Mechanical Energy Sensing and Harvesting in Micromachined Polymer-Based Piezoelectric Transducers for Fully Implanted Hearing Systems: A Review

The paper presents a comprehensive review of mechanical energy harvesters and microphone sensors for totally implanted hearing systems. The studies on hearing mechanisms, hearing losses and hearing solutions are first introduced to bring to light the necessity of creating and integrating the in vivo energy harvester and implantable microphone into a single chip. The in vivo energy harvester can continuously harness energy from the biomechanical motion of the internal organs. The implantable microphone executes mechanoelectrical transduction, and an array of such structures can filter sound frequency directly without an analogue-to-digital converter. The revision of the available transduction mechanisms, device configuration structures and piezoelectric material characteristics reveals the advantage of adopting the polymer-based piezoelectric transducers. A dual function of sensing the sound signal and simultaneously harvesting vibration energy to power up its system can be attained from a single transducer. Advanced process technology incorporates polymers into piezoelectric materials, initiating the invention of a self-powered and flexible transducer that is compatible with the human body, magnetic resonance imaging system (MRI) and the standard complementary metal-oxide-semiconductor (CMOS) processes. The polymer-based piezoelectric is a promising material that satisfies many of the requirements for obtaining high performance implantable microphones and in vivo piezoelectric energy harvesters.

Implementation of a fully implantable middle-ear hearing device chip

BACKGROUND AND OBJECTIVE: Recently, with the increase in the population of hearing impaired people, various types of hearing aids have been rapidly developed. In particular, a fully implantable middle ear hearing device (F-IMEHD) is developed for people with sensorineural hearing loss. The F-IMEHD system comprises an implantable microphone, a transducer, and a signal processor. The signal processor should have a small size and consume less power for implantation in a human body. METHODS: In this study, we designed and fabricated a signal-processing chip using the modified FFT algorithm. This algorithm was developed focusing on eliminating time delay and system complexity in the transform process. The designed signal-processing chip comprises a 4-channel WDRC, a fitting memory, a communication 1control part, and a pulse density modulator. Each channel is separated using a 64-point fast Fourier transform (FFT) method and the gain value is matched using the fitting table in the fitting memory. RESULTS AND CONCLUSION: The chip was designed by Verilog-HDL and the designed HDL codes were verified by Modelsim-PE 10.3 (Mentor graphics, USA). The chip was fabricated using a 0.18 μm CMOS process (SMIC, China). Experiments were performed on a cadaver to verify the performance of the fabricated chip.

A Vibro-Acoustic Hybrid Implantable Microphone for Middle Ear Hearing Aids and Cochlear Implants

To develop totally implantable middle ear and cochlear implants, a miniature microphone that is surgically easy to implant and has a high sensitivity in a sufficient range of audio frequencies is needed. Of the various implantable acoustic sensors under development, only micro electro-mechanical system-type acoustic sensors, which attach to the umbo of the tympanic membrane, meet these requirements. We describe a new vibro-acoustic hybrid implantable microphone (VAHIM) that combines acceleration and sound pressure sensors. Each sensor can collect the vibration of the umbo and sound pressure of the middle ear cavity. The fabricated sensor was implanted into a human temporal bone and the noise level and sensitivity were measured. From the experimental results, it is shown that the proposed method is able to provide a wider-frequency band than conventional implantable acoustic sensors.

A Retrospective Multicentre Cohort Review of Patient Characteristics and Surgical Aspects versus the Long-Term Outcomes for Recipients of a Fully Implantable Active Middle Ear Implant

Objective: To summarise treatment outcomes compared to surgical and patient variables for a multicentre recipient cohort using a fully implantable active middle ear implant for hearing impairment. To describe the authors' preferred surgical technique to determine microphone placement. Study Design: Multicentre retrospective, observational survey. Setting: Five tertiary referral centres. Patients: Carina recipients (66 ears, 62 subjects) using the current Cochlear® Carina® System or the legacy device, the Otologics® Fully Implantable Middle Ear, with a T2 transducer. Methods: Patient file review and routine clinical review. Patient outcomes assessed were satisfaction, daily use and feedback reports at the first fitting and ≥12 months after implantation. Descriptive and statistical analysis of correlations of variables and their influence on outcomes was performed. Independently reported preferred methods for microphone placement are collectively summarised. Results: The average implant experience was 3.5 years. Satisfaction increased significantly over time (p < 0.05). No correlation with covariates examined was observed. Feedback significantly decreased over time, showing a significant correlation with microphone location, primary motivation, gender, age at implantation, and contralateral hearing aid use (p < 0.05). Patient satisfaction was inversely correlated with reports of system feedback (p < 0.05). The implantable microphone was most commonly on the posterior inferior mastoid line, in 42/66 (65%) cases, correlating with less likelihood for feedback and consistent with author surgical preference. Conclusion: Carina recipients in this study present as satisfied consistent daily users with very few reports of persistent feedback. As microphone location is an influencing factor, a careful surgical consideration of microphone placement is required. The authors prefer a posterior inferior mastoid line position whenever possible.