Factors Improving the Vibration Transfer of the Floating Mass Transducer at the Round Window

Objectives: With the placement of a floating mass transducer (FMT) at the round window, a new approach of coupling an implantable hearing system to the cochlea has been introduced. The aim of the present experimental study is to examine the influence of different ways of FMT placement at the round window on the vibration energy transfer to the cochlea. Material and Methods: Experiments were performed on 8 ears of human whole head specimens. A mastoidectomy and facial recess approach were performed to access the middle ear structures. Seven different conditions were compared, that is, a perpendicular or 90-degree rotated position of the FMT in the round window niche, overlaid or underlaid with connective tissue or with tight fixation and disrupted ossicular chain. The FMT was stimulated electrically and the movements at the FMT, the stapes head, and the promontory were measured using laser Doppler vibrometry. Results: Vibration transmission to the cochlear fluids was best with the FMT placed perpendicular to the round window membrane and underlaid with connective tissue. The energy transfer to the inner ear was up to 45 dB higher compared with tight fixation condition, where the poorest energy transfer was found. Underlaying the FMT with connective tissue improved energy transfer even for a suboptimal orientation of the FMT. Conclusion: The way of coupling of the FMT to the round window has a substantial influence on the vibration transmission. Energy transfer to the inner ear is highest with the FMT placed in the round window and underlaid with tissue.