RU162237U1 - HYBRID TYPE IN-HEAR HEARING CASE FOR Hearing Aid Hearing Aid in Patients with a Hypermobile External Hearing Aid - Google Patents

Abstract

The body of the in-ear hearing aid for hearing loss hearing loss in patients with a hypermobile external auditory canal, comprising a frame made by casting the external auditory canal from solid incompressible material LP / H Egger for the production of housings in which the electronic part of the apparatus is located, characterized in that between the first and the second bend of the external auditory canal is equipped with a ring-shaped sleeve, which is made of soft material LP / W Egger, has adhesive contact with solid material LP / H Egger.

Description

The utility model relates to medicine, namely to otorhinolaryngology and audiology, and can be used for acoustics of patients with hearing loss in whom hyperactivity of the external auditory canal is observed.

The rehabilitation of patients with hearing loss and deafness is one of the pressing social, medical and pedagogical problems, since the number of such patients in Russia exceeds 13 million people [Tavartkiladze, G.A. Rehabilitation audiology: fundamentals, principles, perspectives / G.A. Tavartkiladze // Ros. otorhinolaryngology. - 2003. - No. 3. - S. 132-135]. In the structure of hearing loss, 70-90% falls on the share of sensorineural damage to the organ of hearing [Pisanko, V.N. Hearing replacement for patients with perceptual hearing loss / V.N. Pysanko // Journal of ear, nose and throat diseases. - 1993. - No. 6. - S. 70-75]. In the presence of a sensorineural damage to the organ of hearing, drug treatment is effective only in the acute stage, while in the presence of chronic sensorineural hearing loss, the only method of hearing restoration is hearing replacement, that is, the selection of hearing aids. Patients with a conductive and mixed type of hearing loss also often use hearing aids if it is not possible to restore hearing by surgery. Intra-ear hearing aids have a number of advantages compared to behind-the-ear devices, such as a subtle cosmetic body, as well as the use of physiological amplification of the auricle sound [Dillon, N. Hearing Aids. - N. Y., 2001. - 158 p.].

For patients using a behind-the-ear hearing aid, the solution to the problem of the apparatus slipping out during the movement of the lower jaw may be the use of a soft compressible insert that ideally matches the movements of the auditory meatus and moves along with the movements of the lower jaw. According to U. Voogdt (2005), a liner having a flexible connection between the first and second bend of the ear canal is also a solution. The author indicates that this solution, named by its inventor Henning Bruckhoff as a “tandem otoplasty”, has proven itself in many complex cases when the hearing aid insert is slipped out in people with hypermobile external auditory meatus [Ulrich Voogdt. Otoplastik. Median-Verlag von Killisch-Horn GmbH, 2005. - 380 p; Ulrich Voogdt. Otoplastik. Median-Verlag von Killisch-Horn GmbH, 1998. - 344 p.]. An individual earmold, proposed by Henning Brookhoff and Ulrich Vogdt in 1998, contains two parts connected by an articulation.

There are several problems with the Brookhoff-Wogdt liner. Firstly, it is quite difficult to make this type of insert technically, since there are no special certified articulated joints for joining two parts of this insert. Secondly, the soft sound guide at the junction of the two parts of this liner wears out quickly, since it is not surrounded around the liner material. Thirdly, the accumulation at the junction of the two parts of the earwax liner leads to the need for a daily toilet liner. The laborious process of removing “dried” sulfur from the “bottleneck” of the connection of the two parts is inconvenient for the patient, requires additional patient time, and in elderly patients, sometimes involving relatives to help.

In addition, when using the Brookhoff-Vogdt insert, the problem arises of correctly installing the insert in the ear, since the flexible middle part is movable, which causes the insert to slip or bend during installation in the ear. This makes it difficult to use hearing aids, especially in the elderly. In addition, the soft type of the insert and the Brookhoff-Vogdt insert cannot be used for the manufacture of cases of in-ear hearing aids, since the installation of an electronic filling (faceplate) requires a fixed rigid body.

For the prototype of the utility model, the case of an individual intra-ear hearing aid has been selected, which is made by casting the external auditory meatus from a solid incompressible material, for example, LP / H Egger. Such a solid case protects all the required electronic stuffing (faceplate) inside itself [Voogdt, U. Otoplastik special / U. Voogdt. - Median-Verlag von Killisch-Horn GmbH, 2005. - 259 s].

Despite the individual manufacturing of the intra-aural hearing aid, some patients have a problem of the apparatus slipping out during the movement of the lower jaw and the appearance of feedback — a whistle heard by others and the patient himself. This problem is associated with a change in the size of the external auditory meatus during movements in the temporomandibular joint during a conversation or eating. The role of the temporomandibular joint in electro-acoustic hearing correction is described by Oliveira R. et al. (1992) and Okeson G. (2012) [Oliveira, R. Jaw position and changes in the external auditory canal / R. Oliveira, N. Gilliom, D. Goldstein // Audiol. Today. - 1992. - Vol. 4. - P. 48; Okeson, G.P. Management of temporomandibular disorders and occlusion / G.P. Okeson. - Mosby, 2012. - 504 p.]. The authors used casts of the external auditory canal when opening and closing the mouth to study the effect of changing the topography of the external auditory canal depending on the position of the lower jaw and studying the negative effects of these changes on the appearance of feedback when using a hearing aid, as well as the appearance of discomfort when using a hearing aid. The authors found that with changes in the position of the lower jaw, the most significant deviations and changes in the shape of the external auditory meatus occur between the first and second bends of the external auditory meatus.

Oliveira R. (1992) and Okeson G. (2012) showed that the most significant changes in the size of the external auditory meatus are observed in individuals with a pathology of the temporomandibular joint. In this category of patients with a “hypermobile external auditory canal”, when using in-ear hearing aids in a solid case, the apparatus slips and feedback appears in the form of an extraneous whistle. According to published data, the prevalence of the pathology of the temporomandibular joint is high. 14-40% of the population have signs of temporomandibular joint dysfunction [Weinman A., Agerberg G. Mandibular disfunction in odolescents // Acta Odontol. Scand. - 1986. - Vol. 44. No. 1. - P. 55-62; Thompson J., Christiansen E., Hasso A., Hihshaw D. Dislocation of the temporomandibular joint meniscus (arthrography, computer tomography) // Amer. J. Roentgenol. - 1985. - Vol 44. No. 1. - P. 171-174]. According to Pisarevsky Yu.L. (2003), the temporomandibular joint pathology occurs in 70-80% of the adult population and takes third place after caries and periodontal diseases [Pisarevsky Yu.L., Semenyuk V.M., Khyshiktuev B.S. Pain syndrome of the temporomandibular joint in women. M .: Medical book, 2003. - 104 p.]. Thus, the literature data indicate a significant prevalence of the temporomandibular joint pathology, which leads to hypermobility of the external auditory meatus between the first and second bends, which is a potential problem in hearing prosthetics.

The objective of the utility model was the development of the body of the in-ear hearing aid for hearing loss hearing loss in patients with a hypermobile external auditory canal, devoid of the above disadvantages.

EFFECT: increased reliability of fixation of a hearing aid in a patient’s ear, prevention of its slipping out and occurrence of acoustic feedback.

The specified technical result is achieved by the fact that in the body of the in-ear hearing aid for hearing loss hearing loss in patients with a hypermobile external auditory canal containing a frame made by casting the external auditory canal from solid incompressible material LP / H Egger for the production of housings in which the electronic part of the apparatus is located , according to a utility model, between the first and second bend of the external auditory meatus, the frame is equipped with an annular coupling, which is made of soft material LP / W Egge r, has adhesive contact with the solid material LP / H Egger.

The utility model is illustrated by a figure depicting the proposed body of the intra-aural hearing aid in the patient's ear (general view).

The proposed body 1 of the in-ear hearing aid contains a frame 2, which is made of solid incompressible material LP / H Egger for the production of cases of hearing aids, which allows you to maintain the integrity of the frame of the hearing aid to ensure the safety of the electronic filling of the device. An annular sleeve 3 of soft material LP / W Egger, which is fully compatible with a solid material and having strong adhesive contact with it, is applied between the first and second bends of the external auditory meatus in the movable part of the auditory meatus. The coupling is designed to compensate for the movements of the lower jaw, since due to the compressibility of the material it prevents the apparatus from slipping out as a result of movements of the lower jaw.

The proposed housing of the aural aural device is intended for patients with a mobile external auditory canal against the background of hypermobility of the lower jaw in the temporomandibular joint. The modeling features of this case allow you to reliably fix the hearing aid in the patient’s ear, preventing it from slipping out and, as a result, preventing the occurrence of feedback acoustic communication (ear whistle). This type of case is convenient to use in people of any age, including elderly patients, since there is no need for laborious care for this type of case). The hybrid case due to the solid incompressible frame protects the electronic faceplate of the device, due to the soft coupling between the first and second bends of the external auditory meatus, the material is compressible and the device is prevented from slipping due to movements of the lower jaw.

The hybrid-type intra-aural hearing aid enclosure was used in the case of 7 patients with mobile external auditory meatus and hypermotility of the temporomandibular joint.

Example 1

Patient A., 52 years old.

Diagnosis: Bilateral chronic sensorineural hearing loss III-IV degree. Sop. Hypermobility of the lower jaw on the right.

ENT examination: ENT organs without features. Otoscopic picture: eardrums are gray, contour. Tonal threshold audiometry: disturbance of sound perception from two sides. Tympanometry: tympanogram: AD: type "A", AS: type "A". According to the accuracy of the data, the patient did not perceive whispering before hearing replacement, colloquial speech near the ear, 80% speech intelligibility was achieved at a signal intensity of 80 dB, 100% speech intelligibility was not achieved. The patient had experience using intra-ear hearing aids for 4 years, noted discomfort when using the right hearing aid, his slipping out when opening his mouth, and an extraneous whistle while eating.

The patient underwent binaural selection of intra-ear hearing aids and the inventive hybrid-type case was made on the right. When using a hearing aid with the proposed type of body, a positive functional result is obtained. After hearing prosthetics, the patient can clearly distinguish conversational speech from a distance of 6 meters, whispering - 5 meters. Subsequently, after 7, 21, 60 days during the control examination of the patient, he noted the convenience of using this type of body, the absence of discomfort during its use, the absence of the body slipping out of the ear and extraneous ear noise (whistling), good speech intelligibility in any situations, and the absence of distortion sounds of speech.

Example 2

Patient M., 41 years old.

Diagnosis: Otosclerosis. Mixed hearing loss II degree on both sides. He wears an in-ear hearing aid on his right ear for 12 years. The patient notes discomfort in the apparatus when chewing and eating, when opening her mouth - sometimes a whistle in the hearing aid, is forced to constantly correct the body of the hearing aid in the ear, as it slips out.

ENT examination: ENT organs without features, with otoscopy, the eardrum is pale, contour. Impedanceometry: tympanogram-type “As” on both sides, acoustic muscle reflexes not recorded, tonal threshold audiometry: mixed-type disturbance, average hearing threshold in air at 4 speech frequencies - 52.50 dB to the right and 51.25 dB to the left; on the bone - 32.50 dB on the right and 33.75 dB on the left. According to the accuracy of the data, the patient did not perceive whispering speech, conversational speech - from a distance of 2-3 meters, 80% speech intelligibility was achieved with a signal intensity of more than 65 dB, 100% speech intelligibility - 80 dB.

A hybrid-type casing was made, consisting of a solid casing with a soft ring-shaped coupling at the site of the greatest mobility of the auditory meatus between the first and second bend. When using the in-ear hearing aid with this type of body, a good functional result is obtained. The patient noted the convenience of using a hearing aid. The device stopped falling out of the ear, and there was no whistle when opening the mouth. Speech intelligibility during a conversation simultaneously with several people improved, there was no distortion of speech sounds.

Claims (1)

The body of the in-ear hearing aid for hearing loss hearing loss in patients with a hypermobile external auditory canal, comprising a frame made by casting the external auditory canal from solid incompressible material LP / H Egger for the production of housings in which the electronic part of the apparatus is located, characterized in that between the first and the second bend of the external auditory canal is equipped with a ring-shaped sleeve, which is made of soft material LP / W Egger, has adhesive contact with solid material LP / H Egger.

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