Classifications

• • 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
  • H04R25/604—Mounting or interconnection of hearing aid parts, e.g. inside tips, housings or to ossicles of acoustic or vibrational transducers
  • H04R25/606—Mounting or interconnection of hearing aid parts, e.g. inside tips, housings or to ossicles of acoustic or vibrational transducers acting directly on the eardrum, the ossicles or the skull, e.g. mastoid, tooth, maxillary or mandibular bone, or mechanically stimulating the cochlea, e.g. at the oval window
• • H—ELECTRICITY
  • H04—ELECTRIC COMMUNICATION TECHNIQUE
  • H04R—LOUDSPEAKERS, MICROPHONES, GRAMOPHONE PICK-UPS OR LIKE ACOUSTIC ELECTROMECHANICAL TRANSDUCERS; DEAF-AID SETS; PUBLIC ADDRESS SYSTEMS
  • H04R2225/00—Details of deaf aids covered by H04R25/00, not provided for in any of its subgroups
  • H04R2225/67—Implantable hearing aids or parts thereof not covered by H04R25/606

Definitions

• the present invention relates to an acoustic hearing aid for the rehabilitation of patients with partial sensorineural hearing loss.
• the hearing aids available on the market are classified into two product categories: behind-the-ear devices and in-ear devices.
• the devices around the ear include a box in the form of an arc of a circle intended to be housed behind the ear, this box generally containing one or more sensors such as microphones, a source of energy of the battery type, and electronic circuits for amplification and analog and / or digital signal processing.
• the electronic circuits generate an audible signal which is sent into the ear canal of the patient via an acoustic tube held in the ear canal by an intra-auricular plug.
• This in-ear plug also makes it possible to reduce the phenomena of acoustic feedback between the earpiece and the point of emission of the sound.
• these devices have great ease of implementation, good reliability and sufficient performance, due in part to the relatively large available volume, making it possible to integrate all the electronic circuits. required.
• these devices have the disadvantage of being painful to wear, and of risking falling as a result of certain movements of the head.
• they are relatively visible and lack aesthetics. They do not completely eliminate feedback phenomena because the microphone is relatively close to the earpiece, which forces them to be set in under-amplification mode.
• the in-ear plug also has drawbacks, in particular an unpleasant sensation of a blocked ear, perception of parasitic sounds during chewing, and hygiene problems and potentially infections, due to the fact that it plugs the ear canal.
• in-ear devices are in the form of small housings intended to be inserted directly into the external auditory canal.
• This case consists of a resin shell, the shape of which is adapted by molding to the anatomy of the external auditory canal of each patient.
• This box brings together in a very small volume the sound sensor, the electronic amplification and signal processing circuits, the earpiece, the energy source (electric battery).
• the energy source electric battery.
• devices around the ear they have the advantage of being significantly less visible and space-saving.
• they generate significant feedback phenomena, both mechanical and acoustic, due to the proximity of the microphone and the earpiece, which obliges them to be set in an even weaker under-amplification mode than the devices. behind the ear.
• the miniaturization of the microphone and the earpiece does not make it possible to obtain good sound quality.
• the low volume available makes it difficult, if not impossible, to add additional microphones or more sophisticated signal processing functions. It has a low autonomy due to the use of a necessarily small battery. Due to its small size, its handling, especially when adjusting and changing batteries is delicate, which leads to the risk of falling when it is removed from the ear canal. As with devices around the ear, they cause unpleasant sensations of plugged ear, pose hygiene problems, with risks of infection and premature wear of the device.
• the present invention aims to eliminate these drawbacks.
• This objective is achieved by providing an acoustic hearing aid device, generating at least one audible signal and intended to be fixed to the body of a patient, this device comprising an external housing containing an electronic signal processing module. connected at the input to at least one microphone and at the output to an earphone designed to emit a sound signal in the external auditory canal 5 of the patient, and a source of energy.
• this device further comprises:
• the first magnetic part is a magnet.
• the second magnetic part is a magnet.
• the first and second magnetic pieces are permanent magnets, and the second magnetic piece is arranged in the implanted case so as to have a north-south magnetic axis substantially parallel to the surface of the patient's skin. at said location, and the first magnetic part is arranged in the external case so as to have a north-south magnetic axis substantially parallel to the wall of the case intended to come into contact with the patient's skin.
• the second magnetic part is a magnet and the first magnetic part comprises two permanent magnets arranged in the external casing so as to have north-south magnetic axes substantially perpendicular to the wall of the casing intended to come into contact with the patient's skin, and in opposite directions, these magnetic axes being spaced from each other by a distance corresponding substantially to the distance between the poles of the second magnetic part.
• the first magnetic part is a magnet and the second magnetic part comprises two permanent magnets arranged in the implanted case so as to have north-south magnetic axes substantially perpendicular to the surface of the patient's skin at said location, and in opposite directions, these magnetic axes being spaced from each other by a distance corresponding substantially to the distance between the poles of the first magnetic part.
• the second magnetic part comprises at least two permanent magnets arranged in the housing implanted so as to have north-south magnetic axes substantially perpendicular to the surface of the patient's skin at said location, and alternately in opposite directions
• the first magnetic part comprises as many permanent magnets as the first part, the magnets of the first magnetic part being arranged in the housing so as to have north-south magnetic axes substantially perpendicular to the wall of the external housing intended to come into contact with the patient's skin, and alternately in opposite directions, the magnetic axes of the magnets disposed in the external housing being distributed in a plane substantially parallel to said wall in a configuration corresponding substantially to the configuration of distribution of the magnetic axes of the magnets in the implanted housing.
• the second housing is designed to be implanted in the temporo-occipital area of the patient's skull.
• the earpiece is arranged in the external casing and connected to the patient's external auditory canal by an acoustic tube comprising an intra-auricular end, the hearing aid device further comprising a system of mechanical anti-feedback damping.
• the earpiece is placed in the patient's external auditory canal and forms an in-ear end of the connection, the connection being constituted by an electric cable.
• the intra-auricular end of the connection is maintained in the external auditory canal of the patient by means of an intra-auricular support comprising means for centering and maintaining said extremity in the auditory canal.
• the external housing comprises a base and a cover rotatably mounted on the base, and means for blocking the angular position of the cover relative to the base, the second magnetic part being fixed to the base, while the microphone (s) are attached to the cover.
• the implanted case is connected to at least two electrodes for collecting evoked or spontaneous hearing potentials, the implanted housing containing at least one electronic signal collection and processing module connected to the collection electrodes, a transmission module connected to an antenna and to the collection and processing module, for transmitting to the external housing the signals produced by the collection module according to the signals collected by the electrodes, and a power supply.
• one of the collection electrodes is designed to be placed on the round window.
• the implanted housing is also connected to at least one active stimulation electrode intended to be positioned close to the patient's inner ear or in the cochlea, the implanted housing containing at least one module stimulation electronics connected to the stimulation electrodes, a transmission module connected to an antenna and to the stimulation module, the stimulation module being designed to generate electrical stimulation signals which are applied to the stimulation electrodes from signals received from the housing external 1 via the transmission module, via the antenna located in the implanted box.
• one of the active stimulation electrodes is designed to be placed on the round window of the patient's middle ear.
• the collection electrodes and the stimulation electrodes are at least partially common.
• the external unit further comprises a signal transmission module connected to at least one antenna and to the electronic module.
• the implanted box is also connected to at least one electromechanical transducer vibrator intended to be positioned in a bone or cartilaginous zone near the inner ear of the patient, the implanted box containing at least one electronic stimulation module connected to the vibrator.
• a transmission module connected to an antenna and to the stimulation module, the stimulation module being designed to generate electrical stimulation signals which are applied to the vibrator from signals received from the external housing 1 via the transmission module , via the antenna located in the implanted box.
• Figure 1 shows schematically in partial profile view, the head of a patient equipped with a hearing aid according to the invention
• FIG. 2 shows a sectional view of part of the patient's head shown in Figure 1, equipped with the hearing aid according to the invention
• FIG. 2a represents in axial view a support for an in-ear earpiece, according to the invention
• FIG 3 shows in more detail the prosthesis shown in Figure 1 and the prosthesis fixing device according to the invention
• FIGS 4 to 6 show three variants according to the invention of the device shown in detail in Figure 3;
• FIG. 7 shows in section another advantageous variant of the device according to the invention.
• Figure 8 shows a top view of the device shown in Figure 7;
• FIGS 9 and 10 show two other variants of the implanted housing of the device according to the invention.
• Figures 1 and 2 show respectively in side view and in section, the head of a patient equipped with a hearing aid device according to the invention, held on the skull.
• This device comprises an external box 1 equipped with at least one microphone 13a, 13b and containing a source of energy, (for example a cell or a battery), and electronic circuits for amplification and signal processing, this box being connected to a device for distributing sound signals in the ear canal 5 of the patient, this device comprising a earpiece 3 and a connection 4 between the housing and the interior of the ear canal.
• a source of energy for example a cell or a battery
• the housing 1 is maintained according to the invention on the patient's head by means of '' a magnet housed in a box 2 implanted under the skin and optionally fixed to the skull bone 7, this magnet being intended to exert a magnetic force of attraction on a magnetic part placed in the external case, when the latter is placed near the implanted box 2.
• the housing 2 has a substantially flat shape of small thickness, so that it can be inserted under the skin, preferably under the scalp, in order to be masked by the patient's hair, even at an advanced stage of baldness.
• it is implanted for example on the mastoid or on the temporo-occipital bone as shown in FIG. 1.
• the housing can be easily attached to the patient's head and held in all positions and during normal movements thereof.
• the microphone or microphones on the housing 1 are sufficiently distant from the earpiece, and separated by the pinna of the ear which serves as a screen between the reverberated sound coming from the external auditory canal and the microphone.
• the acoustic feedback effect between the reverberated sound coming from the external auditory canal arriving on the microphone (s) is very attenuated, or even eliminated (depending on the amplification and the opening of the mouthpiece, sought after) due to the combination of the two means consisting on the one hand of sufficient distance between the ear canal and the microphone (s) located near the temporo-occipital zone, and on the other hand of the existence of a natural acoustic barrier formed by the ear pavilion.
• the housing 1 may have a small thickness so as not to reveal any excess thickness when it is masked by the hair.
• the connection 4 between the housing 1 and the earpiece 3 is constituted by an electric cable.
• the earpiece comprises an electroacoustic transducer intended to be inserted into the external auditory canal of the patient.
• this link 4 is an acoustic tube.
• the earpiece is integrated into the external housing 1 and extended by the acoustic tube 4 which is watertight and of suitable length to reach the bottom of the patient's external auditory canal.
• the earpiece contained in the housing is equipped with a mechanical anti-feedback damping device (damping of vibrations generated by the earpiece). It should be noted that there is no acoustic feedback phenomenon due to the fact that the sound waves generated by the earpiece are channeled by the acoustic tube.
• the cable 4 is semi-rigid so as to precisely follow a predefined path between the housing 1 and the bottom of the external auditory canal, for example by bypassing the ear from above, and to maintain the earpiece 3 in a certain position in the external ear canal.
• it is not necessary to close the ear canal with a plug to keep the earpiece in place.
• connection 4 can be flexible and the earpiece 3 or the end of the acoustic tube is maintained and centered in the external auditory canal by an in-ear support 9.
• the support in-ear 9 comprises a central housing intended to receive the earpiece 3 or the end of the acoustic tube, this central housing being connected to an external tubular element 8c by spacers 8a, 8b delimiting with the external tubular element vents allowing good ventilation of the ear canal.
• the tubular element 8c is preferably made of a compressible and / or elastic material, or is molded according to the anatomy of the patient's ear canal.
• the invention makes it possible to maintain a hearing aid device on the patient's head in an almost invisible manner, only the connection 4 remaining visible, while being very discreet.
• the virtual absence of feedback makes it possible on the one hand to increase the hearing performance of the patient thanks to better amplification, and on the other hand, to reduce the problems of hygiene and phenomenon of occlusion (sensation of 'blocked ear' resulting from the quasi-obturating ear plug, which can advantageously be replaced by the open ear support 9.
• the housing 1 contains a magnetic part 12, for example of a ferromagnetic material, which is arranged against one side of the housing so that it can be placed opposite and close to the implanted housing 2, when the prosthesis is placed on the patient's head.
• the housing 1 also contains electronic circuits 11 supplied by a thin battery (not shown), as well as a sensor 13 connected to the electronic circuits.
• the piece of ferromagnetic material can be housed in the implanted housing 2, and the magnet disposed in the housing 1.
• the senor 13 must be positioned in a precise orientation relative to the patient's head.
• certain hearing aid devices include a directional microphone or several omni-directional microphones which must be oriented so as to reproduce information on the direction from which the sounds originate, these microphones having to be positioned precisely so that the prosthesis can reproduce exact direction information from where the sounds are heard.
• FIG. 4 represents a hearing aid housing containing two microphones 13a, 13b. So that the housing and therefore the microphones are arranged in a precise orientation relative to the patient's head, the permanent magnet 21 is implanted under the skin so as to have a north-south axis (represented in the figure by arrow 24) oriented in a certain direction parallel to the surface of the skull. Furthermore, the part 12 housed in the housing 1 is replaced by a magnet 12 ', for example a permanent magnet whose north-south axis 22 is oriented in a predefined direction, parallel to the face of the housing intended to come apply against the patient's skin. In this way, the housing 1 can only be held on the patient's head in a certain orientation.
• the permanent magnet 12 ′ shown in FIG. 4, is replaced by two magnets 12a, 12b whose north-south axes 22a, 22b are oriented perpendicularly to the face of the housing intended to be applied against the patient's skin, and in opposite directions.
• the north-south axes 22a, 22b are spaced by a distance corresponding to the distance separating the north and south poles of the implanted magnet 2.
• the housing 1 can also be held on the patient's head in a certain predefined orientation thanks to the embodiment shown in FIG. 6.
• the implanted box 2 comprises two magnets 21a, 21b whose north-south axes 24a, 24b are oriented perpendicular to the surface of the skull, and in reverse directions.
• the housing 1 then contains a single magnet 12 'as shown in Figure 4, or two magnets 12a, 12b as shown in Figure 5 or 6, these magnets being arranged in the housing so as to come opposite a magnet implanted 21a, 21b respectively, of the same orientation, when the housing 1 is placed in the desired orientation on the patient's head.
• the outer housing 1 comprises a base la of circular shape in which are housed one or two magnets 12a and 12b, and a cover lb also of circular shape, in which are attached the microphones 13a, 13b, and possibly the electronic circuits, and the power source.
• the base 1a is maintained on the patient's skull always in the same orientation in accordance with one of the embodiments shown in Figures 4 to 6, depending on the respective polarities of the magnetic pieces 21, 21a, 21b, while the cover lb is pivotally mounted on the base la, and locked in an angular position relative to the latter by a fixing means, for example consisting of a central screw 25 passing through the cover and screwed into a central pivot provided in the base la.
• a fixing means for example consisting of a central screw 25 passing through the cover and screwed into a central pivot provided in the base la.
• Figure 8 shows in broken lines three different positions of the cover relative to the base (the cable 4 rotates while the magnets 12a, 12b remain fixed).
• the microphone (s) 13, 13a, 13b can thus be oriented in an optimal manner and with great precision by the practitioner responsible for adjusting the device or by the patient, following the implantation of the housing 2. From this In this way, any inaccuracies in the implantation of the implanted case 2 are overcome, resulting in particular from differences in morphology from one patient to another.
• the patient can thus arrange and remove the box 1 with great ease, always having the assurance that the microphones will be oriented correctly.
• the microphone or microphones 13, 13a, 13b can also be arranged at the end of a respective rigid cable, connected to the external housing 1. If the cable is conformable by the practitioner following the installation of the implanted housing 2, in order to arrange and correctly orient the microphone (s) relative to the patient's head, it is not necessary for the external housing 1 to have an adjustable part.
• the implanted box 2 advantageously comprises, in addition to the magnetic part or parts 21a, 21b, a system for collecting evoked or spontaneous hearing potentials.
• This system comprises at least two extra-cochlear collection electrodes 35, 36 connected to the housing.
• This system also includes an electronic collection module 32 making it possible to amplify, and optionally process the signals coming from the electrodes, 35, 36, a transfer module 33 comprising in particular a transmitting antenna for transmitting towards the outside for example by electromagnetic waves , via amplitude or frequency modulation, the signals produced by the collection module 32, a power supply 31 comprising a battery and / or coils capturing electromagnetic energy coming from an external coil, for example provided in the housing external 1.
• the box 1 can also comprise a reception module connected to a coil / antenna for receiving the signals transmitted by the transfer module 33. In this case, the external coil and the antenna of the reception module can be fixed to the base or on the cover lb of the external box.
• At least one of the collection electrodes 35, 36 is intended to be implanted near the inner ear of the patient, preferably on the round window.
• the collection module is designed to amplify and process the evoked or spontaneous acoustic potentials.
• the collection electrodes 35, 36 are implanted under the skin of the patient, also in the temporo-occipital region of the skull, to measure evoked potentials and the collection module 32 is designed to amplify and possibly treat such potentials.
• the electrodes are for example arranged at the end of flexible tongues 34a, 34b attached to the housing 2.
• a reference electrode R disposed on the housing 2 and connected to the collection module 32.
• the housing 2 contains, alternatively or in combination with the collection module 32, a stimulation module 37 connected to at least one active stimulation electrode 38, 39, implanted near the inner ear of the patient, for example on the oval window or the round window of the middle ear, or in the cochlea.
• the stimulation module 37 is connected to at least one neutral stimulation electrode remote from the inner ear.
• the stimulation module is designed to generate stimulation signals from signals received from the external box 1 via the transfer module 33.
• the electrodes 38, 39 can be replaced or combined with an electromechanical transducer vibrator, for example of the piezoelectric type, implanted in a bony or cartilaginous zone, preferably close to the inner ear of the patient, to perform electromechanical stimulation.
• an electromechanical transducer vibrator for example of the piezoelectric type, implanted in a bony or cartilaginous zone, preferably close to the inner ear of the patient, to perform electromechanical stimulation.
• the collection and stimulation electrodes are, according to an advantageous variant, common and can operate alternately in collection mode and in stimulation mode.
• one of the electrodes 38, 39 is positioned on the round window and is both an active stimulation electrode, and alternatively, one of the potential collection electrodes hearing.

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• 2002
  • 2002-06-21 FR FR0207738A patent/FR2841429B1/fr not_active Expired - Fee Related
• 2003
  • 2003-06-19 US US10/519,123 patent/US7266208B2/en not_active Expired - Lifetime
  • 2003-06-19 DE DE60334002T patent/DE60334002D1/de not_active Expired - Lifetime
  • 2003-06-19 EP EP03760752A patent/EP1522208B1/de not_active Expired - Lifetime
  • 2003-06-19 AT AT03760752T patent/ATE480108T1/de not_active IP Right Cessation
  • 2003-06-19 AU AU2003260612A patent/AU2003260612A1/en not_active Abandoned
  • 2003-06-19 WO PCT/FR2003/001889 patent/WO2004002193A1/fr not_active Application Discontinuation

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