EP1014755A2 - Implantable hearing aid with tinnitus masking - Google Patents

Abstract

To rehabilitate tinnitus, the hearing aid has an electronic module (90) producing a signal masking tinnitus or a so-called noisier function (reference included). This is fed into the audio signal processing path of the hearing aid.

Description

Erste Implantationen eines vollständig implantierbaren elektronischen Hörsystems bei Patienten mit Innenohrschwerhörigkeit"; Zeitschrift HNO 46:853-863, 10-1998, H. Leysieffer et al., Ein vollständig implantierbares Hörsystem für Innenohrschwerhörige: TICA LZ 3001"; US-A-5 277 694; US-A-5 788 711; US-A-5 814 095; US-A-5 554 096; US-A-5 624 376). Insbesondere bei vollimplantierbaren Systemen entfällt die Sichtbarkeit des Systems, so daß neben den Vorteilen der hohen Klangqualität, des offenen Gehörgangs und der vollen Alltagstauglichkeit von einer hohen zukünftigen Patientenakzeptanz ausgegangen werden kann.Partially and fully implantable hearing aids for the rehabilitation of inner ear damage with mechanical stimulation of the damaged inner ear have recently become available on the market or are about to be launched on the market (magazine HNO 46: 844-852, 10-1998, HP Zenner et al.,

First implantations of a fully implantable electronic hearing system in patients with inner ear hearing loss "; Journal HNO 46: 853-863, 10-1998, H. Leysieffer et al., A fully implantable hearing aid for the hearing impaired: TICA LZ 3001 "; US-A-5 277 694; US-A-5 788 711; US-A-5 814 095; US-A-5 554 096; US-A-5 624 In the case of fully implantable systems in particular, the visibility of the system is eliminated, so that in addition to the advantages of high sound quality, the open auditory canal and full suitability for everyday use, high future patient acceptance can be assumed.

Many patients with inner ear damage also suffer from intermittent or permanent ringing in the ears (tinnitus), which cannot be remedied by surgery and for which no approved forms of drug treatment exist to date. So-called tinnitus maskers are therefore known (WO-A-90/07251); These are small, battery-operated devices that are worn behind or in the ear, similar to a hearing aid, and cover up the tinnitus in a psycho-acoustic way ("masking") with artificial sounds, which are emitted into the ear canal, for example, via a hearing aid speaker lower disturbing ear noises as far as possible below the threshold of perception. The artificial sounds are often narrowband noises (e.g. third-octave noise), which can be adjusted in their spectral position and their volume level via a programming device in order to enable the best possible adaptation to the individual ear noise situation. In addition, the so-called "retraining method" has recently existed, whereby the perception of tinnitus is also to be largely suppressed by the combination of a mental training program and the presentation of a broadband sound (noise) near the resting hearing threshold. These devices are also referred to as "noisers" (magazine Hearing Acoustics "2/97, pages 26 and 27).

In both of the above-mentioned methods for the device therapy of tinnitus, hearing device-like, to carry technical devices visible on the outside of the body in the ear area, which the Stigmatize wearers and therefore do not like to be worn.

From US-A-5 795 287 an implantable tinnitus masker with "direct drive" ("direct drive ") of the middle ear, for example, via an electromechanical coupling coupled to the ossicular chain Converter known. This directly coupled converter can preferably be a So-called "floating mass transducer" (FMT). This FMT corresponds to that from US-A-5 624 376 known transducer for implantable hearing aids. US-A-5 795 287 in particular the term "direct drive" is clearly described: below these are explicitly only those Understanding types of coupling to the inner ear for the purpose of tinnitus masking have mechanical character, i.e. direct mechanical transducer couplings to an ossicle of the middle ear, such as through the FMT converter and also air-gap-coupled electromagnetic transducers, such as described in US-A-5 015 225.

In US-A-5 795 287 only implantable tinnitus masking are used Systems described based on direct mechanical stimulation of the inner ear mask the tinnitus with masking waveforms. However, as above described an inner ear noise very often simultaneously with a non-operable inner ear damage occurs, must be in the carrier of the implant known from US-A-5 795 287 Additional technical and equipment measures are taken to damage the inner ear rehabilitate. This is only more conventional due to the additional application of a hearing aid Design, that is, a hearing aid to be worn on the outside of the body with acoustic stimulation of the eardrum, possible. In particular, there is neither a partial nor a fully implantable one System in question, since such systems are also mechanically coupled to a require suitable middle ear structure for mechanical stimulation of the inner ear; a such, simultaneous application of two different implants, their actuator In principle, having to deliver the stimulus at the same destination is hardly operational or technical sensible; it also brings with it other significant clinical risks.

The present invention has as its object the one mentioned Inner ear damage and tinnitus in the event of simultaneous occurrence while avoiding the Deficiencies outlined above can be treated more easily and effectively.

Starting from a partially or fully implantable hearing aid for the rehabilitation of a Inner hearing loss, with a microphone that emits an audio signal, one in one audio signal processing, electronic hearing aid path lying electronic Signal processing and amplification unit, an implantable electromechanical Output converter and a unit for energetic supply of the implant, this is Object achieved according to the invention in that the hearing aid for the rehabilitation of tinnitus is provided with an electronic module which can be used to mask tinnitus or signals necessary for a noise function are generated and into the audio signal processing path of the hearing implant.

The hearing aid according to the invention allows, with a single active, at least partially implantable system not only inner ear damage, but also and additionally to treat tinnitus. A stigmatization of the patient by visible external Device parts are kept small in the case of a partially implantable simultaneous therapy system, and it is completely avoided with a fully implantable device. The one for the at least partially Implantation of the combination device required surgical intervention and thus associated residual risks do not go beyond what is at least partially the case implantable hearing aid only or with an at least partially implantable tinnitus masker only is to be accepted anyway.

An implantable electromechanical output converter is particularly suitable Converter according to US-A-5 277 694, that is a converter in which a wall of the Converter housing is designed as a vibratable membrane, which together with one on the Piezoelectric ceramic disc applied to the inside of the membrane an electromechanical represents active heteromorph composite element.

Another type of converter suitable for the present purposes is in the older EP patent application 98 121 495.0. It is a transducer arrangement for partially or fully implantable hearing aids for direct mechanical stimulation of the middle or inner ear with one at the implantation site with respect to the skull fixable housing and a mechanically rigid with respect to the housing movable Coupling element is provided, with an electromechanical transducer in the housing is housed, with which the coupling element can be made to vibrate after implantation of the transducer assembly on a middle ear ossicle or directly on the Inner ear are transmitted. The electromechanical transducer is an electromagnet arrangement formed, which is a component fixed with respect to the converter housing, in particular a toroidal coil, and a vibratable component, preferably in the form of a has a central opening of the ring coil immersing permanent magnet pin, soft with the coupling element is connected in such a way that vibrations of the vibratable Component are transferred to the coupling element.

However, a converter of the type disclosed in the older EP patent application 98 121 613.8 is also advantageous described type. It is a converter for partially or fully implantable Hearing aids for the direct mechanical excitation of the middle or inner ear, with a housing that can be fixed at the implantation site and a movable with respect to the housing mechanically rigid coupling element is provided, with a piezoelectric in the housing Is housed element with which the coupling element can be set in vibration, after implantation of the transducer on a middle ear ossicle or directly on the Inner ear are transmitted, and wherein also in the housing Electromagnet arrangement is provided which is a component fixed with respect to the housing and has an oscillatable component, which is so soft with the coupling element in Connection is that vibrations of the vibratable component on the coupling element be transmitted. Such a converter has the advantage that the frequency response of the converter both purely piezoelectric and purely electromagnetic Systems can be improved so that an adequate auditory impression with sufficient Volume level is enabled. In particular, a largely flat frequency response the deflection of the coupling element in a wide frequency band at sufficiently high Stimulation levels and low power consumption can be realized.

In the hearing aid according to the invention, there are preferably patient-specific ones Signal parameters for tinnitus masking or noise function using an electronic Unity to the needs and pathological needs of the patient individually customizable.

The electronic signal processing and amplification unit expediently has one Microphone downstream amplifier, one with the output signal of the amplifier applied audiological signal processing level and one the electromechanical Output converter upstream driver amplifier. This can be advantageous electronic module with a signal generator arrangement for generating the for Tinnitus masking or the noiser function necessary signals and one between the Signal processing stage and the driver amplifier-connected summing element, via the driver amplifier both the output signal of the audiological signal processing stage as well as the output signal of the signal generator arrangement.

According to a modified embodiment of the invention, however, can also be used as audiological signal processing stage, a digital signal processor can be provided both for processing the audio signal and for generating tinnitus masking or Noiserfunktion necessary signals and for the summary of the the latter signals is designed with the audio signal. In such a case Appropriately upstream of the signal processor, an analog-digital converter and a digital-analog converter downstream.

The digital-to-analog converter and the driver amplifier can be combined in one module his.

The signal processor is preferably with a data memory for storing patient-specific, audiological adjustment parameters and / or parameters for the Generation of signals for tinnitus masking or the noiser function.

For controlling at least a part of and preferably all signal processing and / or generating stages, a microcontroller can advantageously be provided expediently a data memory for storing patient-specific, audiological adaptation parameters and / or operating parameters of the signal generator arrangement having.

The signal processor can also itself for controlling at least part of the and preferably all signal processing and / or generating stages.

A telemetry unit, which is equipped with a external programming system communicates wirelessly or wired.

If the hearing aid is designed to be fully implantable, those in the are preferably electronic hearing aid path signal processing and amplification unit, the electronic module for generating and feeding in for tinnitus masking or Noise function necessary signals and the telemetry unit as an electronic module, expediently together with the energy supply unit, in a hermetically sealed and biocompatible implant housing. The electronics module is advantageous here via an implant line with a subcutaneously in the posterior wall of the auditory canal implantable microphone and via an implantable line with the electromechanical Output converter connected. This connection can be fixed or detachable. For a detachable connection is particularly suitable for a plug connection as described in US-A-5 755 743 is explained in detail. Such a connection arrangement has at least a first contact, at least one second supported on an elastic body Contact and a locking mechanism for engaging the end face of the first Contact with the end face of the second contact, wherein the first contact of is surrounded at least one sealing web, which when the contacts engage in the is pressed in elastic body and seals the contacts to the outside.

The output converter is preferably connected to an ossicle via a coupling element Middle ear chain for transmission of the mechanical converter vibrations on the output side connectable. Solutions in US-A-5 277 694 and in are particularly suitable for this US-A-5 941 814 described. Advantageously, an actively vibratable part of the Output converter with a coupling rod to be mechanically firmly connected via a Coupling element is coupled to a part of the ossicular chain. For setting the relative position of coupling rod and coupling element and for fixing these elements in the set Relative position, the coupling element is preferably sleeve-shaped at least in the fixing area formed and is plastically cold-deformable by means of a crimping tool, while the Coupling rod is rod-shaped at least in the fixing area, with a rough surface provided and not under the influence of the crimping force exerted by the crimping tool is plastically cold deformable, with the sleeve-shaped part of the Coupling element deformed cold-flowing by the crimping force on the rod-shaped part of the Coupling rod is free of play and permanently attached. The one remote from the output converter The end of the coupling rod can also be in a hole in part of the ossicular chain inserted and fixed there.

Furthermore, the output converter can also be designed so that it is connected to the air gap The ossicular chain or the inner ear can be coupled, as is described in detail in US Pat. No. 5,015,225 is described.

In a further embodiment of the invention, a fully implantable hearing aid is one external system for transcutaneous transmission of patient-specific hearing aids and Tinnitus masker or noiser programming data to the implant-side telemetry unit.

A primary battery or come in particular as the energy supply unit secondary, rechargeable element, that is, a rechargeable battery. In the latter case, the telemetry unit is preferably also used as an energy receiving circuit for the provision of recharging energy on the implant side for the energy supply unit trained while the external system is also a charger is constructed. A charging system from US Pat. No. 5,279,292 is particularly suitable for this known type or arrangements, as in the older EP patent applications 98 121 496.8 and 98 121 498.4 are described.

A portable remote control unit for setting or changing is also useful of hearing aid and tinnitus masking or noiser functions.

In the case of a partially implantable device, an implant part preferably has in addition to that Output converter a power and signal receiving interface and one between the Receiving interface and the output converter switched electronic system with for the components required for energy supply and data regeneration, and one External system part includes the microphone, an electronic module with the in the hearing aid path lying signal processing unit and the electronic module for generation and Feeding of the signals necessary for tinnitus masking or the noise function, a driver unit and an energy and connected to the output of the driver unit Signal transmission interface.

The partially implantable hearing aid preferably also includes an external system Transfer of patient-specific hearing aid and tinnitus masker or noiser programming data to the electronic module of the external system part.

Fig. 1

ein Blockschaltbild eines erfindungsgemäßen vollimplantierbaren Hörgerätes;

Fign. 2 und 3

Blockschaltbilder von abgewandelten Ausführungsformen des vollimplantierbaren Hörgerätes;

Fig. 4

eine schematische Darstellung eines vollimplantierbaren Hörgerätes im implantierten Zustand; und

Fig. 5

ein Blockschaltbild eines erfindungsgemäßen teilimplantierbaren Hörgerätes.

Advantageous exemplary embodiments of the invention are explained in more detail below with reference to the drawings. Show it:

Fig. 1

a block diagram of a fully implantable hearing aid according to the invention;

Fig. 2 and 3

Block diagrams of modified embodiments of the fully implantable hearing aid;

Fig. 4

a schematic representation of a fully implantable hearing aid in the implanted state; and

Fig. 5

a block diagram of a partially implantable hearing aid according to the invention.

The implant system according to FIG. 1 has a microphone 10, by means of which the sound signal is recorded and converted into an electrical signal, which is in an amplifier 40 is preamplified. This pre-amplified signal is in an audiological signal processing stage 50 (AP: "Audio Processor") processed further. This level can all known, at components common to modern hearing aids such as filter stages, automatic gain controls, Interference signal suppression devices and so on included. This edited Signal is fed to a summation element 70.

Further inputs of the signal-summarizing element 70 are the one or more outputs one or more signal generators 90 (SG1 to SGn) which generate the signals, which are required for tinnitus masking or noiser function. This can in itself known manner single sinusoidal signals, narrowband signals, broadband signals and the like be, the spectral position, level and phase relationships to each other are adjustable.

The audio signal processed by stage 50, along with the masker (s), is related Noiser signals of the generator (s) 90 to a driver amplifier 80 supplied, which controls an electromechanical converter 20. The converter 20 stimulates the damaged inner ear by direct mechanical coupling via a coupling element 21 a middle ear crosspiece or via an air gap coupling in, for example, electromagnetic, implantable transducers. The signal processing components 40, 50, 80 and the generators 90 are controlled by a microcontroller 100 (µC) with associated data memory (S) controlled. In the memory area S in particular patient-specific, audiological Matching parameters and the individual operating parameters of the signal generators 90 for Tinnitus masking or noiser function. These individual, programmable Data is supplied to controller 100 via a telemetry unit 110 (T). This Telemetry unit 110 communicates wirelessly or wired bidirectionally with one external programming system 120 (PS).

All electronic components of the system are except for the programming system 120 by a primary or a rechargeable secondary battery 60 with electrical operating energy provided.

In particular in the case of a fully implantable system, it is advisable to use all the electronic systems described signal processing and processing circuit parts as well as the control components and summarize the energy supply in a module 30; this is in Fig. 1 by the dash-dotted line indicated. On this signal module 30, the implant side only the microphone 10 and the electromechanical transducer 20 via corresponding lines 61 or 59 permanently or possibly connected via implantable plug connections.

A further embodiment of the electronic signal module 30 is shown in FIG. 2. The signal of the microphone 10 is pre-amplified in the amplifier 40 and by means of an analog-to-digital converter 130 (A / D) is converted into a digital signal that corresponds to a digital Signal processor 140 (DSP) with a data storage area S is supplied. The signal processor In principle, 140 takes on two tasks: on the one hand, as in fully digital hearing aids usual the audio signal the described signal processing methods for a Rehabilitation of an inner ear damage prepared accordingly. On the other hand, in the Signal processor 140 digitally or software-implemented the signal generators that the for Masking the tinnitus or necessary to achieve a noiser function Generate signals. The summary of these digital masker or Noiser signals and the processed and amplified audio signal also takes place in the signal processor 140. The digital output signal of the signal processor 140 is in a digital-to-analog converter 150 (D / A) converted back into an analog signal and via the driver amplifier 80 fed to the electromechanical converter 20.

The D / A converter 150 and the driver amplifier 80 can, as in FIG. 2, by a block 81 is indicated to be combined in one module. This is particularly the case preferable in which an electromagnetic system is used as the transducer 20 and in the output signal of the signal processor 140, the signal information by pulse width modulation is included, so that the time required for the conversion back into an analog signal Integration is taken over directly by the converter 20.

All signal processing components are controlled by a microcontroller 100 (µC) associated data storage (S) controlled. In the memory area S of the microcontroller 100 can, in particular, patient-specific, audiological adjustment parameters as well as the individual operating parameters of the signal generators integrated in the signal processor 140 for tinnitus masking or noiser function. These individual, Programmable data is sent to controller 100 via a telemetry unit 110 (T) fed. This telemetry unit 110 communicates wirelessly or wired bidirectionally with an external programming system 120 (PS). All electronic components of the system are down to the programming system 120 by the primary or secondary Battery 60 supplied with electrical operating energy.

The embodiment according to FIG. 3 differs essentially from that of FIG. 2 only in that a signal processor 141 is provided, which also functions as Microcontroller 100 according to FIG. 2 takes over. The patient-specific Data from audio signal processing as well as tinnitus masking or noise function then also stored in the data storage area S of the signal processor 141.

FIG. 4 shows a possible fully implantable embodiment according to FIG. 1, 2 or Fig. 3 is shown schematically. In a hermetically sealed and biocompatible implant housing 56 is an electronics module 31 (shown without a battery), which except for the Absence of the battery corresponds to the module 30 of Figures 1, 2 and 3. It also contains Housing 56, the battery 60 for the electrical supply of the implant and the telemetry device 110. The microphone 10 is preferably known from US-A-5,814,095 Way, optionally using that described in EP-A-0 920 239 Fixation element, implanted subcutaneously in the posterior wall of the auditory canal. The microphone 10 picks up the sound and converts it into an electrical signal that is transmitted via the Implant line 61 is supplied to the electronics module 31 in the housing 56. The audiologically processed and amplified signal, the corresponding tinnitus mask or relation Noiser signals attached by the electronic unit 31 arrives via the implantable line 59 to the electromechanical transducer 20. This transducer 20 is shown in the present example as a directly coupled system, that is, the output-side mechanical vibrations of the transducer 20 are determined by a suitable Coupling element 21 directly coupled to an ossicle of the middle ear chain, in the case shown the anvil 62. This is preferably done in US-A-5 277 694 and US-A-5 788 711 known manner. The transducer vibrations injected there pass through the ossicle chain to the inner ear and cause the corresponding auditory impression there.

Furthermore, the external programming system 120 is shown in FIG. 4, with which, as described the patient-specific hearing aid and tinnitus masker or noiser data transcutaneously through the closed skin 57 to the implant-side telemetry unit 110 are transmitted. A transmit head 121 is used for this purpose, for (bidirectional) data transmission the data is brought over the implant and, for example, inductively transferred. The battery 60 in the implant housing 56 is a secondary, rechargeable Element, unit 110 may also include an energy receiving circuit for the implant side Provision of recharging energy. Then the external system 120 with the transmitter head 121 a portable, wireless charger, for example. It can preferably Arrangements are provided, as known per se from US-A-5 279 292, respectively explained in more detail in the earlier EP patent applications 98 121 496.8 and 98 121 498.4 are. A portable remote control unit 65 is also shown, with which the patient Set essential hearing aid and tinnitus masker or noiser functions or can change.

A partially implantable system is illustrated schematically in FIG. The implantable one Part shown as subsystem 220 and the external one to be worn on the outside of the body Part as block 210. The external unit 210 contains the microphone 10, a signal processing unit 30 and a driver unit 160, which generates the generated signals and operating energy for the implant part, for example, inductively and transcutaneously through the transmitter coil 170 closed skin 180 is transmitted to the implanted system part 220. This type of transmission corresponds to the transmission in known, partially implantable cochlear implants or partially implantable hearing aids or partially implantable tinnitus maskers (see among others US-A-4 741 339, EP-B-0 572 382, US-A-5 795 287). The electronic Unit 30 of external system part 210 contains all the necessary electronic components for hearing aid signal processing and tinnitus masking or noise function, as they are explained for example with reference to Figures 1 to 3. The individual programming of the external system with patient-specific hearing aid and tinnitus masker or noiser data takes place via the programming system 120, which is as in In this case, conventional hearing aids are usually wired to the electronic unit 30 is coupled. On the implant side, the system 220 includes an energy and signal reception interface, in the case shown an inductive receiving coil 190. The electronic System 200 contains everything necessary for energy supply and data regeneration Components such as demodulators and driver circuits for the electromechanical Converter 20.

Claims (23)

Partially or fully implantable hearing aid for the rehabilitation of an inner ear hearing loss, with a microphone (10) emitting an audio signal, an electronic signal processing and amplification unit (40, 50, 80, 140, 141) located in an audio signal processing electronic hearing aid path, an implantable electromechanical output converter ( 20) and a unit (60) for energizing the implant, characterized in that the hearing aid for rehabilitation of tinnitus is provided with an electronic module (90, 140, 141) which generates the signals necessary for tinnitus masking or for a noise function and feeds into the audio signal processing path of the hearing implant. Hearing aid according to claim 1, characterized in that patient-specific Signal parameters for tinnitus masking or noise function using a electronic unit (100) to the individual needs of the patient are customizable. Hearing aid according to claim 1 or 2, characterized in that the electronic Signal processing and amplification unit downstream of the microphone (10) Amplifier (40), one with the output signal of the amplifier (40) acted upon audiological signal processing stage (50, 140) and one electromechanical output converter (20) upstream driver amplifier (80) having. Hearing aid according to claim 3, characterized in that the electronic module a signal generator arrangement (90) for generating that for tinnitus masking or the noiser function necessary signals and one between the signal processing stage (50) and the driver amplifier (80) connected summing element (70) has, via which the driver amplifier (80) both the output signal of audiological signal processing stage (50) as well as the output signal of the Signal generator arrangement (90) approach. Hearing aid according to claim 3, characterized in that as audiological Signal processing stage a digital signal processor (140, 141) is provided which both for the preparation of the audio signal and for the generation of the Tinnitus masking or noiser function necessary signals and for that Summary of the latter signals is designed with the audio signal. Hearing aid according to claim 5, characterized in that the signal processor (140, 141) an analog-to-digital converter (130) is connected upstream and a digital-to-analog converter (150) is connected downstream. Hearing aid according to claims 3 and 6, characterized in that the digital-to-analog converter (150) and the driver amplifier (80) in one module are summarized. Hearing aid according to one of claims 5 to 7, characterized in that the Signal processor (140, 141) a data memory (S) for storing patient-specific, audiological adjustment parameters and / or parameters for the generation of signals for tinnitus masking or the noise function having. Hearing aid according to one of the preceding claims, characterized in that at least a part of the signal processing and / or generating stages (40, 50, 80, 90, 130, 140, 150) is controlled by means of a microcontroller (100). Hearing aid according to claim 9, characterized in that the microcontroller (100) a data memory (S) for storing patient-specific, audiological adjustment parameters and / or operating parameters of the Signal generator arrangement (90). Hearing aid according to one of claims 5 to 8, characterized in that the Signal processor (141) itself for controlling at least part of the signal processing and / or generating stages (40, 80, 130, 150) is designed. Hearing aid according to claim 10 or claims 8 and 11, characterized in that that a telemetry unit (110) for data input into the data memory (S) is provided. Hearing aid according to claim 12, characterized by a with the telemetry unit (110) Wireless or wired communicating external programming system (120). Hearing aid according to claim 12 or 13, characterized in that the device is fully implantable, the one lying in the electronic hearing aid path Signal processing and amplification unit (40, 50, 80, 140, 141), the electronic module (90, 140, 141) for generating and feeding in for the Tinnitus masking or the noiser function necessary signals and the Telemetry unit (110) as an electronic module (31), preferably together with the Power supply unit (60), in a hermetically sealed and biocompatible Implant housing (56) are housed. Hearing aid according to claim 14, characterized in that the electronic module (31) via an implant line (61) with one in the rear auditory canal wall Subcutaneously implantable microphone (20) is connected. Hearing aid according to claim 14 or 15, characterized in that the Electronics module (31) via an implantable line (59) with the electromechanical Output converter (20) is connected. Hearing aid according to one of the preceding claims, characterized in that the output converter (20) via a coupling element (21) with an ossicle Middle ear chain for transmission of the mechanical converter vibrations on the output side can be coupled. Hearing aid according to one of claims 1 to 16, characterized in that the Output converter (20) is designed such that it via an air gap to the Ossicle chain or the inner ear can be coupled. Hearing aid according to one of claims 14 to 18, characterized by an external System (120) for the transcutaneous transmission of patient-specific hearing aids and Tinnitus masker or noiser programming data to the implant side Telemetry unit (110). Hearing aid according to claim 19, characterized in that as the energy supply unit (60) a secondary rechargeable element is provided which Telemetry unit (110) additionally as an energy receiving circuit for the implant side Provision of recharging energy for the energy supply unit is formed and the external system (120) is also constructed as a charger. Hearing aid according to one of claims 14 to 20, characterized by a portable Remote control unit (65) for setting or changing hearing aid and Tinnitus masker or noiser functions. Hearing aid according to one of claims 1 to 11, 17 or 18, characterized in that that the device is partially implantable, an implant part (220) in addition to the output converter (20) an energy and signal reception interface (190) and one between the receiving interface and the output converter (20) switched electronic system (200) with for the energy supply and data regeneration components required, and wherein an external system part (210) the microphone (10), an electronic module (30) with the signal processing unit (40, 50, 140, 141) lying in the hearing aid path and the electronic module (90, 140, 141) for generating and feeding in for the Tinnitus masking or the noiser function necessary signals, a driver unit (160) and an energy and connected to the output of the driver unit Signal transmission interface (170) comprises. Hearing aid according to claim 22, characterized by an external system (120) for Transmission of patient-specific hearing aids and tinnitus maskers or Noiser programming data to the electronic module (30) of the external system part (210).

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