the rear end of the fixed shell (402), and is connected with the fixed shell (402) in a welding mode; the internal shape and size of the welded limiting top cover I (507) are matched with those of the guide rod I (504), and the guide rod I (504) and the limiting top cover I (507) form a sliding pair and are pushed along the axial direction of the sliding pair; the front end of the limiting top cover I (507) is provided with a backstop sheet (501), and the backstop sheet (501) can be matched with the ratchet on the upper surface of the guide rod I (504).
7. The fixing bracket of the round window excitation type artificial middle ear actuator as claimed in claim 1, wherein: the supporting rear seat (404) comprises a cantilever bracket (502), a supporting column (503) and a guide rod II (803); the cantilever support (502) is a circular thin sheet, a plurality of cantilevers are cut in the cantilever support, and the support column (503) is located in the middle of the cantilever support; the guide rod II (803) is positioned on the upper side of the cantilever support (502), and the upper surface of the guide rod II is provided with a ratchet; a rack groove (804) is formed in the middle of the guide rod II (803) and is matched with the adjusting gear (802).
8. The fixing bracket of the round window excited artificial middle ear actuator as claimed in claim 7, wherein: and the load indicator (805) is a thin plate parallel to the cantilever support (502) and arranged at the rear end of the cantilever support (502) and used for monitoring the initial pressure between the actuator (107) and the round window film (109).
9. The fixing bracket of a round window excited artificial middle ear actuator as claimed in claim 7 or 8, wherein: the positioning device (403) comprises a limit top cover II (806), an adjusting knob (801) and an adjusting gear (802); the limiting top cover II (806) is arranged on the upper side of the rear end of the fixed shell (402) and is connected with the fixed shell (402) in a welding mode, and the front end of the limiting top cover II is provided with a backstop sheet (501); the middle position of the adjusting knob is provided with a through hole matched with the adjusting knob (801).
10. The fixing bracket of the round window excited artificial middle ear actuator as claimed in claim 9, wherein: the upper side of the adjusting knob (801) is provided with an S-shaped sheet for shifting, and the lower side of the adjusting knob is provided with a key slot which is matched with the adjusting gear (802) through a key.
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| CN202011362922.9A CN112533122B (en) | 2020-11-27 | 2020-11-27 | Fixing support of round window excitation type artificial middle ear actuator |
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| CN202011362922.9A CN112533122B (en) | 2020-11-27 | 2020-11-27 | Fixing support of round window excitation type artificial middle ear actuator |
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| CN112533122B true CN112533122B (en) | 2022-03-29 |
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| CN114587786B (en) * | 2022-02-25 | 2023-04-04 | 中国矿业大学 | Fascia cutting knife for round window excitation type artificial middle ear implantation operation |
| CN115002636B (en) * | 2022-05-27 | 2023-03-14 | 中国矿业大学 | Contact force controllable artificial middle ear actuator |
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| CN102006543A (en) * | 2010-12-03 | 2011-04-06 | 江苏贝泰福医疗科技有限公司 | Novel in-ear hearing aid |
| CN102264023A (en) * | 2010-07-13 | 2011-11-30 | 江苏贝泰福医疗科技有限公司 | Universal hinge in-the-ear hearing aid |
| CN108886664A (en) * | 2016-03-29 | 2018-11-23 | Med-El电气医疗器械有限公司 | The preloading of middle ear connector is fed back |
| CN109788421A (en) * | 2018-12-18 | 2019-05-21 | 中国矿业大学 | A kind of round window excitation type Middle Ear Implant actuator that initial pressure can monitor |
Family Cites Families (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7160244B2 (en) * | 2004-05-10 | 2007-01-09 | Patrik Westerkull | Arrangement for a hearing aid |
| GB0910908D0 (en) * | 2009-06-24 | 2009-08-05 | Sentient Medical Ltd | Coupling apparatus |
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Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102264023A (en) * | 2010-07-13 | 2011-11-30 | 江苏贝泰福医疗科技有限公司 | Universal hinge in-the-ear hearing aid |
| CN102006543A (en) * | 2010-12-03 | 2011-04-06 | 江苏贝泰福医疗科技有限公司 | Novel in-ear hearing aid |
| CN108886664A (en) * | 2016-03-29 | 2018-11-23 | Med-El电气医疗器械有限公司 | The preloading of middle ear connector is fed back |
| CN109788421A (en) * | 2018-12-18 | 2019-05-21 | 中国矿业大学 | A kind of round window excitation type Middle Ear Implant actuator that initial pressure can monitor |
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