WO2009121098A1 - Tissue injection fixation system for a prosthetic device - Google Patents

Tissue injection fixation system for a prosthetic device Download PDF

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Publication number
WO2009121098A1
WO2009121098A1 PCT/AU2009/000351 AU2009000351W WO2009121098A1 WO 2009121098 A1 WO2009121098 A1 WO 2009121098A1 AU 2009000351 W AU2009000351 W AU 2009000351W WO 2009121098 A1 WO2009121098 A1 WO 2009121098A1
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WO
WIPO (PCT)
Prior art keywords
ths
layers
tbs
oss
boss
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PCT/AU2009/000351
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French (fr)
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WO2009121098A9 (en
Inventor
John Parker
Original Assignee
Cochlear Limited
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Publication date
Application filed by Cochlear Limited filed Critical Cochlear Limited
Publication of WO2009121098A1 publication Critical patent/WO2009121098A1/en
Publication of WO2009121098A9 publication Critical patent/WO2009121098A9/en

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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
    • 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
    • H04R25/70—Adaptation of deaf aid to hearing loss, e.g. initial electronic fitting
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/05—General characteristics of the apparatus combined with other kinds of therapy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00—Anatomical parts of the body
    • A61M2210/06—Head
    • A61M2210/0662—Ears
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/142—Pressure infusion, e.g. using pumps
    • A61M5/14244—Pressure infusion, e.g. using pumps adapted to be carried by the patient, e.g. portable on the body
    • A61M5/14276—Pressure infusion, e.g. using pumps adapted to be carried by the patient, e.g. portable on the body specially adapted for implantation
    • H—ELECTRICITY
    • H04—ELECTRIC COMMUNICATION TECHNIQUE
    • H04R—LOUDSPEAKERS, MICROPHONES, GRAMOPHONE PICK-UPS OR LIKE ACOUSTIC ELECTROMECHANICAL TRANSDUCERS; DEAF-AID SETS; PUBLIC ADDRESS SYSTEMS
    • H04R2460/00—Details of hearing devices, i.e. of ear- or headphones covered by H04R1/10 or H04R5/033 but not provided for in any of their subgroups, or of hearing aids covered by H04R25/00 but not provided for in any of its subgroups
    • H04R2460/13—Hearing devices using bone conduction transducers
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T29/00—Metal working
    • Y10T29/49—Method of mechanical manufacture
    • Y10T29/4957—Sound device making
    • Y10T29/49572—Hearing aid component making

Definitions

  • Fisid ⁇ fike Inwnii&n imm ⁇ TIis present rnvs ⁇ tisft relate geser ⁇ liy to prosthetic dsvtees, aad mere. psnieula ⁇ j ts & tissue, ⁇ ajscti ⁇ s Sxstiss sysiasi fer a pr ⁇ stbstse device.
  • wM «h may b ⁇ ⁇ Me to Bxasy dsfiere ⁇ st OJ ⁇ OSSS, is gsassally of ⁇ o types, cosdsicS ⁇ vs or sensorineural In TBany p «opls ⁇ ; feo ⁇ s pro&usdiy ses.1 the te ⁇ »» Csr fessr d t sairxss Is .beariag loss.
  • Thk type of hea ⁇ sg ioss is GUS t ⁇ &e sbseaoe e r r deslxu ⁇ ;tkm of the h&& colls fc fes ⁇ xsch.lea whici?. feae ⁇ uce aes>asfe signals fato ssrvs i ⁇ sp ⁇ ls €s.
  • pmstisetls h ⁇ riag i ⁇ ⁇ iaat is refs ⁇ x ⁇ ti to ss & cocMsar ⁇ s ⁇ ia ⁇ t.
  • JS&SSJ Hasbsr individuals safferfsg fern cmstsc-we fsesrmg loss typically receive.
  • ss acoustic Iiesring aid, referred to & ⁇ s hearing *sd isateis. Heating aids rely ⁇ s.
  • M psrts ⁇ dar, a lsssrkig aid typically i ⁇ «& ssi sirasig ⁇ smsat positiossd £ ⁇ && resiple&t's ear caa&l Jo a& ⁇ i ⁇ ly a soutsd roeerre ⁇ by ths oatsr ear of the tecfptsst ThLs a ⁇ spHfied sound resch.es the csoclsitsa aad casises ⁇ rso ⁇ ioji of Lhss cocMsa ffaid and stimulation of &e eocM ⁇ a hear cs ⁇ is.
  • ss is ⁇ isniabb aachor cos ⁇ dsisg s ⁇ fet& ⁇ iy of ⁇ bmeats coailgssred to %e iss ⁇ t ⁇ ed ta M least oss of the ess or sscs ⁇ s kycrs of tfesus sdjss«i5t the skull s «cn that vibratioas apph'ad theratc are irattss&rred to ih ⁇ ssmil; as ⁇ a vibrator?
  • FIG . 2 is a schematic diagram of a boss c ⁇ s ⁇ &c&s ⁇ device; stss ⁇ j FlG. 3 is aa expbded vl ⁇ w of sa external sedate for a bone coadiictssa dsadcs; prj
  • ⁇ & ⁇ 3- 5 is a gR ⁇ pfe iihistsrstiag tte loagtio-lsjai fcsdiisg fores atrvs S>r a ham screw s ⁇ t ial « she sb.j. ⁇ l boss as the boss ksals over time;
  • FIG. 6 is a scctbasl view of a first alternative oml ⁇ dimeat for ⁇ s. ⁇ ? vibrst ⁇ ry sssxplcr ssscsristed with fee externa! ⁇ s ⁇ lale of a bs>s « eosdr ⁇ tsaa device ⁇
  • ⁇ t ⁇ zii BG. 7 is & sectbaal view of a second aM ⁇ snstive smbotiisaeat for th « v3 ⁇ ais?y couplet sssoeist ⁇ d ⁇ ith the ecstesmi i ⁇ dute of a bose coa ⁇ iuc ⁇ ioa dcvic-s;
  • FIG. 8A is a sestfosal visw of a Srst siteniatiys embodlass ⁇ fo ⁇ ⁇ m soutsseas of & f> ⁇ $£ . ⁇ sducdo ⁇ s ds ⁇ 'ice;
  • ISS24? FIO. 9A is s perspective view of & first alt ⁇ sMms embodssisai &r slwsg demeats isssodst ⁇ d. wi ⁇ the at?a ⁇ S2i ⁇ i;
  • FIG. 9.3 iOustnstss a scctiossl view of tbs co ⁇ pUsg b ⁇ ees shea ⁇ ag siess ⁇ s ⁇ s of FCG. 9A;
  • FIG. 10 is a sectbasi -view of a feaia aitssastivs ensbodimeat S>r the abutassst af a fcsss
  • I8832J Tlis prsssM in y ⁇ ibs is directed S ⁇ wsrd a sxalioa system for a prosthetic device, such, as boss ⁇ %mdust ⁇ bs devise.
  • As anchor is hx ⁇ l&nte ⁇ is the recipient
  • a T&ratsry coaplef «aasds fess the boss eosKhjciios device.
  • Tiss vibts&osy cas ⁇ ler cos5prls «s S sxmdsctkm sis-feco and & magast.
  • the ⁇ sagast Ia the -vibratory cot ⁇ lsr attracts to the sspk ⁇ sJsb! « a ⁇ bor to ⁇ &tm& ths oosd ⁇ cts>a sssrSc-e Mjacea ⁇ ike one or awe 1&ye?% thereby caabfeig v&sfcas to pass fern Ose ?x>ne conduction device to tlse akulL
  • FIG. I 3S a perspective view of ass es ⁇ mplsry bosa ⁇ smdxsctbn device iOl which e ⁇ odkss ⁇ ts of the prsssnl mvea&js may bs advastageo asly imp ⁇ emss ⁇ ted Tbs felly fur ⁇ bs&s! hsjsssa lssarbg asstomy is geaerally divided ap iaic tits sater gst 105, tM saddle «ar 107, sad the ixrns? «ar 109.
  • tkm device 102 is, sh ⁇ vm pou ⁇ ksm ⁇ behlad tae amiel» II ! of ths rssatpseal, aMho y gh &is dsvise coafd also be podtba ⁇ d m a.
  • Boae ossdactksa device H)I includes sa as4 «sml xns ⁇ &k 127 5 &ad is O5ts ⁇ >ied to Lte skdl of the tec%issi via as isr ⁇ lasied ancbor, sacb as boas s-crew 129.
  • Boac screw 129 is secured to Ik? skuli kme 131 disrisjg fee isspks ⁇ pmse ⁇ sirs.
  • aay sppropnais a ⁇ slmr system may be used i ⁇ lien of fes boss aexw 129 » so l&ag as she sadsor system co&ducis suO ⁇ elesi vgsn&kms fesi rise bass coadtietba dcrs ⁇ cs 101 fas £hs recipient t» perceive ihs vitErslisss as soassi Fcsr ejKSGpfe.
  • Fox sxatspki, tbe tnaierisi may be m m&t ⁇ that does aot stt ⁇ sskii ⁇ aa aBas&imble response ⁇ sf body systems, ⁇ ?r k may fee any stssr type af bbe.osiga ⁇ sbfc ai&terfal. i®83C; Tlie soiHXs s.t ⁇ i slgsai preeessing cotsspoBssts of s ⁇ eraal sa ⁇ dals KS? are schotaatically shows k. FKl- 2.
  • naoduie 215 may also be «?loctroa.osUly eouss ⁇ ed to transducer us ⁇ du-fe 21 J , ⁇ aay ⁇ flier csis ⁇ oseat ⁇ ⁇ f ⁇ xi ⁇ -D&s jBs& ⁇ fe 127, Cssirc4 ⁇ aodu& 215 sxsoa&vm m ⁇ «ontf«ls spera ⁇ oB of the ds ⁇ teorsc u>i ⁇ 5oaest5 ss5d ckcaits to wi ⁇ it is eejmsct ⁇ d.
  • control ⁇ o-yidQ ⁇ hy control mods ⁇ e 215 ta&y vmy deps&diag upon ths isosspoxsaa or cir ⁇ dt tjfgc, C ⁇ stml ⁇ »dsls 215 ts&y also servs as a fsedback hop io gmvMs isorrsctioss to ths oi ⁇ pst sf aajy sss or s ⁇ r ⁇ of the pOBipssaots wlisre S£S; «SS ⁇ 5. J ;
  • Is cestasis «as ⁇ 3 ⁇ dii ⁇ !ST!iS j slgssl psrscesaor 2 ⁇ 7 may be of substotially the snx&& as tfao so ⁇ sd pmscss&f thai is 53SS3d ITS as air soxiduclssn bsarsig aid As & ⁇ >thsr option, sdgTial processor 2 Q 7 £say laclude fEsssi iJB ⁇ fcg to dfg ⁇ isl css ⁇ vert ⁇ s' and a digital sigm! processor.
  • FiG. 3 illustrates m. exploded view of tsm smbo ⁇ ime&i ⁇ f zas. external sasshiie ssf a foons c «i ⁇ 4a €tlos. device, re&rssd ts bsrsis ss exterssi module 3C 5 L Bxts ⁇ ia ⁇ sm ⁇ le 301 skews m FJ.G. 3 i-K&ades SK.
  • Electrcsnics CKcisit 309 (PCB) to «5» ⁇ e5 ⁇ cs% c ⁇ t ⁇ J ⁇ «ct ssd irsieehatsicaliy sspp&n tbe vsss) «s electsotac coH ⁇ ossats ⁇ ad ckcu ⁇ ts, Otsis or sKH-a sscmphssaes 311 sre direesly ajtacssd to PCB 30SJ to Saic ⁇ oss as ss ⁇ ad pickup ⁇ ;&v3ce& A&rsMsveiv, other types of dirsct assdio isgn ⁇ .
  • a sser ktgrfas « 317 is dbpssed ⁇ 3S ose side of ttje i-yp ⁇ « rs>siplssi aeesss to iiss sjtsrfaee sssxfasls 517 factions.
  • ⁇ m&l FICl -I ilimi ⁇ sies a so ⁇ pHsig system is aecord ⁇ s ⁇ e with ombodimeats of ihs fjfesess S£ ⁇ 3iim.
  • sKo%vs, &e oe*spil ⁇ -g system co ⁇ scises a vibrafexy «ouplsr 403 sad as Ia ⁇ lanled ⁇ mcfeer system, fe the i!la ⁇ iixsted embodisne ⁇ t,.
  • v ⁇ atory csiipler 403 sstends frost ass sxiesmi xm ⁇ £ 401, so ⁇ smmes rsf «msd to icrste as a vibrsfea goasratmg tsodde 40S, aasl Is ooupisd 1x5 tkQ ijnpksnfei sschor systsia.
  • Afems ⁇ S ⁇ l 405 saay be s-elsas&biy s ⁇ lx ⁇ d is ⁇ XJ ⁇ SS SCT*W 407, abov? tissue 41 ! so that vilastosy ⁇ supksr 483 smy be s « 3 -tsd o» &but ⁇ 3sss 405,
  • the combs ⁇ stfea of vibratory caxipfe- 4SS, smrtms-st 40S, aad bosc s « ⁇ ?w 407 smbls vtbmthm itom ⁇ sxt ⁇ sms ⁇ rm ⁇ aki 4m IQ be scss ⁇ ictcd
  • tk ⁇ sbatmea ⁇ may sxtsad frsm tk ⁇ oestcsf po ⁇ ts ' Qs sf tfe piatg, im ⁇ feme® mtrnd to the akull fesl ⁇ ss* upoa the ⁇ stsssa ⁇ s>r &e « ⁇ t « ⁇ 3.sl srs>d ⁇ iie wsisid sot impact s surgically modiS «4 s&e, has ratbsr w ⁇ aid is ⁇ i ⁇ ct as uasltcsrsd sssiios oflh « skull boss.
  • the rsdk s sbe ⁇ t the « ⁇ rs ⁇ soss-seetJoa seed BS ⁇ : ⁇ e OSS ⁇ S&SKL
  • a constsst sradkss m&y be men is CHCSisnstancfis whe-ji ⁇ it is de&ted to allow ths ssoduk to bs ssmisi-sd -wish z&y ooastaikm.
  • a sos-cossiasi radius may Ix? used.
  • Ia eircassstascss where the external sjadub is intended to liav ⁇ ot ⁇ y a ssagls ors ⁇ sstatu> ⁇ i w&ers the v ⁇ sausry ⁇ suplsr is ses ⁇ ed ⁇ ss the sbumassl imm ⁇ Is the ⁇ lhisty.s-e& esabodims-aj, sbatraeat 403 comprises a bearsag surSsc ⁇ 413 of wl ⁇ kb. ⁇ steads away Irons, a essadtsctbs surface 415.
  • the ooaduc ⁇ o « surface is preferably platssr to l&ciSate ossipf ⁇ g wkh vsljmto ⁇ y confer 403 asd ooatkctksa of vibmtb-ss.
  • the srsigsetic tsmterkl sn&y havs asj? gsoBi «&iG&! configssatsas that ss ⁇ tts oHi&r desiga cfe ⁇ iees that are made cosce ⁇ isag sbuisssai 403 ss ⁇ vujrsiojy ctsspkr 483.
  • Msgsssfe ⁇ s ⁇ sat ⁇ rial 419 Is ps&rably sasgae-fesafele matssial, ssx ⁇ sot a psnsaae&t smgaet, sfek) ⁇ gh a petarnaeM ss ⁇ gset could ' bo ased.
  • the ksk&g fbi ⁇ s- sh ⁇ uld also be suSk ⁇ eni io nsaMafe the seaissg wf ⁇ «& tae trss ⁇ aataseous fbrcc gesisrassi fey vibsa ⁇ o-Bs fro ⁇ s.
  • external rmxiule 401 are coi ⁇ isd wiife the weight of vlhr&tory couple * 403. pss ⁇ ] Lever&giag cxkmsksxi.
  • Ths coaSgtsstbti of iiis kveragisg sjcte&ssos 425 ssay vary widely.
  • ers_bo ⁇ &mjst, tsore s ⁇ m are pis&mfeK hswewr, ss Ibw s» tw ⁇ sxzm 1 WUi gsaes&ily sisftlcs, imszi FiG, 4B Ulssi ⁇ ss &>v ⁇ ths ⁇ i?rator>'- c-ospfe 403 is ⁇ &cmipisd I ⁇ S sbaimsst 405 when a pssi of ihs extemsl oxxMe 401 ss sabjeetsd ix> a lores sism is taagent ⁇ al t ⁇ tls ⁇ skull.
  • Th(s pivcstkg action is satssed by Ifae fevsmgisg «fes3S3«s 42S s «&ts ⁇ l ⁇ pea the sheif 417 of abifessxEt 405 ois ths opposJta ⁇ ⁇ s of vibraion-' c ⁇ v ⁇ ks 1 4(53 S ⁇ J where the fbrse is msid ⁇ sst.
  • Upoa of tfes force-, F, ievc ⁇ sgi ⁇ ig ext ⁇ sioxi 425 acts as a !evs?r a nr ⁇ s:aci assist ss i ⁇ issg aid isagseiically mags «i 421 tr ⁇ m magsstie material 419 « By esusiag ths dssoupSsg m thk ⁇ jsss ⁇ sr, the ssmiasS of t ⁇ asget ⁇ si ⁇ i ibr-c « to whlca abu&isgnt 405 k sabjsscted is sig ⁇ -if ⁇ ca ⁇ iy reduced,
  • boss screw ⁇ implaated, fee aissousss of taageatM ksadiag Ssrce to v ⁇ skk it saiy bs sabjeeted is sos ⁇ swlat b%h.
  • Ths decisase is sst fe ⁇ s ⁇ ps ⁇ tklly das m
  • H structure the damaged s ⁇ e bef ⁇ te begk&kg so retalkl m ⁇ ise&i the bom Ti&is, tbil ⁇ wbg i ⁇ ipk ⁇ t ⁇ tiios of a boss screw, iisstil a pfeysieiss dsssrxsiass thai the issjsLast site is Hilly sesis ⁇ , Jf share is sigmficsst risk si d-ss&gjtag lh« bom s£ &e si ⁇ kst sits by xveamg ths asternal tHOdislSj tlses ⁇ ise SKtessal ssodsile Is sot generally worn.
  • S .Ssr my particular aspksr recipi ⁇ it. piSS5j FKl. " sltetmt-ss ssother emfecsdmnsjaf of a vibra&sry ⁇ siEpisr 701 fa scsorda ⁇ ce with «s ⁇ bc ⁇ Kmssts of tKe presest fcvi ⁇ a ⁇ s ⁇ s, As sknv-s, vibratory co ⁇ kr 70 J koludss a jsbssth 793 is fbrsss!
  • S illustrates atamtivs s ⁇ dHse « ⁇ s for as abut ⁇ ssal fa aecsrdass ⁇ e with. ⁇ sskxfegisfe of lbs pressor sr>ssn.tiOB s -refersd to as stessa ⁇ t 8DL
  • A.bt * irB su % ⁇ l f ⁇ di ⁇ £r educes fee smsaust of tsi ⁇ ge&ls& ⁇ io ⁇ xs& to which use betas senssv S(B,- or other boa ⁇ snshor, might ho subjected.
  • ⁇ sa sur& ⁇ s Qf ths places. 811 may ba psifehed, or aitemsn ⁇ eiv, & Mbrlca ⁇ t may bs iacludsd w ⁇ hia osster sheath.805.
  • ssa ⁇ e ⁇ al I ⁇ JEB wMck j?kt «s SIi s ⁇ e somts-acted is a ⁇ sMlsr of design, choice. For example s they say be s ⁇ astru ⁇ cd Sons.
  • ⁇ wstii O ⁇ itsr s ⁇ ath 805 serves st Issst s fe%v purposes m this enisodsssst Pksl »ss ⁇ «r sksith 80S ssafctaiss esscb pijsts 811 wj£hss th ⁇ stack si physscai c ⁇ sisot wt& ⁇ s$? ⁇ a4jacoai piafe to ecsiar ⁇ that aln ⁇ scs ⁇ 805 is mschasiesily .stiff ' ia s dirssdon so ⁇ smi to tbs sk ⁇ s ⁇ Sy siaistasaisg sscb ojstsct, sB.d thereby .fcsspsjg fe ⁇ si&ak olpktsij 80S sjeds
  • Asotfesr pcrpos ⁇ of outss sbssik Z ⁇ 5 is in lls ⁇ xt b ⁇ s ⁇ & ⁇ sik&g sf fee pls ⁇ es 811 so fess: & eo ⁇ ductios paik Is msfets-s&ed is psss vibnsik>ss iroBJthe ⁇ sstes'osl jsociuls ⁇ o ⁇ s ⁇ bono &csr«w 8C3.
  • Yai aisofees panose of ⁇ &s outer sheath S ⁇ 5 is fe sssist m refcssisg pls ⁇ es B.I 1 to ibe ⁇ :k4saU- st»dc cottSgsarstJoa & ⁇ owiag ddbrmatson of tiss sissk wlsss subjected to l ⁇ s?i FIO. iB sM>ws t&g stack »f pk ⁇ ss 8ii witb. the top two plates SHa 5 811b Ustesnal ⁇ y displaces! as a resslt of a kteraJ torce F.
  • the pfc 903a sathss sadpkts 90Ia (as sfaowa).
  • s&gk- adjacent piste may siilssr b» oxait ⁇ ed fesm ⁇ s? ooaslrsctisa or vised for sfi ⁇ thsT piirpose—lackiag as astjs ⁇ ?m pisS ⁇ s the pis 903 of the ead pisse 901a is mi imasbcA kto s the s ⁇ t 9(35a ⁇ d is «sck pkie 9 ⁇ la ⁇ d is csrve ⁇ 3 so that when tlio «tad ⁇ 901 is siiij
  • dfeplas ⁇ roesi of any one or m y i& pktes will iisleo cssss rotatiojs of the displaced plates.
  • Such ⁇ sla ⁇ ba helj&s in ikrtfesr absorb asy sicidoat ⁇ szsml S>rees.
  • Bscssae the plate ars Imerkjck ⁇ d, aisd an outer sheath ss tsot required, sitk y ogh o ⁇ .e may ! ⁇ s sssd.
  • the out ⁇ - sksaik may be eos ⁇ stnseted tssiag s shape saesBssry ss ⁇ srk! &$ ⁇ .
  • smbodii ⁇ ssst of as abaitne ⁇ i is scc»rdsts.ce with « ⁇ 3hG ⁇ isB£ns:5 of sfe prssstit kvemiss, is iHustnuM as abu ⁇ msat 11 Ol is FIO, IL 7Ms atjutmest iseMdes tm ®8tes ⁇ shea ⁇ . H03 -with >m exts ⁇ isl pr ⁇ Sle wMs'a is a ⁇ isitsr of design choies.
  • Ou&sr shsatth 1103 issy be Ss ⁇ t&sci s,s s ius ⁇ ws, it taay be fcrs ⁇ ed say of the sthsr smbodirse ⁇ -i& tiissassssd .bcjBJD, sr it may h&vv mi sstirdy differsat sbap ⁇ to sus other dessga Outer shss& ibrxas sa iatg ⁇ sal ssv&y 1105, Ia -wMcfe is ⁇ k$os#& & jjmxinaai piste 1107, & ⁇ hts.1.
  • piM ⁇ ! 109 a W ⁇ B lllL whiolj ferns a Sssibis cotsdsscticfn pafL arid a spiisg i!13.
  • the pmxiraal pkts .1107 k disposed adjacest to, ssd may be cosplM fe, ttse co ⁇ jdio « ssrfsss 11 IS o£ ⁇ sy ⁇ te ⁇ shesjth 1103 sKch ih&£ vifers ⁇ as applied Co r ⁇ sdsictfoa sur&ce IUS psm fe distal canal H 09.
  • ss ⁇ sg H IS is disposed betwees pr ⁇ yimsi & «d distal pistes J ?07 S 1109, bM spring 1113 biases tlic plsiss 1107, 1109 sway from ose ssotfaer,, thereby gkcisg the vdrs HU mi ⁇ &t tsBsios asx ⁇ «ssb ⁇ ag the mrs 1111 to soaduct vsbr ⁇ &sas applied to pmxiisal plate 1107 sii ⁇ j ⁇ gh.
  • osr ⁇ tiu ⁇ cd is a as ⁇ sr of design dsosea Tksse sk ⁇ lcd ia iis art will ⁇ x «gas ⁇ e llsat cerlals tsaic ⁇ ate, suc& as jsstaia and oihs ⁇ ssaimsls tfest ⁇ s?e less suscqjt ⁇ bls to >>er ⁇ jsas?il ds&rsj&i'bo. due fe stresclimg, srs.
  • J 203 Is prsferably ⁇ osstr ⁇ ete- ⁇ usmg s sjssps i&e ⁇ ory si&kd&l to ⁇ mvi ⁇ e some SsssbiHSy, bat ai the same ikas be sufSciesdy ngid So seat s "v&r&Sery coupler.
  • Outer sbsaih 1203 isefodss 2 ctatslsctjos sar&os 120?
  • the spiral spdsg 12-13 ha ⁇ aa o ⁇ tsr esd coupled to distal surface 1209 ⁇ ami the ⁇ sagnst_ 1215 b coiipi «d IB tfas csatsr w ⁇ of tks spiral spring.
  • Tl ⁇ e 3B£g£5et 1215 has a magsetb sxi% M 5 .
  • fe « spirsi spr ⁇ g 1213 biases the tmgast 1215 so that &o ssagBJsHfi axis fe sot psia ⁇ lei to, sad is rssfersb ⁇ y p ⁇ rpess ⁇ csilsr fe s t ⁇ se soEdastsos axis .A.
  • Whan use vihs&iory confer is ses&sd on abutei ⁇ s ⁇ st 120U ' « ⁇ JwagsK wilhia ths vilsratosy coupler, as des ⁇ il> «?d Ia HG. 4
  • S ind ces magsei 1215 Ia ab ⁇ taisat 1201 to mt- ⁇ te sasd aUgjj. magsie ⁇ e axis, M, wiih the ⁇ >ssdxsctk> ⁇ axis, A.
  • the niagaet 1215 is the sbsssnm ⁇ 1201 ⁇ &taics, is Is attracted toward tks tssg ⁇ et is tfee vibratory cottier. & additfoa, caagacs 1215 Is alsiti ⁇ ist 1201 ⁇ will seat ags&si ⁇ Iisfel smdsce 15.i)9 s ils ⁇ reby ⁇ iablmg vibratbas spp ⁇ od fe> abnt ⁇ sst 1201 to pass bcjs « astchssr 121.1.
  • She canpljng system cessprises a -vibratory es>tipbr 1306 sstsckDd to, asd extssdistg Som, an sxters&l sBoda?e 13 ⁇ 3i of a Isos-e coiKkastksa device, Dkpoi8 «si wJ ⁇ S ⁇ j vilx-jdorj- v ⁇ s ⁇ ler 1306 is a tumgas ⁇ s3C>8.
  • WEssfesi by estersai module 1301 is car ⁇ pled thr ⁇ wgh i ⁇ sipisxstsd ancksr 1316 ta the skall 1.304.
  • mm As aousd, is She sikstrated ejufcodmssait, s s asga ⁇ : BOS is disposed wM ⁇ s eoiiplcr 1306. Msg ⁇ et 1308 is ⁇ mggisred to jjr ⁇ vMe as atimctkss Ssrce fesiwses vibrsSssy CGiipks- 3306 sad particles 1310, TkIs mtra ⁇ sm rstsias exteraai m ⁇ dale 1301 in posiibad «ra% sssr ⁇ ai ⁇ s ⁇ s SEd is saiS ⁇ isst to at ⁇ sdi sxtarsa!
  • sxsagset 1308 may cosx ⁇ nse a asagsssdc sssaterM ifcst Is sat a
  • Use particles may be coated, with collagen to ⁇ mt Other pssti ⁇ lss ss>£ ⁇ risiBg, sack as silicons particles, may $ZQW&t$ tissos Is-gro- ⁇ vth. there with to ⁇ nsvsst islgrsJioo. s ⁇ ?;i
  • TKs g ⁇ ssaklsd jaaterkl 1322 may say a ⁇ ibsr of dsSsres ⁇ Syjses of material, Scorn sasd, to magsetizeafe ⁇ partscfes, to s ⁇ mll ' beads, wk « ⁇ «r plsatic. glass, or isefcai and the like.
  • M&gnst 13S8 is eostsgared !o provide &a attrsstfes fees beiw$ «s vsbnstory e ⁇ apier 13 ⁇ € ⁇ and psr&ies 1310. This s; ⁇ sctios r&t&tss sxie-sasi ssodais 1301 ta pos&b ⁇ ⁇ i?jrisg UOHBS!
  • tlis fetsjdsfe m ⁇ ®x ⁇ s &f ⁇ $ ⁇ ps ⁇ sssBi kyss ⁇ fes sboaid set be iks ⁇ ted by my of the ⁇ ovs-dsserfbsd axetapiary sisljodime ⁇ ts, !? ⁇ t sb ⁇ aM be deOa-sd ⁇ sly isi sca ⁇ jniasea wish tk ⁇ iblb?ai ⁇ skims aa ⁇ l tlssr aqaivalsss ⁇ .

Abstract

A fixation system for a bone conduction device is disclosed. The fixation system comprises an implantable anchor comprising a plurality of elements configured to be implanted in at least one of the one or more layers of tissue adjacent the skull of a recipient such that vibrations applied thereto are transferred to the skull. The fixation system further comprises a vibratory coupler, extending from the bone conduction device, comprising a conduction surface and a magnet, wherin when the condition surface is adjacent the one or more layers, the magnet is altracted to the implantable anchor to retain the condition surface adjacent the one or more layers, thereby enabling vibrations to pass from the bone conduction device to the skull.

Description

TISSOE IMI&CnON MXATIOK SYSTEM FORA PROSTHETIC DKVICg
CROSS-REFERENCE TO RELATED ,4PFLIOVfIONS
[Orø.3 Us.© ψεesssά application claims the benefit of U.S. Frovissosai Midgut AcpLicaiioa 61/041,182; Sled March 3 U 200S, oMέb. k kersby mcotposaJsd by rsfsrsBce OSRΪIΪL
Fisid βfike Inwnii&n imm\ TIis present rnvsπtisft relate geserεliy to prosthetic dsvtees, aad mere. psnieulaφj ts & tissue, έajsctiδs Sxstiss sysiasi fer a prαstbstse device.
imβ) Hεaxisg loss, wM«h may b© <Me to Bxasy dsfiereϊst OJΪOSSS, is gsassally of ϊ^o types, cosdsicSϊvs or sensorineural In TBany p«opls ^;feo ^s pro&usdiy ses.1 the te^»» Csr fessr dtsairxss Is .beariag loss. Thk type of heaπsg ioss is GUS tα &e sbseaoe err deslxu<;tkm of the h&& colls fc fes <xsch.lea whici?. feaeάuce aes>asfe signals fato ssrvs iϊspϋls€s. Varbuspiosihetic- liasrkg iϊaplaats havs bssn developed 1© prt>vϊde iad∑vidaak who suffer torn sers&srissu«il hs&risg loss with tlis ability to psrsxive sound. Oss such, pmstisetls hαriag iϊϊψiaat is refsϊx^ti to ss & cocMsar ϊs∑φiaΩt. Caαhlsax smpksis nss as eisctjode axrsjf fespiaaied* in the cQdslsja of & recipkat k? bypass the mechanisms oftϊsβ §sr. Mors spscSeaily, ass sisctricsl stbaϊks Is ^ts^ssed via lbs electrode array directly to the codifea serve, thersisy csasssg a bsesraϊg sessalioa.
\mm Cosdiictive kearlsg loss occiss ^ises the asrasal rαssshasπcal pathways to psϋvlde sotmd to hair cells in. Oss soeblea ars iϊΩpώdfid, ^" exatspb, Vy damage to lbs ossicular cask to oaϊ e&sssl However, bdϊviduals wk> suf&r from sonductiv© te£ϊit5g foss may stsil hsw seme Ssπs of rssidiud tjscsαse tKs bair cells k tke cecMea ssxe gssisraliy uud-imsgsd. ξ§SS5| Individuals wbo sdSsr Sots, coi-duotive headag ksss JSΪ^ tjφicsliy sot caadidatss fer a codϊlsa.- isspiast ύws to ifee fe^versible sature of tk? cochlear kspiam. SpedScally, issαtbsj of &s electede aimy isto & recipient's sochiea sresuita k tbs dsstmctiøϊϊ of tli« sssjotw o f h&k ceils vvithm the eochks. The destmcsfeti sf the cochlea h&k cells rssuits m ih& hss of all residual feaisg by the recipie^. JS&SSJ Hasbsr, individuals safferfsg fern cmstsc-we fsesrmg loss typically receive. ss acoustic Iiesring aid, referred to &≤ s hearing *sd isateis. Heating aids rely ©s. prisdpkss of sir SGndsc&Ds KJ trsssmil srøusfc sigssls tfero-ugh the sister asά ssiddle- ears to tfes cochlea. , M psrtsαdar, a lsssrkig aid typically i駫& ssi sirasig^smsat positiossd £α && resiple&t's ear caa&l Jo a&ψiϊly a soutsd roeerreά by ths oatsr ear of the tecfptsst ThLs aαspHfied sound resch.es the csoclsitsa aad casises ϊrsoέioji of Lhss cocMsa ffaid and stimulation of &e eocMβa hear csϊis.
$$37] UsslbttunateJy, not ail jBdiyidtϊals who ssifer issm cofsducfive hesrrsg loss are able ts d*rhrc ratable beaefe &>tE hssring aids. F&r exsaφie, some iadividaais sre prose to cisroski isilamπ^-stm or i&feetbπ «f the car esaai ss&d «-aκaot wear liearlag mύ&. Other fadtvldsjals havs rπai-brssed <sr alsseπϊ o^tfir sar aud/ϊjr esr sss&fs as a rβstilt of a btrtk dsiest, or as a ressiK »f couiiSssa Bsedica! coadkioas sisoh ss lssaaho1 CaSias »yo.4rδBie ot Mierom, Fisrifeaamors, lieariag skis aie t]φi«ϊMy aasiiftabtc fer individuals who ssffer ikjtn jsiagfe-isidisd dsa&ess (total Iiαsrsig hs& tmly m oiϊδ e-sr) or sadividusis vvfe suffer from mϊxsd bearing tosses (fe. Cossbissϋoas «>f SKOSoπjiesra! ;«sd coaduetive kearkϊg fess), lϋWSξ Ttess ϊftdws<laals wk> oassssi ixaøSt fern heaπag aids ϊ∑-ay bcaei^ fern hesπsg ρtχjsthc3ϊ*.s ϊksst SiSC llϊe isπncψϊes »f Ijotsc coisdsotlssi device to pvø/viάs acousric si'gaals to s T£&ipi$$t. Such kesrisg pmsthsses άkzci vjbratlotϊs Jsas ths boBS, so that the
Figure imgf000003_0001
srs coϊsώseteά ssts ih« c^chlss «ssd result m stisεαilstioa of tlis hsks in ϊhs eocMea, Has tjpe ol pκsstαc3ls Is tjpioally r§Sfiτ«4 to ss a boss cos.ds.onon davϊcs.
Figure imgf000003_0002
devices fenicnaii fey cεκ}vsttiag a reε-sJ¥«d soiiδsl signal info a fπects&skϊsl v^rstsin rsoϊssβstaiϊve øf Ck>3 received soiasd. This vϊferatsas ts ihesi trssβførod to the boϊiss sk««hire of tlje sbjii εsuisisg vϊbrsεbs of lho ?essp!*M6s skull. This skull vibratioa ΠSSK&S Is .amios of tac ϊMά of &e es>eMea> t^greby sfeiilsfeg she oseMea Ijair ssila sad c;m;?fef a hssrfsg -seasatioπ εs IΪS j&erssh'αϊ hy llis ξ-estpfest. Vibratioa Hoss & bos.c ccmduciios device Ϊ$ gcacrsUy coadacisd to the xscφiest's sodiJea via a screw ssϊpkatsd ia the txscψiϊϊsst's
p«8§ llx÷ xksli boϊjsjj at Us© ixsixit of impiaat of the bone screw, is susceptible ks άajoagx; &ois Merai S>TO«JS s>a this base scrgw, psjticukrly ώsri?^ tfec .heaibg p«sriød Ibllowiag tls© irsplsut procedars. This he^mg persod varies ?rom persi>ts ts jrøsotj, dqsssdkg tψm mmy mc-tora assootstsd wi£h ώe pstisHt*s overall lssalth and gβsstscs, bat geaasaMy tates six weeks ot mam. øuπ&g &e Jbesli*s§ period, fee boss is so susceptible to da∑sage thai tks gsssrs! practice is thsi ihs- Iwas e&adacfca device Is as* coaplsά to bone screw oπ&i lbs hsaiisg psrfosS IMSS esded. Furshe?.. while siss boas ϊs less suseeptibls to daxssgs follovresg the BssHsg period, <krϊ$ag« may sifii "bs possible if & lsrgs latex&l S>rcs is sppEsd thereto.
;§§SΪ| lsi accordsncs witis isspects of ilie present lαvsaiisHs, a fb&aiibs system t>x sougSsg a k>as sosdϊictba∑ device to a m%is$ϊ have ess &r mors layers of tfesiss sdjacsst the skall ox tBs rrøpieal is pssjvsded. The ilxadoa system cstspsises: ss isφisniabb aachor cos^dsisg s φfet&ϋiy of ώbmeats coailgssred to %e issφtøed ta M least oss of the ess or sscs∑s kycrs of tfesus sdjss«i5t the skull s«cn that vibratioas apph'ad theratc are irattss&rred to ih© ssmil; asά a vibrator? αsupbs; «stss5diπg fern ώ£ bans oaxiάndm-n device, coπ^sisfeg & scsaducfϋots sarfe© sad &
Figure imgf000004_0001
whgs the mnήuctkm sωr&cs is %diaceat ihs ons or τmv& kysra, ύx» rsϊsgaet ss sEtrscted ks the isiplasstaHs sαehos to xetaia the cendαctloa sarfass sijassaϊl ihss one αr asϊrs thsreby «asbitsg vfeatsoas to sass frøxstiss boas coudactios device to the skull.
IW3| Is ssGfcrάsssεe ith other aspects of εhs presεat issvsatba, a fis&tjo» system ^r coapϋag a prasisβfe device to ?oι 5-@φism Ijsvissg αn$ or αiαre layers ef tϊssss© is provided Ths fesϋioa sj'Stsjs c<mspdses sπ. iϊjsplgsϊώte sacaor εossψrismg a pfcπilϋy of eiemssiss eø&Sgsrø- to fee iπφfeatcd m. si least os« of tfea ose or mat® layers of tissue; asd s csrølsr, exieaάbig %om the pmsthe&s device
Figure imgf000004_0002
s .SJSI surface &nd a isagsst, wi-srem wksx fee Srst sur&cs is adjscsst tk« OBS Ot more kyeεs, lbs ssigse-t ss aitrsictsd to the fespkπtsble sschor &* rstøk the first sαrSiss sdjaαcsi the osss or tmse \&yssB.
{89S31 IlkisεtsdYS atxsbodimesϊs of the present iswesiios srs dsscrsfesd herds w&is. πjfexssce to ifes sccsε&psπymg dr-awmgs, i& ^tiick FlQ, I is & psrti&i sed-baai view of a sk&ll showing the ear sassi the coshlss, -ssd s. booe sosdsct&m device with the fe&ss a&cksr ksgiaatted sa έ&s sksili mά the e-xierssl ssssdab soispisd ;s ϋss boss asckor;
:3&35| FIG . 2 is a schematic diagram of a boss cøsά&c&sϊ device; stssδj FlG. 3 is aa expbded vlεw of sa external sedate for a bone coadiictssa dsadcs; prj| FlG. 4A is s psrttai ssctibaa? view of a Sxβtsoa system for x O»BS ooβdϊistbs da^;ice;
«S| FlQ. 4B iUsstrXι«s the vibratory oajφte ptvotsd on the ataimβM ibr the hems c^άuctios device of HG. 4A; mis) ~&<3- 5 is a gRϊpfe iihistsrstiag tte loagtio-lsjai fcsdiisg fores atrvs S>r a ham screw sεt ial« she sb.j.ϊl boss as the boss ksals over time;
$SES} FIG. 6 is a scctbasl view of a first alternative oml^dimeat for ϋs.<? vibrstσry sssxplcr ssscsristed with fee externa! πsπlale of a bs>s« eosdrøtsaa device^
{tøzii BG. 7 is & sectbaal view of a second aMβsnstive smbotiisaeat for th« v3κais?y couplet sssoeistεd ^ith the ecstesmi iπødute of a bose coa<iucϊioa dcvic-s;
3®££] FIG. 8A is a sestfosal visw of a Srst siteniatiys embodlass^ foτ ύm soutsseas of & f>ø$£ .ζϊsducdoεs ds^'ice;
■m22\ Fill , SS ϋiasέraics tlse lateral defetssatios of th& abutπseat of HO. S-A ;
ISS24? FIO. 9A is s perspective view of & first altøsMms embodssisai &r slwsg demeats isssodstώd. wiώ the at?aϊS2iβκi;
[382Si FIG. 9.3 iOustnstss a scctiossl view of tbs co^pUsg b^^ees sheaπag siessβϊsέs of FCG. 9A;
:882:^ FϊG. 10 is a s«cdb£S-d view of 3 seooad idtersiaπvε crasfes>d!m.eri tor the abats^st of s IQ0S7J FlG, 11 b & sccmntά view of & third alterative emfcocl&sest fcr tka abu&seri of a boas irnm FIG. 12 is a sectbasi -view of a feaia aitssastivs ensbodimeat S>r the abutassst af a fcsss
{W&$ FiQ, 13A h csos&-s£c£søs&i view of a ctxαpiiπg sysiam is socordasjcs wisis esϊkidiβϊests
^S5§) FXG- 13B i? «j£sss-sectioϊjal vkw of a co^plisg sj&esi Is accotdaaoe "wsili etrsfedtnseats
\<mtl FlG, 13C .Is cπss&-S3stiθϊ3ai view of & sosφ&g system Is accordance with esmsάfeses&s
I8832J Tlis prsssM inyβπibs is directed Søwsrd a sxalioa system for a prosthetic device, such, as boss <%mdust∑bs devise. As anchor is hxψl&nteή is the recipient The implantable aacksr caπτprbs& a pkrsl&y of elements configured to be sapl&sted SK &t least otjs of fee ess or SKTΓS iayesss of tissue adjacent ths skull ssαch that vibrations sppϊsedl to the sxsehsr are &amim<s«l to the skull A T&ratsry coaplef «aasds fess the boss eosKhjciios device. Tiss vibts&osy casφler cos5prls«s S sxmdsctkm sis-feco and & magast. The ∑sagast Ia the -vibratory cotφlsr attracts to the sspkϊsJsb!« a∞bor to τ&tm& ths oosdιιcts>a sssrSc-e Mjaceaϊ ike one or awe 1&ye?% thereby caabfeig v&sfcas to pass fern Ose ?x>ne conduction device to tlse akulL
[βsss] FIG. I 3S a perspective view of ass esβmplsry bosa εsmdxsctbn device iOl
Figure imgf000007_0001
which eπάodkssΩts of the prsssnl mvea&js may bs advastageo asly impϊemssϊted Tbs felly furøbs&s! hsjsssa lssarbg asstomy is geaerally divided ap iaic tits sater gst 105, tM saddle «ar 107, sad the ixrns? «ar 109. The »«t«r ear 105 iackde^ th& aarsols 111 &nά the ear saasl 113. S«*sϊϊt %vsχf»8 115 sre eollec^d by aaaicle IJ l smd chaaseled hύo (md ibivuφ. ear eaaai 113. Tbs tyjDp&siic jseasbfβss 11 ?, whicls Is located at the bαxsackrj? between Lbe auks1 ear 1OS &sά ϊhδ Ωilddie e^r 107s -vibtstss is tosporsse to tlϊs so^εd waves 107. Wstkk the middle ssr 107, γ£bsass>a of tke tyπipasic membraas 117 b c»«|>Isd to the lcaestja ovaϋs 219
Figure imgf000007_0002
thr«e iJorsBSj caliXHVsly refered to as t!ie ossicles 121. The øs&iδ&s 121 .SIter asd smpϋly lh« vuvrsdojjs, feereby «κjsmg lbs faesέra svaϋs 119 to articulate. Tks tmv<%nmt ofibs fasstra svdis 11? gcserijles pressure waves ia fee fluid wϋbia αscMsa 123, which Ia tssns induces ϊsovsϊtϊSΩt m the hsks lmisg &e msida of the cocMsa 123, Movssssπt- of the hsks gsneratcs aerrø impulses ia spsrsl gatsglioa cells to which ihe hairs srø csssjϊeeted, SSJG those n&r?& inψulses ar« parsed to ihs wά&ory aervø 125, ϋsd ikss to ϊ&s br&ls msϊ shows), wfeire they axs perosϊved as sound,
§«»«! Boss «>Bdia;tkm device 102 is, shβvm pouϋksmά behlad tae amiel» II ! of ths rssatpseal, aMhoygh &is dsvise coafd also be podtbaβd m a. variety of other possϋbss ia the skall of i lie reeipieat Boae ossdactksa device H)I includes sa as4«sml xnsώ&k 1275 &ad is O5tsχ>ied to Lte skdl of the tec%issi via as isrφlasied ancbor, sacb as boas s-crew 129. Boac screw 129 is secured to Ik? skuli kme 131 disrisjg fee isspksέ pmseάsirs. $§353 As tisseusssd m ssjra εbtaϊl "bebw, ctmseoted to K&smal πso&tle 127 Is a vi&ratoty coupler 133 wlssrfi secures external ss>άols 127 to boas screw 129. As should be appreciated, aay sppropnais aπslmr system may be used iύ lien of fes boss aexw 129» so l&ag as she sadsor system co&ducis suOϊelesi vgsn&kms fesi rise bass coadtietba dcrsπcs 101 fas £hs recipient t» perceive ihs vitErslisss as soassi Fcsr ejKSGpfe. as discussed bsJsw> th& asohar sj'sterπ sssy be isϊξϊiaMod vύάsr skis 133 of the recipient, witbis 3S3"us«l« tissas 13? ssd/or IM tsms? 139, Ia addϊtksa, tbs siat-srial fesπs.
Figure imgf000008_0001
ύ.υs boss stiehsr Is cosstraytαi is a matter of dssiga csoics. Fox sxatspki, tbe tnaierisi may be m m&tά that does aot sttπsskiiε aa aBas&imble response <sf body systems, <?r k may fee any stssr type af bbe.osigaέsbfc ai&terfal. i®83C; Tlie soiHXs s.tκi slgsai preeessing cotsspoBssts of sϊάeraal saαdals KS? are schotaatically shows k. FKl- 2. Søaαd v^sves 203 as-e ϊεcetvcd by a soBsd pϊdαjp device 205 asd δosvsϊted inio s s^prssssisti^s sigsst, wbkls ϊ& <lscstscl too a signal processor 207. SigϊBl processor 207 eoϋvsrϊs U5s ϊsρrc6st3ta«v« signal Into sa apprspriats signal adjusted, as aso^sasy, fe the Iraoscsiocs" dr∑vs circuit 2δ&, which o«t|jtJts a skive signal Lo a traasώieer siodsi-C 21 L Adjust
Figure imgf000008_0002
ssgaal may delude ftϊfeπag, rsaiov&l of dssεorέfoss, rsάαetϊoΩ. of backpouad aossss, sϊϊd tlsc ϋk$, Trεnsdyeer ssidsile 211 gesersiss s sasolsusoal vibratioa ^srssssis^tvε sf ths soϊmd "waves 203, smά these assciausicsl vibrMks^s are csϋicksctetl to lbs ska!! via s msc&sssicd coap&g bet^ees. trse&ducssr tso«fe!e 21 ls sasaeJy vibrstosy osapiαr 133S &ad boa« scs'ew 129. Λ& appropriate powsr sssdule (sot
Figure imgf000008_0003
is i∑xeiaded as past of ihst e^cnsai assduk to ρκ>vtds pother So each of tbs various ctsεsψovssε&s. ψmπi A ctmtrøl rssoduiβ SIS5 baviag oofittsl cleatmrfcs tJssrstϊi, is eiscSKsmcally swtnseted to so\£s4 piclssp devics 2OS, aigsal pmoesser 2Q7, sM. trassdiscer drive ciπsώ 209. Cass?»! naoduie 215 may also be «?loctroa.osUly eoussάed to transducer usϊdu-fe 21 J , αε aay ©flier csis^oseat^ δf ©xiα-D&s jBs&ϊfe 127, Cssirc4 εaodu& 215 sxsoa&vm mά «ontf«ls speraϋoB of the dsεteorsc u>i^5oaest5 ss5d ckcaits to wiώώ it is eejmsctεd. The assosst of control ψεo-yidQά hy control modsύe 215 ta&y vmy deps&diag upon ths isosspoxsaa or cirαdt tjfgc, Cβstml ø»dsls 215 ts&y also servs as a fsedback hop io gmvMs isorrsctioss to ths oi≤pst sf aajy sss or sϊϋrε of the pOBipssaots wlisre S£S;«SSΪΓ5.J;
[5M?3&] A.SS. soserikes isoduie 21.7 Is cosascscd to costrøi
Figure imgf000008_0004
2 J 5 iύ p«nsat tfce recψisaϊ, sr a skilled pϊuctidotisr of Jbs siedisal arϊ$, to adjissέ |5rsaelsøέ«d settings of extsnsai sBadtils 127, Tlis pjesekqtsd settings j&ay tseia<k vsϊaias, sσaad psrøoessteg sHaJcg?esb power o-r/ot? the device, ssd the like. Optsojjally, the i&tcrSee tδøώife sad ihs control madssle tssay be integrated
9} Those skilled m. Ihs art will apjsredste that, as a msάtst of design, choke, m$ of tae sϊgsals befwesa dϊrcuϋts fessiag part, of cxisssii isødukp .127 saay be traastslilsd via & wsπsd cojnjecnssi or wireLe&ily. Fialiacr, not all cirαxέls seed be feoisss<l WUIΪΪS a single cassϊg,
I8Θ4S] Sϊgaas pmosssor 20? ϊϊjay ΪΪSC one- or tsκ>re diS%πsκt ted-tώpss or stsstegies Jo seJacdvely procsss, &5spli%, aisd/or ftBcr ihe sigm! ϊβ|aeseatafϊv'e of souad waves 203. Is cestasis «asϊ3θdiiϊ!ST!iSj slgssl psrscesaor 2Θ7 may be of substotially the snx&& as tfao soβsd pmscss&f thai is 53SS3d ITS as air soxiduclssn bsarsig aid As &ικ>thsr option, sdgTial processor 2Q7 £say laclude fEsssi iJBώfcg to dfgϊisl cssβvertϊs' and a digital sigm! processor.
(^1Mi] FiG. 3 illustrates m. exploded view of tsm smboάime&i ύf zas. external sasshiie ssf a foons c«iϊ4a€tlos. device, re&rssd ts bsrsis ss exterssi module 3C5L Bxtsπiaϊ smώϊle 301 skews m FJ.G. 3 i-K&ades SK. δlectroϊsics mϊ4ii!δ 303, & tr<sjsrfucxτ π»duls 395, ssd a kittssry stos 307 for l?ow«rb.g tlsa oloctesals ojs3p&sss.ts. Elcctroeics tsoάsie 303 &nά tiss teasscfecsr πxxhsfe 305 cpisraie sss dsscπbed above. Electrcsnics
Figure imgf000009_0001
CKcisit 309 (PCB) to «5»≥e5πcs% c©tϊJϊ«ct ssd irsieehatsicaliy sspp&n tbe vsss)«s electsotac coHφossats δad ckcuϊts, Otsis or sKH-a sscmphssaes 311 sre direesly ajtacssd to PCB 30SJ to Saicβoss as ss^ad pickup <;&v3ce& A&rsMsveiv, other types of dirsct assdio isgnύ. could Is? used as tks sosM pickup dcγiec,ϊ ϊδstsjsd o.ξ or ύi add&iea to, mieropt-ases 3I i. Sssda aMsroadves feckde digital sr δϊmksg 34sd» hφixt poή&, a telecofi, aad the Mke.
$m®\ Ths kjiis-Bg fer the sstssssl mockls 30ϊ iacludss a fep part 313a ssd a lx>tsssi part 31.3b. Tk« fW3 parts 313a, 313b srs coofigjared to πtat* wϊtk one s&othsr- tssvisg as osesiag t>r isserties. «f battery shoe 387. Fαiks"wϊng fssartέoti of bstteτjr sb»w 307, hoissitsg parts 313<% 313b sslxα«sϊlaEy scsl fe Mmsai sjyirφoisssjls of extcxsal tm>daie 301 irosrs exterrøl siesiests. The k>p IxmssBg part 313a jsslades one or sssra 5sap-ss Ωiicsxsphsjaβ covers 315, ^Meh protect the nsisrojsassss 311 fcm dust dirt sad otfesr debris. A sser ktgrfas« 317 is dbpssed <3S ose side of ttje i-yp
Figure imgf000009_0002
^« rs>siplssi aeesss to iiss sjtsrfaee sssxfasls 517 factions. m&l Ths bottom ksusmg part 313t> irxiudes as opsaiag 31? &r assertion of a Sastener (sot shows), Tbsi fe&sβr sscures tssnsducsr module 3OS to the tøsKk of the bottom ksussag part 3= LTb5 asd/or sssBres S. vibratory «o«pisrs sacli as otss of the vibratory couplers shews. b*k>ws to the ςmtside csf tks bottom housing par! 3 Bb asd/or trsasduecr sssoduie 3D5, As such, a dinsct jjiβchssuesi Is established &r soαckcϋøs of vilw&tjoiis fern Use transducer sssdsie 305 tQ iis: vibmoxy coupler, assd Ssmthsje iato the bosse saohor, Ctece Ike fastest is ia place, Qpssiiig 319 sssy *ts>ϊ seakd agaisst ecsfejmui dcsnerfs by uss of as. ø-rfag sr vύwε sesia&t
\m&l FICl -I ilimiϊsies a soϋpHsig system is aecord^søe with ombodimeats of ihs fjfesess S£ϊγκ3iim. As sKo%vs, &e oe*spilϊ-g system coϊϊ^scises a vibrafexy «ouplsr 403 sad as Ia^lanled <mcfeer system, fe the i!la<iixsted embodisne^t,. vϋ^atory csiipler 403 sstends frost ass sxiesmi xmάύ£ 401, soϋsmmes rsf«msd to icrste as a vibrsfea goasratmg tsodde 40S, aasl Is ooupisd 1x5 tkQ ijnpksnfei sschor systsia. The implsstted anchor sptsrs s&ixφwts as abaisrø± 4t>5 asd as saϊhor <1t)7s such as Ixsas sww 407. Afems≤Sϊl 405 saay be s-elsas&biy sølxδd is ΪXJΪSS SCT*W 407,
Figure imgf000010_0001
abov? tissue 41 ! so that vilastosy αsupksr 483 smy be s«3-tsd o» &butø3sss 405, As discussed below, the combsϊstfea of vibratory caxipfe- 4SS, smrtms-st 40S, aad bosc s«π?w 407 smbls vtbmthm itom <sxt<sms^ rmάaki 4m IQ be scssώictcd
wmi Tlssss skilled is ώc ssή, will rocogsizs? that alternate ooaSgurstsjss &r a box® sschαr πasy also b<? ssδd is^s&d of sis bossc screw. Oss max ssasφie is a pMe sssαirad t» the boss? is $X least twt> bcsSism alotϊg the edge sf the plate, sacls that &s esrasr p - sxmn Qt the pkie sesi^ against or ss ϊaeeϊmns®jl]y coapisd to ihs skull boss, ihs∞by enablkg vibxstbns ajpsisd to the hows saϋbar Is |>sss Mo !hs boas. With sach a boss ssjchor, tkε sbatmeaϊ may sxtsad frsm tkϊ oestcsf poϊts'Qs sf tfe piatg, imά feme® mtrnd to the akull feslάss* upoa the ώstsssaε s>r &e «ϋt«π3.sl srs>dϊiie wsisid sot impact s surgically modiS«4 s&e, has ratbsr wαaid isψiεct as uasltcsrsd sssiios oflh« skull boss.
P8471 The fep psrSioa of the abMπrsaπi 4G5S wMch exteεsds
Figure imgf000010_0002
the t&ssae 411 x hs& a rcguisrly dϋfisRsi ere&s-sfscsso-s, asd asay bo cteάfer, ei&tical, or aay otkeε sfespe sccordfet to dessgs pretsresccs. Is addition, the rsdk:s sbeαt the «ππrs <soss-seetJoa seed BS§: ^e OSSΪS&SKL A constsst sradkss m&y be men is CHCSisnstancfis whe-jiβ it is de&ted to allow ths
Figure imgf000010_0003
ssoduk to bs ssmisi-sd -wish z&y ooastaikm. Os the o&sr ha&d, a sos-cossiasi radius may Ix? used. Ia eircassstascss where the external sjadub is intended to liavθ otύy a ssagls orsδsstatu>τi w&ers the vϋsausry αsuplsr is sesϊed <ss the sbumassl imm\ Is the ϊlhisty.s-e& esabodims-aj, sbatraeat 403 comprises a bearsag surSscβ 413 of wlϊkb. ^steads away Irons, a essadtsctbs surface 415. Bearing surfees 4 B «s£esds away Son* coaductioa sorfsoe sseh that sa acuϊs asg!& or aέ least a sosHsirhogassl asgie, is fbrm&l al»ag the surisss of sfeSssest 405. The sha|?e5 of faearisg svtϊfees 413 asd th& cotKiscSoa surfeca 415 sr« & ϊB&tter sf desigε choice,
Figure imgf000011_0001
the ooaducβo« surface is preferably platssr to l&ciSate ossipføg wkh vsljmtoϊy confer 403 asd ooatkctksa of vibmtb-ss. A&ematnisly, if bearϊag surface 413 is curved, the
Figure imgf000011_0002
surface &ϊsd cosductios ssr&ce 415 may fetesrssct tasgestkliy.
[884S) In ths ϋlustrstsd sssb&d&asnis, as bearing .*5rl*acs 413 estβads away fom oosductssa sjjr&ce 415, a shelf 41? is Jbrπsβd k the bsarmg siir&ce. The p&stroiat geometry of tats shelf 417 ssay vary aocordiag to other αssiga cs!ssldsratsjo&, patikiukrly the gsαisstrv of vibrsicsry eoiipkr 403. Optionally,, ΪM agsss de|3«adiag -$$χm the geomsstry of T&πstoty oov^>kr403> shfiif 41? sssy bs entirely ømslted SXΪΪS sfemmsat 405. Is csrta&s smbodimsπts, as
Figure imgf000011_0003
SB FiO. 4, sbutssesi 405 ^iiso itsc-iϋdss & tsagsstSe rnatøiatl 41.9 Sd ixiio the abϊfesiest 405 st rø-ndsass&xδ sis'fssis 415- TMs magsstk; snat^rM 419 maj<- &.π-i ι>ait of cosjisetibs sssr&cξf 4151 <$ϊ sitsrsaiivsiy- it m&j be disposed benca&tlis surface. Moreover, the srsigsetic tsmterkl sn&y havs asj? gsoBi«&iG&! configssatsas that ssϊtts oHi&r desiga cfeϋiees that are made cosceπisag sbuisssai 403 ssά vujrsiojy ctsspkr 483. Msgsssfeύs ϊsatεrial 419 Is ps&rably sasgae-fesafele matssial, ssxά sot a psnsaae&t smgaet, sfek)υgh a petarnaeM ss^gset could 'bo ased. pssβξ As sϊeiαl y&rs&sy coa^slex 403 exέaads outwiεrd irojs external ssssdulε 401 snd fach-des a magnet 421. Vϊbraijyry coi^ies:403 i%tfesr iεusiudos a coadactioB sarSsas 423, mά a isτ«;ragiδg «xtessκ>Ω 425. Omάuϊ±bϊi ssr&ee 423 of ■vibratory courier 403 hss & ssos-φllmsδtasy shape to txsndactioss sur&ce 415 of atetiBδ-at 405. «ad. seats dtreeOy oa the δsadϋcέsoε surfsce of ths abϋtsssiϊ such that raschasisoal cssstest is siade bstvvsssa j&c two coadty^sss sur&ces 415,,- 423, Magsct 421 si yibr&tosy oβ«plsr 4<I3 atεeructs wstit the .πsagsiεsic ϊsstsris! 419 k &s sbatmffat 405 IΪS re&ώϊ the two coisdiicticK ssr&css 415, 423" seated togsϊlisr smdes* tsorxssύ use ssosdkϊous. T!κs kukikg §>rεc gesesrated ?xϊhv«κo sssagπet 421 &od ssagastfc jπsisns! 419 shoaid be srafSoisKϊ to rnsi^sss ^ss ssstsng -sadsr fee S>s^» gesaessted by t&e -wsighf, of vibrsioπ? soupissr 403. Is.
iO addition, the ksk&g fbiεs- shøuld also be suSkήeni io nsaMafe the seaissg wfϊ«& tae trssέaataseous fbrcc gesisrassi fey vibsaϋo-Bs fro∑s. external rmxiule 401 are coiφisd wiife the weight of vlhr&tory couple* 403. pssϊ] Lever&giag cxkmsksxi. 425 ©xiesds sway fesm cosKbεfeB surface 423 af vxlsπsiery couples* 403 s&ch thai at feast a distal edge 42? si tkj teversgkg sxtcnsioa seats tφ»a the bear kg sydsee 413, sad preferably »fsøn. shelf 417. Op&»a!ly> the entire ΪΏSSST surt&ee of Lεvsr&gmg sxtess-ios 425 sαay s«at oa bcsrssg sssαrSice 413. Ths coaSgtsstbti of iiis kveragisg sjcte&ssos 425 ssay vary widely. Far sxsmpte, the k^ssagsag sstesskjB snsy .§sm- aa sϊssaiks ristg at the distal «fϊd, sr siteπMively, the assular rixsg may oc divided up Mo two, &m\. or SJGΪS sectssm, sscli secfioo cossectsd Sc- the sstain body of the Moratory coupler vi& s& arπi, In. &&Qxksx altessanvcj ths .kwersgssg esϊsssics may h& a piisraHty of ΪJJSΪS 5?stosdisg a-way lhsss the snaπj body af the
Figure imgf000012_0001
Is such sπ. ers_bo<&mjst, tsore sπm are pis&mfeK hswewr, ss Ibw s» twδ sxzm 1WUi gsaes&ily sisftlcs, imszi FiG, 4B Ulssiπώss &>vγ ths ^i?rator>'- c-ospfe 403 is ά&cmipisd IΓΏΣS sbaimsst 405 when a pssi of ihs extemsl oxxMe 401 ss sabjeetsd ix> a lores sism is taagentϊal tβ tlsβ skull. Ths Isϊigcjmsϊl &rκe ss ϊssaεked "by SΪS arrow, F,
Figure imgf000012_0002
nmn ssd-icscs of this Sasϊgxϊsiiai Bros on cxtfstssi SΪKXIUIS 401, ooti<fec*ios sϊsrfecs 423 of the vibratory coupler 405 is pivoted ap a&4 away ϊrona the ootsd^stbn sur&css 415 «f abutoesi 405. Th(s pivcstkg action is satssed by Ifae fevsmgisg «fes3S3«s 42S s«&ts<l υpea the sheif 417 of abifessxEt 405 ois ths opposJta ήώs of vibraion-' cβvφks1 4(53 SΌΏJ where the fbrse is msidδsst. Upoa
Figure imgf000012_0003
of tfes force-, F, ievcϊsgiϊig extδπsioxi 425 acts as a !evs?r a
Figure imgf000012_0004
nr^ s:aci assist ss iϊissg aid isagseiically mags«i 421 trøm magsstie material 419« By esusiag ths dssoupSsg m thk αjsss∑ϊsr,, the ssmiasS of t≤asgetϊsiώi ibr-c« to whlca abu&isgnt 405 k sabjsscted is sigϊ-ifϊcaβϊiy reduced,
\ms3i Use aaioimt sf έasϊgεatki &rce to wlacis a bens ser«w sasy be sαbjsictsd ibliowksg jmpkat2.tio«r amisssg dsm&gs ξδ ike boss-, is iliastxatsd ia FIG. 5, Ioida!lys wbss s. boss screw ^ implaated, fee aissousss of taageatM ksadiag Ssrce to vήskk it saiy bs sabjeeted is sosπswlat b%h. As tlis IscaHag pr&cs&s begbs sad eosαsϊujss, ths sniαuni of taagsatfei foros to wiu'el- s. boss scra'w wsψ bs subjflctsd ssgsiϊ&ssily decroasss sisd tltsa beg!3is mcπsssiag Ϊ«J & level ibat is hlgh&r Shsn at the sέags of th& kmM. iimsl&m,, Ths decisase is sst feϊϊsέ ps∑tklly das m Use fsicrt έhsi -9/hssn bossss sre da-a-sag^i the fessaα body fkst testes down SDS® of ^c bt>ϊie
H structure the damaged sδe befόte begk&kg so retalkl mά ise&i the bom Ti&is, tbiløwbg iπipkϊϊt≤tiios of a boss screw, iisstil a pfeysieiss dsssrxsiass thai the issjsLast site is Hilly sesisά, Jf share is sigmficsst risk si d-ss&gjtag lh« bom s£ &e siφkst sits by xveamg ths asternal tHOdislSj tlses έise SKtessal ssodsile Is sot generally worn. For prior ssrf boss eαadsictsots devices, this is how isψiasl patfesis prøcsed—dxey :refrais. fejsi segulsiiy using fe§ ssteπisi oHsdul« 1UStU lseaiiag is c
Figure imgf000013_0001
ss^sisSe. Witk tk« bøaa coissMotioss S)?steis dssmbδd stxsvs, ir is asticφ«tsd tts&t- tfae a
Figure imgf000013_0002
st^sal mo<ksle xaay lte seated and -used -wkk ih& knphm.su boss 5Cfew assxjst Hamedkέdy tbifevisg tbα impϊmϊ ρroc«dars asd i»sfeaέβg tisroagls. tk: ea&s iseaiisg prCiC&ss.
|8δs*[ Aa altsmativs ^snbodm^st of a vlisratory cooler is aceordissce with «ssbadisssnl:s «f tbε pfτssβs£ isvestbs. is sbown. Ss FIG, 6. & Use Hia^rated STSibodimssέ, a sheath 603 enends IHJBJ housmg δ03 of sxtOTsal module 6OL A oαuplfsg ana 60? is pasti&lly disposed whhm shβsih 603, C«φllsg ai~iB 607 Js &sk! tD the body of esteraal saα4uie SOl vis a. fastcasr 609, vήtkk eaablos the posltios of cmsplmg ?xm 60? srdstivo to Mmsssg 6SS us bs aφssted. Aψήng 611 fa us® iscϊudcd withia sKsath 603 sad biases agslaάt ssdjui^πseπis sasdc by the fastsaer 6S9. .As tbe position, of the ∞ispllng ami 607 is &3jasi«4 the distκl edgss 613 of the sheath 603 sxsti prøssurs oa fevssagiϊig
Figure imgf000013_0003
6! 5, some Ysrsstios smy be kiτod«c«4 ∑s the sssosst of tsagαaM iαrce ϊsqxsfeβd. ΪO
Figure imgf000013_0004
ths yfestojy vOuploT
Figure imgf000013_0005
ths ahinsseat, Msssofey caxabirsg a cusloss. S .Ssr my particular aspksr recipiβϊit. piSS5j FKl. " sltetmt-ss ssother emfecsdmnsjaf of a vibra&sry αsiEpisr 701 fa scsordaπce with «sϋbcκKmssts of tKe presest fcviϊaϊsøs, As sknv-s, vibratory coϊφkr 70 J koludss a jsbssth 793 is fbrsss! ssftwo pafts, a first past 70S whl&U sxlesrJs &>m body 707 of sstamsl moώiic 70! , aisl & sssQunά p&.ri 709 which is tαreaded into Brst pan. 70S, Willi ibis srrsngesasnt the oveϊsll length ofthss shsnxh. ?tκι Is adjastabis. Stssikr to ώe eπxbβdisseaϊs described sbovs,
Figure imgf000013_0006
SS-JΪS 711 extasids Jsto skssfe 70S. Hϋτyev«r, s& shswss, & post 713 tsxtsmh ϋ∞m body 70?s ;sr<d fe: co-apMαg srm 7\ 1 sHdϊsgly fss oski posl ?I3, A spring 715 disposed wϊthia msssύh KB biases lise so^p&ϊg STJSΪ 7! 1 kswsro body 707 of external jaodule "SL Here, aotsstxictbn «f le-yersgiπg δsissjsba 717 k enabled by teag&esiag sheaϊfo 707 sad b[&sj∑3g ihe coupliag arπs inio She she&tis by ϊ5&e of spring 715, Omvgrsefy, ih& mrnτ>nή of somiήezhn tmy be ϊedyaed by shortening she&sij 7OT. SS856J FKΪ. S illustrates atamtivs sκώødHse«ϊs for as abutπssal fa aecsrdassεe with. εsskxfegisfe of lbs pressor sr>ssn.tiOBs -refersd to as stessaαt 8DL As described below, A.bt*irB»su %ύl fκdiϊ£r educes fee smsaust of tsiϊge&ls&ϊ ioτxs& to which use betas senssv S(B,- or other boa© snshor, might ho subjected. fSδsη Abstmem SOi assumes as oaϊer steals S05 which sacludss & e&sducisss surface 887 wά s 'bearing ssr&cs 809 as described above wkk rdfere&ce to FIGS. 4Λ ssd 4S. Oiisr otestlϊ 805 Hjay be soϊ^ructad s£ tMs walled titashsssj, or ofeer similar saaέςs-ial, wisoh ^au be laser welded so Jke bcss^e screw is ssBDoJJs a-jsd does s,ot pBJvide ersvises ior the Iødgδ5&t5t of debris. C>53jsr shesath 8δ5 ϊs iS3TiSMic4«d is ksisϊs a plur&l&y of sbsarisig sleϊSδBts, fc tMs ease, ssvarai stacked phaXss 811. Ths plafe^ SlI are ss5t cotssseϊed tø øse asoϊher> sad sδβii may. slide !M≤fa!Kr wth respect tβ Αάpcvm piales. The pktes SIl do ssst Jϊsβd ι» be sisiusrly cimen&iosed. To ik?iJItale slidiBg, ύsa sur&ββs Qf ths places. 811 may ba psifehed, or aitemsn^eiv, & Mbrlcaαt may bs iacludsd w^hia osster sheath.805. Farther, use ssaέeπal IΪΪJEB wMck j?kt«s SIi sεe somts-acted is a ∑sMlsr of design, choice. For examples they say be sαastruαcd Sons. » figi« weight plssέfc or polyπssr ϊBisterial, & fessco-rspanbie mslsrks, of a heavier mstsi ssaSsaiaL Iu
Figure imgf000014_0002
έh& fjMes may be ooisstπjeted fam a snagastiεeafcis Tsstsri&l, bat psefeably «ot S-ooa ssateπal th&t is & |ϊersas.n£at Ωiagsstj as s'αcls a eoasirosubs is likely to sigmfic-sntly iπMbS laterssl sϋdfeg betwe«a sdjscs∑ii
ϊwstii Oϊitsr s^ath 805 serves st Issst s fe%v purposes m this enisodsssst Pksl »ssέ«r sksith 80S ssafctaiss esscb pijsts 811 wj£hss th© stack si physscai cøsisot wt& §s$?ι a4jacoai piafe to ecsiarβ that alnϋϊscsϊ 805 is mschasiesily .stiff' ia s dirssdon soπsmi to tbs skϊsϋ Sy siaistasaisg sscb ojstsct, sB.d thereby .fcsspsjg feδ si&ak olpktsij 80S sjedsims&iiy stlS ths atmk αϊnduds vibfsifeus fern eosinstios sκr&as;- 807 fecygk to boss scrsw 803. AddltrøsUy, contact berwcssa pisses 811 keep s&di plats 6om lstsrally sHdssg wfek scspsct to a4jasc«at pku≥s vsoάsx sssnml use *s®8diikm&. Asotfesr pcrpos© of outss sbssik Zϋ5 is in llsάxt bέsϊ&ϊ sik&g sf fee plsϊes 811 so fess: & eoπductios paik Is msfets-s&ed is psss vibnsik>ss iroBJthe ^sstes'osl jsociuls ϊo ώs^ bono &csr«w 8C3. Yai aisofees: panose of έ&s outer sheath Sδ5 is fe sssist m refcssisg plsέes B.I 1 to ibe <:k4saU- st»dc cottSgsarstJoa &ϋowiag ddbrmatson of tiss sissk wlsss subjected to l∞s?i FIO. iB sM>ws t&g stack »f pkέss 8ii witb. the top two plates SHa5 811b Ustesnalϊy displaces! as a resslt of a kteraJ torce F. Outer shsatk SOS defer∑os &bπg with, the stack of plates Si!, To snsMs outer shs&fh 805 its rst&ro the plates to the default stack coniiguratioa, øoter shesik 80S ϊϊsay l>« fexxasd iksns. a sb&p« τansmaτy xs&terissi Altsssmivdy., springs ss&y be ischided wϊfcsjs outer sbs&fe S05 to aid as biasing the stack of pistes Sl 1 toward tfes defsraii stack OTsSgssraSs&α Fim^ssmmssu issgπsis, sira^sgicaU3>- placed -wfilsa sack &1acted piaέe, coiϊld siso be used is sdd is sc&ligaiassS of tks staεksd mates i∑slo tke deisitM sέaek c&αl5gutstiosi, f!H»5 FiG. 9Λ sbows as. alternative ssraBgsmsnt )Bτ a pbr&lϊSy of staekssd pialss 9Ol wliscb :sa3j ^e υsed is. accordasxcg with embodimeflts of tb.e pxeseM is.γetϊtk>s. ϊa t&s liliistrst«d ssxsbodimetsi, each psMβ is fctertecked with, adjacsst plates. £ack plale 5X)Ia-Q. kc-iades aε^ ost??srd pm 903 and a slot 90S. FMes 9δla-4aεβ stacked S3 giϊai pm 903a-d of eseh pkts 5£ iBS&rt&ά mm dse sfoi 905a~d. o£an adjsesni plale. The pin. Φ3 of esds. plsε« seats Wi&m &s slot 905 of as adjscssS plats as &bowtι ts FlG- 9B. The pfc 903a sathss sadpkts 90Ia (as sfaowa). having osly a s&gk- adjacent piste, may siilssr b» oxaitέed fesm ώs? ooaslrsctisa or vised for sfiøthsT piirpose—lackiag as astjsα?m pisSδs the pis 903 of the ead pisse 901a is mi imasbcA kto s
Figure imgf000015_0001
the sϊαt 9(35a~d is «sck pkie 9δla~d is csrveά3 so that when tlio «tadε 901 is siiij|«cted. to & kterai feros, dfeplasβroesi of any one or myi& pktes will iisleo csssss rotatiojs of the displaced plates. Such πslaέba helj&s in ikrtfesr absorb asy sicidoat ϊszsml S>rees. Bscssae the plate ars Imerkjckδd, aisd an outer sheath ss tsot required, sitkyogh oπ.e may !κs sssd. Moreover, Usis embodtmsssS asight also bs impkntesl sufestaxi&SKSh?; S«ch & ««bcuiaasoas £steϊϊ5.€ni
Figure imgf000015_0003
n≤cesssrily scmple with tlss
Figure imgf000015_0002
sπodiiie thmugh the skin of ills rsscspksiS, ssά all vibratbsϊs would bs trsssiratisci &ro»gb tissies, iaciudiπg skla, soveriag the ksplssi. The pia»f the sadpk&s jssy !?e rassd to assist w& tbe coupling.
!#δgi3 Yet ssoiihsr altsmativs smbsdsBssst $f aa afejtSBSsK έa ssεoτ<isa.cs mih &tsk4imsBl3 of tke ps'ΦSSΩi sϊώodiϊaes^, abatmsat 1001 o»!κprisδs &ϊs oTiter shsath 1003 lm^sg as istsrsai oavHy 1005 ssd & grssaiateά ssa&jmJ 1007
Figure imgf000015_0005
TIKΪ grSK&bSsd J2jsisri«sl 1007 jrsay aay SMπsbsr of diffsrsaJ tj?pes of tsaisdal.. SΌ2S s^ssd;. Is ϊtsϊgss&saabk partseks, ts sasaU beads, «.%etket pkstio, gkss.{ or tsstai asd iks Ife. Is
Figure imgf000015_0006
wSfem the tϊs>duls would «Hgn ths parfclss to assist ia
Figure imgf000015_0007
a psHs Ix^weca the oosάucti-as Sϊjtiasδ and ths ϊsotss
Figure imgf000015_0008
shssarmg actέss bstwssss fes p&rtk-ssβ k> response to ϊsterai Iferses ∑rssklsM upon the oαtsr shsaJk, A&άϋiGO&l ssateπas may JXJ ssc&idad wsthia. t&s ssviiy to siϋassr loiter eaabie shesriag action of the grss&ks&ct jjsr&ks.. le-.» ssovmerαt hi die lateral dsrsc£kκi is. rsspoπss to ktεtal forces -ssEάssέ xtpou. the sbαtaesi, or to better ssabie sssdtae&ss. of vlbmtkjxss feεa the sjssrssl sssdale, fcsugh the gramkied m&tsϊϊsi, to the soss anchor. Far example, eolkges -siiay be ktchsdbd withm "fee isfeτs.si cavuy> stesg vvstk l>ssd% Lo bstfer sid is the tsrassaissiøs of "vibrstio&s. It ϊs asticipsέδd that collagea might SΪISO aid m. mspsxsviϋg the sheadsg acdoϊs of sack "beads. As w&fe tkϊ p:«vsoas (ssbodixssKit, the out^- sksaik may be eosϊstnseted tssiag s shape saesBssry ss^έsrk! &$ ύά. m rstsirslssg ϋist alxstmstst to a dsx&aϊt shap«, κ.<5Jδ2] A-a<ϊtke? smbodiiπssst of as abaitneπi is scc»rdsts.ce with «Ω3hGάisB£ns:5 of sfe prssstit kvemiss, is iHustnuM as abuϊmsat 11 Ol is FIO, IL 7Ms atjutmest iseMdes tm ®8tesε sheaώ. H03 -with >m extsπisl prøSle wMs'a is a πisitsr of design choies. Ou&sr shsatth 1103 issy be Ss∑t&sci s,s s
Figure imgf000016_0001
ius^ws, it taay be fcrsϊed say of the sthsr smbodirseϊ-i& tiissassssd .bcjBJD, sr it may h&vv mi sstirdy differsat sbapδ to sus other dessga
Figure imgf000016_0002
Outer shss& ibrxas sa iatg∑sal ssv&y 1105, Ia -wMcfe is άk$os#& & jjmxinaai piste 1107, & άhts.1. piMΦ ! 109» a WΪΪB lllL whiolj ferns a Sssibis cotsdsscticfn pafL arid a spiisg i!13. "The pmxiraal pkts .1107 k disposed adjacest to, ssd may be cosplM fe, ttse coπώjdio« ssrfsss 11 IS o£ <syαteε shesjth 1103 sKch ih&£ vifers αas applied Co røsdsictfoa sur&ce IUS psm
Figure imgf000016_0003
fe distal piata H 09. Sksjilssrly, the distal plass I J 09 is deposed adjsceat atid ccs«plεd έo.b&ss anchor 1 H 7, The ft^ire UH oϋsαds brfwβ«a asd is coupled to bs& psasiissl pMβ 1107 ssά άi&&\ pfeέ© U 09. Likewise., ssπsg H IS is disposed betwees prøyimsi &«d distal pistes J ?07S 1109, bM spring 1113 biases tlic plsiss 1107, 1109 sway from ose ssotfaer,, thereby gkcisg the vdrs HU miά&t tsBsios asxύ «ssbθag the mrs 1111 to soaduct vsbrε&sas applied to pmxiisal plate 1107 siiπjϋgh. so th& pxjxύnai plate 1109, sad tbωs M to sb.» boac aaolior .111?, iss«3| Add-stiOK&i wiϊ^ss raay 'bs> ssduded to feia aβktiέksBa! e«&dudkκ& paths, Tk; mai«ml Irørs wlύch r,h« wk« or wkss b osr^tiuάcd is a asδsr of design dsosea Tksse skϋlcd ia iis art will κx«gasκe llsat cerlals tsaicπate, suc& as jsstaia and oihsε ssaimsls tfest <s?e less suscqjtϊbls to >>erπjsas?il ds&rsj&i'bo. due fe stresclimg, srs. better sxtit&d i>r k>ag tens mo wjt&m lfee absjtsastst, Tlsose ssaέcrials tlsat sr« suscegHbfe to persssπent dff&isssskss du$ to strstehlπg may still be ΪJ&&5, Ixsi sbutassists esψk)yi.sxg such materials nssytxsqaire ssore frsquesύ aψiseea\est. ms&n YeJ smother smbods&ssi: of aa abutsusm. 1201 is sbσwa. sa FIG, 12. Is the iUasirsied embodissssst, sbatsssst 1201 inchsdss &xi outer sheath 1203 §>πsisg as internal cavsty !2I)S, As %iiii oihga: embodiment outer sbεsfb. J 203 Is prsferably ©osstrαete-ά usmg s sjssps i&e∑πory si&kd&l to ψmviάe some SsssbiHSy, bat ai the same ikas be sufSciesdy ngid So seat s "v&r&Sery coupler. Outer sbsaih 1203 isefodss 2 ctatslsctjos sar&os 120? asd S distal surface 1209 which is o&vφloά io loae ascKox 1211, snd vibrasioas sjspSied 1& dssέai sisrfacs 12Sf sse cosdacJsd mtβ boss sschoϊ 1211, A coτsdsctj(yα ax-'s. A, dslfees the coπdactba psth skjsg wMcb v-btats>ns pass Srom as extsrE&I BXxivJe to box>& aschø? 1211 osc© the sstemaS ϊsskfob is sesiβd oa fes sbaέϊmant A spiral sptssg 12 O aad s rr:%set 1215 aro (fepβsed •wi&sa fee aavsty 1205. The spiral spdsg 12-13 haπ aa oαtsr esd coupled to distal surface 1209} ami the κsagnst_ 1215 b coiipi«d IB tfas csatsr wά of tks spiral spring. Tl∑e 3B£g£5et 1215 has a magsetb sxi% M5. dsSsed by the tø® m&ξβϊsύo poles, H asd S> atsd. fe« spirsi sprøg 1213 biases the tmgast 1215 so that &o ssagBJsHfi axis fe sot psiaϊlei to, sad is rssfersbϊy pδrpessϋcsilsr fes tϊse soEdastsos axis .A. Whan use vihs&iory confer is ses&sd on abuteiκsτst 120U '«■ JsagtsK wilhia ths vilsratosy coupler, as desαil>«?d Ia HG. 4S ind ces magsei 1215 Ia abϊtaisat 1201 to mt-ϊte sasd aUgjj. magsieϋe axis, M, wiih the α>ssdxsctk>κ axis, A. OHCC the niagaet 1215 is the sbsssnm^ 1201 ϊ&taics, is Is attracted toward tks tssg^et is tfee vibratory cottier. & additfoa, caagacs 1215 Is alsiti^ist 1201 ■will seat ags&si <Iisfel smdsce 15.i)9s ilsεreby αiablmg vibratbas sppϋod fe> abntπ^sst 1201 to pass bcjs« astchssr 121.1.
[9965] Time, a SX&UOΏ. system. Ssr & botsg oon^ssoa device is disclosed, ^^lsiie >2js.bo<i|jaα3is of this isvssitiess hsv© bssa sbswa sxύ dsscribed,
Figure imgf000017_0001
to -ihoss skilled fa. the art that massy sxKϊ? rø3<liScstksas ss^s poasibiβ withosji departing SΏBI the szrvealiv^ soseejyls herein. The &erei«rsj is sol io be rssdrktesi sscspt is ihs spirit of the S>udwnig claims, p«SS| HG, J3A Is sϊsss-StJCtsjϊi&I vϊsw of a syyplfeg system m aϊϊcoπiaacs wills. ctsiκs«ϋsassts of lhe present isvsstssa. As showtJ, She canpljng system cessprises a -vibratory es>tipbr 1306 sstsckDd to, asd extssdistg Som, an sxters&l sBoda?e 13<3i of a Isos-e coiKkastksa device, Dkpoi8«si wJώSϊj vilx-jdorj- v<sψler 1306 is a tumgasϊ s3C>8. fespksted wihm skfc 1302 ts as ssshor .13U), WEssfesi
Figure imgf000017_0002
by estersai module 1301 is carπpled thrαwgh iϊsipisxstsd ancksr 1316 ta the skall 1.304.
KS fSH5δ7j ϊ& As ilkstrsted sϊsboεfeθϊsts, kjφlastcd saofaor 1310 eoτspπses a piasaisty of particles, beads, or ofees- skmests 1310 which, ate kjeάsd or ϊsψiasasd sato skis 1302. The pførairty of particles 1310 a&sr the tBst«riaI stress of Use skis so that iiss vϊbtsϋou fmm vϊtes&>r soυgslsr 1306 may be sssLSsfisred to the skαJI !304 wiilx lϊttls to BO ibsss thαs sEssiastiag ihs txeed fat sa
S| Assy of s vmisiy of particles saay hi iajsctsd or έnsplaatad Isio skia 1302 of a recipient. M cfisiaia skis .1302 ss stiffened by miεctmg a sαøtessBi qusmsy of csaaπsic δr sistalϋc powder («.g-,, Jitaasuas. powder, pu&anim. powder, esc) into the akm. & other sssfeodinej3l% coSageti or asy otfesr bfcrssorabls material diai assy pcoviάs sϋlSssβs is skis. 1302 may be assd, .For sxasspis, in caϊtam «ouxxKmeaε&, particles that eslissce fibrosis iissse growth m&y bs-- injscstsd sr iujplasstsd isto skin. ISdI. mm As aousd, is She sikstrated ejufcodmssait, s s
Figure imgf000018_0001
asga^: BOS is disposed wMώs eoiiplcr 1306. Msgαet 1308 is αmggisred to jjrøvMe as atimctkss Ssrce fesiwses vibrsSssy CGiipks- 3306 sad particles 1310, TkIs mtraάϊsm rstsias exteraai mπdale 1301 in posiibad«ra% sssrΛai ^s©s SEd is saiSεisst to atέsdi sxtarsa! ssOtluie 1301 to the rsφi&n£ isndsf the Syree g«tigrg|;&;l by Us* weight of vibrstory coapiβr 1306, Ia additioiSj the atfeaetkss Ssrcs shj»«M sis© be sulSskftt t& πmmtais. lbs attacbmssit whss& the jBStaatsseeiis &rce g&naπaisd by ^bnstioss frώϊs Φxt«msl models BOI are oβϊψfed witii the weight αf vibratory eoαpksr 1386. Ia csrtaia smbodώissst% Biagssϊ 130S smy oompπse a pβmsassaa magsκ;t Is ot&st embodfoisαis, sxsagset 1308 may cosxφnse a asagsssdc sssaterM ifcst Is sat a
Figure imgf000018_0002
$mwϊ Is Birthsxr emfedmieals, parϊfclas 13 IS are prayβsfced fhssi migEaflag &øm ϊh® ksjeetloK s≤s. Is om s&ck >$mboάimm% fhs particles snsy b« sied s» *3se m&ihsis: ψmit to
Figure imgf000018_0003
Ia aissthsr such, cπibodϊmssaέ. Use particles may be coated, with collagen to ψøψmt Other psstiεlss ss>£ϊφrisiBg, sack as silicons particles, may $ZQW&t$ tissos Is-gro-ϊvth. there with to μnsvsst islgrsJioo. s^?;i| FIO, OE is sκ>ss-sec&sai view of a ceupHag systtas is accsrdanse with, emboάiϊϊissfe of ths present Mvesfcba. Jn this s-sibodknssi, asψlaiϊisd sacKot 13 IS cotspdsss s jξrsassl^ted sjsisrisl 1322 bounded by a vobst-s 1320. TKs gπssaklsd jaaterkl 1322 may say a πibsr of dsSsresά Syjses of material, Scorn sasd, to magsetizeafeϊβ partscfes, to s∑mll' beads, wk«^«r plsatic. glass, or isefcai and the like. Volume Ϊ320 ssiy csixψtise, Sr sxsjjφk, a surgss&Uy iaipkated mgsk «r αsgs 1320 wMds pretests π&gr-sέieB of grssnlated nsamial .! 3'22. iWΩ.} Slss&sr to the ss-sbodimests ds&eribsd slxsve wife rsfeδsee to FICi. 13A* a δsagsei 1308 S3 disposed wsthia v'feslery oospkr 1306. M&gnst 13S8 is eostsgared !o provide &a attrsstfes fees beiw$«s vsbnstory eøapier 13δ€< and psr&ies 1310. This s;έϊχsctios r&t&tss sxie-sasi ssodais 1301 ta pos&bδ <i?jrisg UOHBS! sse, Jiπd Js safKciest is sSfcseh exteπs^ sssdnle J 301 to tEc reeψignt ΪSM«SΓ the isrcs gsBsrsted by ibβ weigh* of viljratoiy coupler 1306. Is. addSώs, Jfee sϊlssctiaa force should alse b« a^fSclsBf to πsaiπtsia tlic sέtacMiest whes the jnstojjaneoxis fcrδ« geπesskd by vibϊstioϊss &»ΪΪ5 esissxial modal© ! 301 srs CiSgplad. with, ths wdgtst of vibratory coupler 1306* Is c-ertsin embocHroeiύs, tmgasi I30S may comprise & ;o«n2ian«aj. tsssg-iβt. M other smέsjiismsats, ampjeϊ 1308 tssy sojsprlse a ssagsedc ϊsaέesial thai Js set s- peπsaasst
{<m% Fl€s, I3C h cmss-ssctkϊtia! visw of a coupling system sa accordsaδi" wjjh mshύάh&snt& ox fe prasest kv^stioa. Stmilsr to the esslsoditssats dessribsd sbov« ^h ϊefeκιcs to FI0, 13B, a grasssMsd sisisriai 1334 ijαuBded hv a wbtss 1336. The gr&ϊuslssed materisl 1322 m&y my msΑbφϊ of diSssrsni έjψes of Ksaterisl Imp lasted asebor O32 Sirther røxs^πsss s, sm^aet 1330 aάjsc-sros «lcull 1304. Yihralssy coupler 1306
Figure imgf000019_0002
a permssest
Figure imgf000019_0001
vibratosrv soxjpkr O06 is positioned adjaceat skis 1302. κ®gs«ώs 1330 asxi 1328 casss gfsKuktsjd sϊ&tϊrrM 1334 & be sabstaπtially aligasd, &srelsy sxapmvmg ife lsassmis^m of
li$H4\ WMe ■/εs'jaus ejsbodisϊsnts of tfce |7i«si?iit mvestjcn hm& been described above, it sisα«M IiS ysdemaoϊ! ϋhst they luive bees pr&semed by way of sxaiiφfe osh', &sd sjsst Umststioβ, It will be sppsxesi to pssBoss skilled Ia ϊbs rsbvsπέ ssi ξjmi vsrbαs cMages SΪ hrtn axd detail caa tjs S5ad« tberdft wiilxnή dspastisg fesϊ έbe άpirsr asd sε©pe of the toveatios. Thus, tlis fetsjdsfe mύ ®xψs &f ά$} ps^sssBi kyssϊfes sboaid set be iksάted by my of the ώovs-dsserfbsd axetapiary sisljodimeπts, !?κt sbøaM be deOa-sd αsly isi sca<jniasea wish tkε iblb?ai§ skims aa<l tlssr aqaivalsss^. All |5afe?is ssd publicatsaπs dbcussβd htcrek sre Iseαqjoraiεd. isi thek sϊitisrety by rs,%reκce ibarstUj.

Claims

Wha£ is ciaiδsod. is:
L A fixation system, ffer cøypimg a boas eoδώϊctjoa device to a rsc-ipissi hsvs one or mors kyers of tissue sds&tsat lbs skull of £bs r&φjesit misprising; as implantable aselsør cαmprissig a phirality of skmeMs coaSgu∑ed to bs ssgjissited m @£ least oss oHbs one or moτs layers oi tissue adjsce&i &s skαl! m&h thai nbrstfeas ag^lied tlieεeto ϊS'<s transferred to th© &tol1; asd s vibratory cs\ϊplsτs «xtsrsdis| ifem ih.8 bone cossluclsos device- ftO-Kψs&kg s ssssdustkm surfeee and a smgaat,
-wδerctϊsi >-h«B th© εeτ3dastx>a surface ss sdf&ceat the oae &r ss>re hyvxs, tka jsagaet is s&rrøed is tb$ϊ irs|ikmnMe ss,ck>τ is rstaia tbs csMuciio^ satis.es sdjscest tfe.e osie δr issssra layers, thsreby saabϋsg v&alioss ts pa^s SX>BΪ &g boBe cesductfcsδ de-vice to rhs skall
2. Tb© S.xi5ϊjs>a sysi^m of claim 1, wksrefc tba tsagsetfe attsaclios betwessiibs m&gnet sad tbe iϊϊϊplaatable sacbør fe csiifigsred ^ts I^ ^φi^red -wh&a a tsκg«satkl S>rcs is jscident aa tits "■fisπϊSoiy ccBpier,
3.
Figure imgf000020_0001
aixfeor is cosflgarsd to bs ssjjf&ated. m the skknyf xbs tschβksή,
4, Tke fύstba s^sϊ^m of cisϊm I5 wker&iπ. the plurality sf p&rέsolss sssnsprisss a ssstaiHo m.st«f hit mύ wk<smm the sss.gsst sltr&sjs Um sssgαetio materiai.
5, The &ϊ34"foa systsm «f skiss i, wliφreia l&s pisπdity of efessaats coisψπ≤s s |>hjrølsty of fjarijciss c-oafsgssfsd to bv inj&dcά ssto tjbs si least oss kw,
6.. Tlis ikstiasϊ system &f elsim S5 wixsseis she plurality of pasϋcles eαssyπse & gsjta∑siϊty <sf mβtsliic powder partssks,
7, Hie fixstitϊs syssasa sf akfes I, wkseis t!κ pkrsiity of eiβmesils easiprlse a. pfealsf of bssds j&φissϊt&d as tJi« aJ least oas ΪΑγsr, S. Ttse fkstios system of elaϋts I, whesreii the pkraitiy of desssats comprise as* &πκnsst of coilsg«&.
9. Tk-e jϊs.&dsκ system af el&im 1, wherein the plurality of slsjsssts are csssiSgursd to "&s substantially rsϊahasd m ihs impiasfstbn. ksssliosi,
.10. Υb& festϊos system of claim 9S wkereia tbs pfcr&iϊty of dsrøestts SJ?S sabstsntkily πjtaiaed in Sbs ixnpkst bcstioB by a surgseaHy !jnpl;sstεd sage samsiaϊ&g tb& phε&lky of «kmβsts.
! I, T!s.« fk&tkss
Figure imgf000021_0001
w^h cs>U^es rematlje d«msϊsts is the sragiast bcatfea.
32. A Sxistioa Sj1St^nJ fi>r «oypllag a piusthsϋs dsvics t» a rscϊpϊeϊS tevktg osβ »r tsoj"© layers of Ussus sosspπsiϊϊg:
SLSI jBspktϊJsfeis a&dhssr cøjϊsjϊdsiϊϊg a plwality of eleaiems- coϊsfigarsd to be iπ^slai-ted Is si iam OBS sf tbs ose or ΠSOΪS layssrs of tisaus; and a i555ϊ|ϊ!ers gsisastϊδg fesxtte ptos&stϊc άmcs, cxsjspissag s Sr$t si5?&o« said a siisgseE, ^hsrsin wh&z ih& Srst s«r&;e is adjacent the oss or møre layers, &» isssgset is attπ^s-d
5s the impkέπi&blc. aac-liot tø sctaiaihe Srst s>s&c-e adjacssit tfesϊ <its& OT JSSS"© lay&fs,
13. The tlxstios Sj1StCSi of clϊam 12, whares; th<$ magsstic stϊrasdos between, the ^ssagset and ihs hiψhsύ&bh ascbsr ;s cβnϋϊgsred to be πφtarsd wlsss a
Figure imgf000021_0002
ferss is kcidssl oss ths
14, The featiosi system of «kim 12, whas^ia tbs Isϊspissisbie saclsor is^lastgd ts tlsst skis of the r^cipisst.
55. T&s Sxatsos system of claim 12, Theresa Shs phraϋty af psϊtlεlss ooϊiψrises ΪS motslEs ϊmEsri&l, &m hss-ek the SG&gsost sέfescts ϊss sssagaόtsc ssatssiaL
16. Tlie ϋxsfea system of stsim 12, whsrβis. ths plurality sf sieisie&is eoαφrise a pkraiay of pussies cosfigsr&d to be injected istc the at feast gse kysr.
17. Ths fbcadc-n sysSsm ofcksa 16, whsrem the pfejraifey of particles cosκpHs« a pkrsliy of s:s€tκϋ£c pGwάεx particles.
IS. Tb& βxaifoss sj^tssm of claϊssi 12, wtiersm ϊ&s pkrsi^y øf «isrsssfe coss|yrlse a pkralfty of bsads feoiastssd Is tlss as isasε case lsγer.
19. 'Th& SsMkssj. sX'Bέesis of claim 12, whεrεis the pfesxaϋty of dessδtϊis eoxsjsise ss asnoijxst oi oos-l&gsa
20, Th« festioB. sysstsm of claim 12, wherein the plurality of sistssπts are cosfigaπsd to fes substastsaUy rstaised ai ϊbs isaplantatbs kscatibπ-
21 , TSss Ixsstba system of sisiss 20, whβre∞ tke piura&y of slsmests ^s sufestsκsia% rstaiasd. is the implssi bc&tfos by a surgically sϊiϊpkstsd sags sssTGttsdfeg tks pkraSy ofelstπaiis.
22, 'lbs &xats3s system of ckiϊn 2S? wtersk tse phsmiity of oiemeaSs sr® coated wife collages, to sufetsatis% rstsisϊ tlj.« ^lemsBts k ibss mzplmύ kseatioa.
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PCT/AU2009/000358 WO2009121104A1 (en) 2008-03-31 2009-03-27 A mechanically amplified piezoelectric transducer
PCT/AU2009/000363 WO2009121109A1 (en) 2008-03-31 2009-03-27 Tangential force resistant coupling for a prosthetic device
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PCT/AU2009/000372 WO2009121116A1 (en) 2008-03-31 2009-03-30 A piezoelectric bone conduction device having enhanced transducer stroke
PCT/AU2009/000365 WO2009121111A1 (en) 2008-03-31 2009-03-30 Bone conduction hearing device having acoustic feedback reduction system
PCT/AU2009/000369 WO2009121115A1 (en) 2008-03-31 2009-03-30 Bone conduction devices generating tangentially-directed mechanical force using a linearly moving mass
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PCT/AU2009/000359 WO2009121105A1 (en) 2008-03-31 2009-03-27 Piercing conducted bone conduction device
PCT/AU2009/000360 WO2009121106A1 (en) 2008-03-31 2009-03-27 Dual percutaneous anchors bone conduction device
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PCT/AU2009/000369 WO2009121115A1 (en) 2008-03-31 2009-03-30 Bone conduction devices generating tangentially-directed mechanical force using a linearly moving mass
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PCT/US2009/038933 WO2009124036A2 (en) 2008-03-31 2009-03-31 Manufacturing implantable medical components
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US20100121134A1 (en) 2010-05-13
US20090247814A1 (en) 2009-10-01
WO2009121117A1 (en) 2009-10-08
US20090248085A1 (en) 2009-10-01
US20090248086A1 (en) 2009-10-01
WO2009124005A3 (en) 2010-01-07
WO2009121111A9 (en) 2009-11-05
WO2009121114A9 (en) 2009-11-05
WO2009121097A1 (en) 2009-10-08
US20090245554A1 (en) 2009-10-01
US20090247811A1 (en) 2009-10-01
US8433081B2 (en) 2013-04-30
US8655002B2 (en) 2014-02-18
WO2009121111A1 (en) 2009-10-08
US20090252353A1 (en) 2009-10-08
EP2271282A2 (en) 2011-01-12
WO2010008630A1 (en) 2010-01-21

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