WO2009121109A1 - Tangential force resistant coupling for a prosthetic device - Google Patents

Tangential force resistant coupling for a prosthetic device Download PDF

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Publication number
WO2009121109A1
WO2009121109A1 PCT/AU2009/000363 AU2009000363W WO2009121109A1 WO 2009121109 A1 WO2009121109 A1 WO 2009121109A1 AU 2009000363 W AU2009000363 W AU 2009000363W WO 2009121109 A1 WO2009121109 A1 WO 2009121109A1
Authority
WO
WIPO (PCT)
Prior art keywords
anchor
shearing
abutment
bone
conduction
Prior art date
Application number
PCT/AU2009/000363
Other languages
French (fr)
Other versions
WO2009121109A9 (en
Inventor
John Parker
Original Assignee
Cochlear Limited
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Cochlear Limited filed Critical Cochlear Limited
Publication of WO2009121109A1 publication Critical patent/WO2009121109A1/en
Publication of WO2009121109A9 publication Critical patent/WO2009121109A9/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

  • the present invea&ioft relates gcsersMy to prosthetic cievices 5 atsd ⁇ sore particularly, to s tang-s ⁇ tia ⁇ ibres resistar ⁇ esupling for a prosthetic device.
  • ⁇ j IIeamg loss which so&y be due to soa ⁇ y different c&us&s, is gessrally of two types.
  • cssmi ⁇ ctrve or sensorineural Is many people who axe prxjf ⁇ u&diy ⁇ esf, the reason for their destfcess is ssssorme ⁇ rs! hearing loss.
  • This iy ⁇ « of hearing loss is ⁇ ise ro ⁇ bs absessce or dsutract ⁇ on oft.be hair ceils in the cochlea which traasdssce acoiis ⁇ ic s ⁇ gsabs into serve impulses.
  • Various prosthetic lisariag imp lasts have bess developed to provide individuals who make SroBi sensorineural hearing loss % ⁇ ith the ability to perceive soutid.
  • One such prosthetic h «-a:isg i ⁇ spbat is referred to as a cochlear implant.
  • Cochlear in ⁇ ia ⁇ ts use aa electrode array impiaisfsd is the cochlea of a rcc ⁇ icm to bvp ⁇ s the xaecha ⁇ isros of tfcs? ear. More $pec ⁇ kaUy s an.
  • clectricai sti ⁇ Bii ⁇ s is provided via she electrode array directly to dss eooblea nerve, thereby c-axisisg a hearing sensation,
  • Such sesriog prostheses dir ⁇ « vibratlous iato the boms, so iba ⁇ t ⁇ e yibmtkras are cosd ⁇ cie ⁇ into the cochlea sad result m stimul ⁇ tios of the haks SSJ the cooi ⁇ ea, Tbi$ type of prosthesis is tvpic&Hy referred » as a b»se conductlo-a devio-s.
  • Bone conduction devices function bj coavertkg & received sound signal mto s mecha-nica! vibration representative of the received sound.
  • This vibration is thes trsnsfersd to the bone stnictxsrs of the skull, Kiusing vibration of the rec ⁇ issf& skull.
  • This skull vibration resuks is. ss»ik>s of the fluid of the cochlea, thereby stbmU&ttng the cochlea hair cells asd causing & hearing sssaatioa t» be perceived by the recipient.
  • Vibratios ⁇ fcotn & boss coaductsoa device is gsssraiiy ⁇ osducted to the tecipiex «'s cochlea via s screw isnpknted Lu fes txx.ipient s . ⁇ skull.
  • the slasli boss at the poki of implant of the bose screw, is susceptible to dsciage from, laier&l forces at; tlie baas screw, particular Iy droig the hs&li ⁇ ig period fo [lowing the i ⁇ kai procedure. This healing period varies &om person to parsoa.
  • Durisg ths h ⁇ a ⁇ ng period the bone is so susceptible to damage that the general practice is that th « b ⁇ sae soad- ⁇ etioB device is sot eo&pied to bone screw vs&il the healing p « ⁇ od has esded.
  • ⁇ s botse is less susc ⁇ ptj ⁇ ic to damage following the healing period, damage ussy still fee possible if a large lateral ferce is applied thereto.
  • the fixation system comprises: a bons asch ⁇ r oo& ⁇ gupsd to be i ⁇ tplsatsd in s rcclpisat; as ab ⁇ imcm coupled, to the boas sachor dsfh ⁇ ig a condactios path, to the bone anchor s ⁇ ch that vibrations applied to die abutmeat sre to the boxs ⁇ ?
  • the implantable sncbor comprises: s hose aticksr coaSgurcd to be implanted vs.
  • FIG. 1 Ls a partial sects ⁇ rsal view of a skull showing the ear canal, the cochiea, and a bone co ⁇ 'ductios device "with the b ⁇ B « ssjchor Impiasled in ike sku.ll s ⁇ sd the external xsodate coupled to the boue a ⁇ chsr; imts]
  • FIG. 2 is a schematic diagram of a boss coaductba device;
  • $8? ⁇ jj FlG, 3 is as exploded view of an external i ⁇ ckde fer a bone coaductsoa device;
  • pmj FlG. 4A is s partis J sectioBsi view of a iixatsot: system for a bo si ⁇ so ⁇ dudios. device;
  • FlG. 5 is a graph illustrating the badi ⁇ ig force curve for a boss screw set into the skull bo ⁇ e &s tb « bone haste over time;
  • imwi FlG. 6 is a sectional view of a first alternative embodiment for the vibrasory coupter sssocissted with the external models of® bosc conduction device; irni.il FIG. ? is a secuoaal vi «w of & secoad aEer ⁇ ative essbodtmssr fe th.& vibratory coupler associated with the external module of a boss conduction device; iwrn. ⁇ FlG.
  • SA is a seeilosal view of a first alternative embodiment ibr the abutms ⁇ ir of a kr ⁇ e iXKiduciioi ⁇ device-; f ⁇ 823]
  • FlG. 88 illustrates the krera ⁇ dsjbmiatios of tbe abuteiciu of FlG, 8A; imzQ
  • FIG. 9A is & perspective view of a first alternative embodimetrt fer shearing ekrnenis ;5.s$eek ⁇ td vnih the sbutmesti
  • FIG. 9.8 Iliustraies. s scctksnal view of the couplisg besweesi shearing SLC ⁇ ISBIS of FIG. 9A; iwi&i FlCJ. 10 is a sectkm&l view of a se ⁇ otid sMenistive embodtme ⁇ t for the sbutrrsast of a bone cosjd ⁇ icii»n device; ⁇ ? ⁇ FlG.
  • FIG, 12 is a sectkmal view of a iburth alternative embodiment for the abutment of a bosie
  • FIG, 13A is cross-sectional v; ⁇ w of a coupling system is accordance with embodiments of the present i&vs ⁇ itkm;
  • FIG. 138 is er ⁇ ss-seetkssal vsgw of a eoap&sg system is accordance with embodiments of the present i&vesskjn; im ⁇
  • FIG, 13C is cross-sectkj ⁇ sal view of a coupihig system Ia accordance with smbodsT ⁇ sents of the ⁇ rx;ssrst ssvession.
  • the pteseal iiivessios is directed toward a fixation systems &r & ⁇ tostbstic device, sash as bose co ⁇ li ⁇ ctio ⁇ device.
  • a b ⁇ s sacbor is kiiplssted iat ⁇ the skull, g ⁇ d ss al>t ⁇ tsssx5t is wsipisd ; to the- bss ⁇ s sjichor so as ts d ⁇ fesa s c ⁇ aduc-ioxi path to ⁇ fee boss sachor such, that viteatio ⁇ ss applied to Use abutnieat asre u-sasferred ID the boae aticbor.
  • HG, 1 is a perspective view of an s ⁇ esi ⁇ fHary bone c ⁇ dscNo ⁇ i device i01 with which ⁇ snx ⁇ disue ⁇ fs of ihs present iisvsriioa may bs advaiuageo-asiy itnplcniented.
  • the oai ⁇ r ear 105 itsckdes ths auricle 111 asd the car cssa! 113.
  • Soaad waves 115 arc- collected by auricle 1 U asd chasm ⁇ led into aad through ear easi&J 113.
  • the movement of the feass ⁇ ra ovasis 119 generates pressure waves in ths Suid m ⁇ ki cochlea 123, which as tsira .induces ntowment in fee hairs
  • tsira .induces ntowment in fee hairs Using the inside of the cochlea 123, Movement of ⁇ hs hsirs generates serve
  • Impulses is spiral gs ⁇ glios ceils IQ -which, the hairs are casaected, aad those nerve impulses srs passed to the auditory serve 125, and tb.es to the brain (not shows;, whers they are perceived as sound.
  • PB4i BO ⁇ C co ⁇ xmctkm device 101 k shown positioned behind the auricle i l l of the recipient, although the device could also be pssitkme ⁇ fe a variety of other positions is the stall of the recipient.
  • Bors ⁇ coadocties device IQJ includes as external module 127, asd is coi ⁇ led to tlis skuH of the recipient via an iraplaiited. anchor, such m bone- screw 129.
  • any appro pri&re anchor system msy be used in iic « of she bose scs ⁇ w V2SK so loag as ⁇ e anchor system conducts sujf ⁇ cssnt ⁇ 'ibratiotu; fbois the hsme cotKhsciksn device 101 tor the recfcieat so pci-cejve the vibrations as sonsid.
  • the anchor system rsay be smplssiied xjnder skis. 135 of fee ⁇ eeipient, wi ⁇ hia muscia tissue 13? asd/or mx tissue 139.
  • the aiaterial torn wMch lhs boss sachor is coastfucted is s tssUer of desiga choice.
  • the materml may be a metal that does sot stimulate aa undesirable response of body systst ⁇ is, or it may ' be any other type &£ biocompatible snale ⁇ ai.
  • the sou ⁇ d sM asgnal processing conspossnis of external module 127 are sdsem ⁇ eaHy shows is FIG. 2.
  • So ⁇ sd waves 203 are received by a scraad pickup device 205 and converted i ⁇ sr ⁇ a sigrsal ⁇ whkh. is directed jsto a signal processor 207.
  • Sigsal processor 207 converts the represeatstiw signal ssto au ap ⁇ intestinalte signal adjusted, as aecessary, for the transducer drive ckvnix 209, wkich outputs a driv « signal to a tra ⁇ sdiscsr T ⁇ odu ⁇ e 211.
  • ujst ⁇ Sis?nts ⁇ tha rsprese ⁇ tativs may Include ⁇ liermg, removal of dkt ⁇ rtioss, reduction of bsckgKj-usd ⁇ oiscs, ssd the like;.
  • Transducer snodulc 211 generates a moefmmcai vibrstiori rspres-e ⁇ tative of ths sound waves 203, and these meob&mc&l vibratbas are sondycted to the skull ' via a mcchaaics ' I coupling betwesa trsnsdiic ⁇ r ⁇ sodulc 211, aaia ⁇ ly viismtory coupler 133 » m ⁇ boas screw 129.
  • a ⁇ I appropriate power module (sol shovrs) is i ⁇ ckaed as rsa ⁇ of the externa! ssodule to provide power to each of the various components.
  • Control taodule 215 rsay also be electronically connected to transducer medtjis 2H 5 or assy other components of external module !27 V
  • control ⁇ &odute 215 may very depending upon, the compoaest or cir ⁇ ik ⁇ s.
  • Co ⁇ tol jrsodule 215 may also S ⁇ VS as a feedback bop to pr ⁇ cvide corr ⁇ ctksns to ⁇ he o ⁇ ipat of any O ⁇ C ot more of the SOS ⁇ JO s.tms whsre sscessarv.
  • ⁇ . ⁇ i ⁇ terface as ⁇ dyic 217 is somected » CO ⁇ I a ⁇ >dule 215 to permit the recspi&at, or a skilled practitioner of the rrsed ⁇ eal arts, to adjust preselected setfegs of cjasmal module 127,
  • the preselected . ⁇ settings may iaciudc volume, S ⁇ isnsi procs&skig strategies, power oa/off the device, and tks iskSv Optiosaily, iha Interlace module aud the control module m&y bo tategrai ⁇ d ⁇ ito a sstsgle module.
  • any of she ssgssis IxHvvses cir ⁇ uks ibrmjsg pan of sxlsfsal tnodals 127 may be transtaittsd via s wkz ⁇ cor ⁇ ectio ⁇ or we ' -essly. Further, ⁇ o ⁇ all circuits need be housed w&hi ⁇ . a single s ⁇ siag, Sipsal processor 20?
  • ts may use one or xuore diSere ⁇ iechaiquea or strategies ts selectively prc:c ⁇ s.s s ssnptify, &sd/or Biter die s ⁇ ga&l represerststive of s ⁇ isad waves 203.
  • Is certsin etrsbodir ⁇ eats. ⁇ pa ⁇ pmc ⁇ ssor 20? may be of siibstaatiaiiy the satse as me souud processor that Ls u&xi m as sir conduction bearing aid.
  • sigsal ]?rocessor 207 ms.y iaciade sad ssaiog t ⁇ digital converter aad a digits! signal pracessor.
  • ⁇ ffltt FKL 3 iHustrMes sa exploded view of one enibodimers of sn. external itssduie of a boae device, referred to herein as external snodule 301.
  • E ⁇ teraal tsodale 301 shown IB F ⁇ G. 3 isclades an. sieetromes mod le 303, a traasducer modnte 305, and a batisjry shoe 30? ibr powering the ek-ctrosic- co ⁇ oaests.
  • Elecrr ⁇ i ⁇ cs rrsodute 303 and the trs ⁇ & ⁇ ucer modsk 305 operate as described above, Eiectromca siodi-k 303 kscludes a printed circuit board 3OSJ (FCB) to ⁇ kotric&Hy COBBCCI gad tseeh&aically suppoa the various slectrosic cotBposeMs aisd circuits.
  • FCB printed circuit board 3OSJ
  • One or rsote microphones 311 are directly attached to PCB 3 €9 to f ⁇ scsion as sound pi ⁇ ki ⁇ devices.
  • the top bo uss ' sg past 3I3 ⁇ sickdes one or tmro ssap-oa micmpfeonc covers 315, which protect the mJcrophots ⁇ s 311 from dust, dirt and other debris.
  • a user i ⁇ t ⁇ rface 317 is disposed ⁇ is one side of the to ⁇ housing part 313A to give the recipient access to the aiter&cs rssoduie 217
  • the botto ⁇ housing part 313b nselsdes as ⁇ penisg 319 tbr iascrtioe of a festesier (sot siis:s>v ⁇ :5 ⁇ .
  • the fastener secures traasdxsccr xac ⁇ iuls 305 to the mside of the bottom bousing p&tt 313b, aad/br secures a vibratory e ⁇ i ⁇ fer, sach as o «e of the vforsiory couplers shown bebw, to jhe outside of the bottom bous ⁇ g pasi: 313b aad/or trsnsducer rrsoduJe 305.
  • a da-ect j ⁇ i ⁇ chaaical ⁇ sssectibsi is established &r condxicdo ⁇ of vsbratfons &o ⁇ s the t ⁇ x ⁇ ssdsccr Btodufe 305 to the v ⁇ Vasoiy con ⁇ pkr, aad Sx) oa there into the bors ⁇ anchor.
  • op ⁇ . ⁇ J ⁇ g 319 may be sealed against ssstersal els ⁇ ssris by u&o of as o-ring or other seslaat. ⁇ «H4? FIG.
  • the coupling system comprises a vibratory coupler 403 and a ⁇ irsplatt ⁇ ed arschor systes. Is the ili ⁇ strated s ⁇ s ' bcdkBejit, vibrasory soapier 4-03 extends fksm ais sstersal rnodxsic 401 , .
  • the lmpiastcd anchor system comprises a& sbuttnest 405 asd sn anchor 407, sud ⁇ &s !X> ⁇ S screw 407.
  • Abutoient 405 m&y be rsisassbiy affixed to bone screw
  • abutment 405 extends above tissue 411 so that vibratory coapkr 403 may be seated os amstrsent 40S.
  • tss c ⁇ abiaatioa of vibratory co ⁇ uplsr 403, sbuftssx-t 405, asd boae screw 407 enable vibtatsoas irom externa! module 401 to be coaducted isto boTss 409. p ⁇ -6!
  • ssus ⁇ pte is a piste secured to the bone is, at least two IOCSJSO ⁇ S abtig the edge of the plate, such that the center portion of the piste rests sgsisst Q t is mecb&sicaily cx ⁇ kxi to ths .sfcui ⁇ krne, thereby en&Mmg vibrations applied to the boss st ⁇ ch ⁇ r to pass feto the bone.
  • the top pottion sf the aimteietst 405, which extends above the tissue 411 s has a regularly defecd cross-sectsju, atsd may be circular, elliptical, or any other shape according tc design prefer ⁇ ic ⁇ s.
  • a constant radius may !>s used is c ⁇ roimista&ccs -wksre it Is desired to allow the esie ⁇ u ⁇ asodule so be nsou ⁇ ted with &ny orie ⁇ catios.
  • a sojj-constam radius sn&y be ased m.
  • ci j xsimstseces v? b «rs ths external tsodule is ixiJesided to have oaiy a siagls orientation when the vibratory soapier Is seated on the abutment.
  • If beariag sur&ce 413 is cisrved, tb « bearing surface and oossumos surSscs 4 ⁇ $ aaay intersect faagentkliy.
  • ss shown m FIG. 4, 3fe.?t ⁇ x * r ⁇ 405 also includes a inagnetic mate ⁇ al 415 set iaio the abutment 405 at coaducfesi siaf&ce 415.
  • This magnetic material 419 asay form part of caadiictkss sarface 415, or alternative!-/, It may be dispsse ⁇ bexcellenth She surfscs.
  • the magnetic sisrcrial rn&y have any geometrical co ⁇ garsiios thai suits other design choices that ars made concerning sbmtxnest 405 soid vibratory coupler 403, Magnetic materia! 419 is preferably msg ⁇ etiasable material, and sot s. perraaissnt taagnst, although a permanent magnet could be used.
  • vibrsiory coupler 403 sxtesds outward fiojn extssuai module 401 and includes & r ⁇ &grset 42 ! .
  • Vibratory coupler 403 further includes a conduction, surface 423, and a leveraging sxte ⁇ sksK 425.
  • addkkm s ihe holding ferce should also be sufSci ⁇ nt to maintain the sea ⁇ iag whe ⁇ the isssmtanesus force generated by v ⁇ brario ⁇ s ironi extetrsal module 40! are coupled with the weight of vibratory coupler 403. Itmt] a ⁇ t ⁇ asioa 423 ext ⁇ sds sway from coMuct ⁇ oa s «r&c ⁇ 423 of vitwatory cospier 403 such, that at bast a distal edge 427 of the leveraging extension seats upon the bearisg surface 413, ss ⁇ preferably apon shelf 417.
  • the co ⁇ Sgurat ⁇ o ⁇ . of ihs levcragisg extension 425 may vary widely.
  • the leveraging estessioa may form as amiukr ring at the distal s&cL, or shesisativefy, the a ⁇ aiiisr ris.g may " be divkfcd up fefe two, ibisr, or rrsjrs sections, each section, coissected to ih « ⁇ ia ⁇ i body of &e v3>rstory coupler via sa ;5rrss.
  • the leveraging exserjsi ⁇ n may be a plurality of a ⁇ rj; sx ⁇ eridiBg sway from d&e S ⁇ iJi body of the vforatory coapbr, Ifi such as embodiment; more SJSI ⁇ S are preter&bte, b ⁇ wevcr, as few as two i ⁇ r ⁇ is >vii! generally sufEce.
  • FIG. 4 ' S ilhjstratss how the vibratory cotipler 403 is decoupled frorn abistr ⁇ erit 405 when a part of the external module 401 Is subjected to a force that is tangential to the skull
  • conductioa surface 423 of &e -vibratory coupler 403 is pivoted up s& ⁇ away &OS3 tke conduction surface 415 of abutmem 405.
  • TMs pivoting action is caused by the leveraging sxt «asfosi 425 se&ted x ⁇ on die shelf 417 of abutment 405 oa fee opposite side of vibratory ooispler 403 from whers ⁇ hc force is incident.
  • . F 5 leveraging extension. 425 acts as a lever arm, and assists is iiltiiig sad magnetically decoupling s j sgns 42 s fi-om mag ⁇ iedc raatsml 419.
  • csasiBg the daccmpimg in this m&nmt., the amoustf of ia-sigsjitk! force to wMcb abistnaent 40S is subjected is sipiBcaxitly reduced.
  • a sprisg 611 is also mckid&d ⁇ vkhia shesth 603 asd biases agasst adfuscmeats Bia ⁇ s by the fas ⁇ ser 609. As the position, of lhe c ⁇ upli ⁇ g ami 60?
  • H vibxi ⁇ ory coupler frors the abutn>est, thereby essbliag a extern fit ⁇ br any pertainu ⁇ aj impkat recipient.
  • ififmi FKJ. ? illustrates another emfeociimsut of s vibratory coupler 701 is accordance with etnbodi ⁇ enis of the pressm invention., Ai> shewn, vibratory coupler 701 includes s sliea ⁇ h 703 is formed csf ⁇ vo pasts, a fesi psrt 705 whicis extends fern body 707 of externa!
  • the a ⁇ ioi-st of cosstncttoJi tsay be reduced by shortening shells 707
  • FIG. 8 illustrates aliera&tlve embodimssis for aB abutmeai SK accordance with embods ⁇ seats of the present ssv ⁇ nricn, referred ro as afcytmsnt 801.
  • afcytmsnt 801. As described bebw f Abuhscni SG s f ⁇ srher reduces the amoimt of taugeittbl force to which ike teas screw 803, or other boTic anchor, might bs objected, ⁇ irfscs 807 and tt bcansg stirface 8(K> as described above with reference to FIGS, 4A aod 4B.
  • Outer shesth S ⁇ 5 say be constructed of tliis walled t ⁇ tanmT ⁇ , or oilier smislar msterkl, which can be laser welded to the bone screw to easisre that the interface " betwees the outer skeath and ths boae s ⁇ rs ⁇ v b srs-oorh sad does sot provide crevices for the k ⁇ dgrnsn, of debris.
  • Outer .sheath 805 is constructed to house a phsrai-ky of shearing elemeats, ⁇ a tbis ease, several ssaeks ⁇ plares SI l, ⁇ hz plates ⁇ 1 !
  • the plates Bl I do mt aecd ro be simii ⁇ ly dimensioned.
  • the j ⁇ rfkesss of Che plates 81 5 r ⁇ ay be polished, or aSts ⁇ mfivcK ⁇ & lubricanc msy be iaelyded within outer shsjsth 805.
  • tfee material S ⁇ J which plares 811 are cosssti'iicted h & saarter Qf dcslga ei ⁇ tsi ⁇ c
  • they may be constructed from s iigfe weight plastic or peiymer maie ⁇ al a biocompatible maie ⁇ al or a heavier mst&l materiaL
  • ihe plates ma ⁇ be ⁇ a ⁇ ss-ructed from. & materia!, hut preferably ⁇ ot S ⁇ mMeria.1 that is a perasaaetit
  • Outer sheath 805 serves at bast a few purposes is this embodiment. PiM, outer sheath 805 saaistains each plats 81 ! within the stack is physical contact with each adjacent plate So assure that abumiest 805 is taechamcaUy stiff in a direction soratal to ihs- skull By raamiainiag such c ⁇ uEsct, assd thereby keeping the stack, of plates 80S inscksiiealiy stiff, the stack conducts vibrati ⁇ as fes ⁇ conduction surfecs 807 through to bone screw 803, Ari ⁇ kbsaUy, e ⁇ staet between pktss 81.1 keep each plats from laterally sliding wife respect to adjacent plates ⁇ j nder ⁇ norma!
  • Another pmp ⁇ xe of outer sheath 805 is to li ⁇ t lateral sisdmg of " the plates Si I so thst a ⁇ sBcmctioa path, is xmms&ssed to pass vibrations from the sxter&ai module to ths boss scr ⁇ w 803.
  • Yet another piarp ⁇ se of the ot ⁇ er sheath 805 is to sssist TB retu ⁇ il ⁇ g plates SI l to the d ⁇ aiii stack configuration folio wkg defermatioa of she stack whes subjected to l ⁇ C-fal forces.
  • FiG, SB shows Ik; stack of plates SIl with the. sop two pistes SI Ia 1 8Mb laterally iifepl&e&i as a resait of a lateral ferce F.
  • TQ enable outer sheath S05 to retU ⁇ the pk ⁇ es to ths dc& ⁇ lt .stack coaSgiimios.
  • outer sheath 805 may bs formed from s shape me ⁇ >ry sjarerial
  • springs may be included wMm; sutsr shsath SOS to aid IB bss$mg the stack of pkt ⁇ s % ⁇ I jowsrd the default stsck coa ⁇ guratioa.
  • Hot?-permaasni msgusts, strategicaily placed within each stacked plate, could also be used to aid sn reaU ⁇ seat of the stacked ⁇ iat «s ks. ⁇ o tbss default stack soa ⁇ g ⁇ ratioB.
  • FIG. 9A shovvs ass aitwaative srraagemsst ht a plurality of ⁇ acksd pk ⁇ es 9 ⁇ l wbich may be ssed in accordance ⁇ vith ssmbodiments of the present mvs ⁇ tios. fe the ⁇ hsstrated enibodi ⁇ ieat, each pkse ss punrlocked with adjacent pktcs. Each plate 901a ⁇ d isciudes as outward asiendmg pin 903 aad s slot 905.
  • the pin.903 & O ⁇ ike esd plate M i& (as shows), having atx ⁇ & single adjacent plate, ;may either be omitted fkom the coastractioa or ⁇ ised !br soother purpose — lacking as adjacent plate, the pia 903 of the end piass 90.Ia ss sot inserted fee & corresponding slot, As shows, the slot 905a ⁇ d in each plate 90ta-d Ls curved, so tbaS wkes the stack 9Sl is subjected to a lateral force, displacement of any one or more plates will also csssc ramtioB of the displaced plates.
  • saag ⁇ et wftfeirs the external module would aiigs the particles to assist is fo ⁇ r ⁇ ng a casd ⁇ ct ⁇ o ⁇ , path bstweea the conduction surface sad ⁇ he teas actsssr, while $x the same time permitting shearing action bstwses the pa ⁇ iebs in.
  • AdditioB ⁇ sl materials may b ⁇ aieluded wMiis the cavity to either belts? enable she&drsg actios of the granulated panicles, i.e., u ⁇ ovsment b the lateral direct ⁇ J in resprasse to lateral forces tnc ⁇ dsnt upon the ab ⁇ tme ⁇ st, or so " shader esiabie con ⁇ iictfea of vibrstioos grom the sstemsl ⁇ iodtile, thmtigh ihs graai ⁇ a ⁇ «d ma ⁇ csial, to die boss sachor.
  • collages siay be included withls ihs Internal cavity, ;?Josg wir.b beads, to b ⁇ $ ⁇ aid in the traasmissioa of vlbratioas, Tt is anticipated that c-ollsge ⁇ i Blight aJso sid is jjsprovkig the shcariag action of jiuch beads.
  • the oater sheath may be const ⁇ icted using a shape tstensory material to aid in y ⁇ sr ⁇ saig iise abiirsisBS to a de&d!
  • abutment 1 Aaotber e ⁇ bodirseat. of sss abutmeni in accordasce with eusbo ⁇ ixaesis of ih& present invention, is ⁇ lastrated as abutment 1)01 ta FiG. .1 1. This abutment includes aii outer sheath 1193 wilh aa external proMe which, is a matter of desks choice. Outer sfee&th.
  • .1103 may be fenced as shows, is may be fbrt ⁇ ed according to asiy of the other embodimeats discussed fasrem, or it tjiay have sri entirely different shape to suit oihzv design consideratioas.
  • the pr ⁇ x ⁇ mal plats 1107 is disposed sdjfica ⁇ t io, and sissy l>s coupled to, the conduction surface J 1 15 of outer sheath 1 103 such Jhat vibratkHss applied ⁇ O CD&duetisHS surface 1 115 pass through to distal plate 1109.
  • the distal plats 1 )Q9 is disposed adjacent and coupled to bone anchor 1117.
  • the wire 111 1 extends between aa ⁇ 3 is coupled to both proximal plate 110? a&d distal pfee H ⁇ 9.
  • spring 1113 is disposed berweea proximal aad distal platen UOT 5 1109, but spring 1.H 3 biases ihs pUiies 1 107, 1109 away from one another, thereby piaeisg the wire 1111 usdsr tssissos sj;d esstbtmg the %vire 1 1 1 1 Jo conduct vihratkms applied to prnxsm! plate. I 10? through r® the proxkn&l piste 1109.
  • Tz ⁇ Qg ⁇ zG th&t cstt ⁇ ts rsi&terkls such as metais aad other materials tfea ⁇ arc ie&s susceptible to pe ⁇ n-useis- dotsnnatioa ⁇ is to str ⁇ chi»g s are better suited for long term -use withfe the abytmeri:.
  • Those materials that arc susceptible to permanent dslbrm&tios ⁇ us to sin,ichiag may- still be used, fei-t abtsm ⁇ Ms empbyissg materials may reqaire wars Srequsn ⁇ repiacsinesst.
  • oatsr shesfe 1203 is preferably constructed using a shape memory ⁇ material to provide SOJ ⁇ S BsxCbxiity, l>ui at ths sa-mc ti ⁇ ie be sufficiently rigid to seat a -vibratory coupler, Oat «r sheaili 1203 includes a coadacti ⁇ fi swr&ce 120?
  • sad s distal g isriics 1209 which is coupled to boss anchor 121 1, assd vibratioss applied to distal sartsc ⁇ 1209 are ⁇ oad ⁇ eted kio bone anchor I21 L A ootJductbn axis, A, de ⁇ es the wsduetio ⁇ s puth alcmg which vibratiom ⁇ a, « irom as exxsrsa! xaodule to hone anchor 1211 once She external ⁇ so ⁇ ide is sealed ⁇ a the abuCine B t.
  • spiral spring 1213 ssid a strngiiet 1215 are ds ⁇ osed withio fee cavity 1205.
  • the spi ⁇ x? sprmg 1213 has a ⁇ outer and coupled Io disia! surface 1209, asd &e j sagnet 121 S b coupled to the ces ⁇ er end of iks spiral sp ⁇ sg.
  • the amgnet 1215 has s magaetis axis.
  • M dsisned by ⁇ he two tsags ⁇ etic poles, N and S, m ⁇ the spkal sp ⁇ ag 1213 biases ths m&gstst 1215 s ⁇ that the magjistic axis Is soi paraiiei to, and h preferably perpendiciiiar ⁇ o, the cosduciksti axis A- Whes the vibsratory coupler is seated on abuimemt .120L a tsagset within the vibrators' coupler, ss d&scr ⁇ bsd is FIG.
  • iaduces siagnet 1215 m abutrsent 1201 is rotate asd align magnetic axis, M 5 with the eoaductksn axis, A. Oscs the inagaet 1215 ia Ck? absitsssat 1201 estates, it k sttraaed toward the magnet in the vibratory coupler. lr : additioa ⁇ magsst 1215 is abut3S> ⁇ at 120!
  • FKK 13A is cross-sectional view of a coupling system m accordance with ⁇ bodinssuts si " the prcsem Im-catfes.
  • the coupling systsm comprises a vibratory coupler 1306 attached to, sad extending fe ⁇ as externa! sioduic 1301 of a bone oosducrios device.
  • Disposed vMim ' vihrmory coupler 1306 is a ⁇ agrsei 130S.
  • Implanted within skin 1302 ss an i ⁇ lait ⁇ ed ajscbor 1310, Vibration, gsaerstec by external mcxkle 1301 is coupled through is ⁇ laated snebor 1310 ti> ths skull 1304.
  • smpiaated anchor 1310 comprises a plurality of particles, beads, or otter efescats 1310 which are t ⁇ oted or issplanted into skis 1302,
  • the plurality of partscks 1310 alter the rsaterial s ⁇ iffiiess of the skis sso ihar the vibration from vibrator coupler 1306 may be to th « sksiU 13CM wsh. little to BO less, thtis elimfsatkg the naed &r aa exposed &bi ⁇ i ⁇ >s ⁇ t.
  • vs. ⁇ ety m pmicios may fee injected or impia ⁇ tce into skin ⁇ 302 of a recipient.
  • Is other co ⁇ sgcn or any other biorcsorabk siaterisi thai nay provide stiffness to skin. 1302 may be ased.
  • particles thai e&hasce fibrous tissue growth m&y be injected ⁇ ?r implatjied iate skis 1302.
  • a ss ⁇ gne. 1308 is disposed withia vibratory co pler 1306.
  • Magnet 1308 is configured to provide an sttraetioa fores between vibratory cssispler 1306 ssd particles 1310.
  • This a&racdbn retains exteraal module BOi in position -during ⁇ orma ⁇ ase, and is sufficient Jo ⁇ tmh externa? -module 1301 to the recip ⁇ erJ LS)der the fercc gsisratcd by the weight of vibrator? coupler 1386.
  • is&gnet 1308 may comprise a pe ⁇ anc ⁇ t sssagset. Is. other eaibod ⁇ sc ⁇ ts, magaet 1308 may oo ⁇ priss ⁇ s sisg&etie material that is BOt a per ⁇ s&aent tsagBct.
  • particles 1310 are prsvested from, migrating frsffi. ⁇ e ixsjsetioa sitc, Iu OBS such smbodsmsxs, the- particles may " be tied ts ose sssoifaer prtos: to ⁇ j ⁇ ctio ⁇ s/iix ⁇ lantation. IB another such embodiment, the particles may bs coated wids collagen to prevent xsjgy&tkm. Other pariidss comprising, such as silicone panic-las, may pro ⁇ s ⁇ te tissue k-grovth there to prevssr migrstiojs.
  • FIG. !3B ⁇ s cro&s-ssctbaal view of a ecsi ⁇ lmg system in accordance with embodimssfcs of ths present l ⁇ vcmio ⁇ , Iu tills etabodimsnt- irapksted sschor 1318 comprises a granulated material 1322 bounded by & volame 1320,
  • the granulated ⁇ saterisl 1322 may sjxy aamber of dif&rest types of mat ⁇ rid, (rouisiiad, to shielistfeaabk pastic;
  • Vo?a ⁇ ne 1320 may cos ⁇ rise, fbr example, a surgically knplai ⁇ tsd mesh or cage 1320 -which prsvsssts s ⁇
  • Magnet 1308 is configured to provide as. aitractbis f ⁇ ree bebvssa vibratory coupler 1306 snd parttcks 1310, T&ES attractioB retains external module 1301 si podtioa ⁇ vxwg not ⁇ ml uss, ui ⁇ is suSTdest to attach external ⁇ s ⁇ dule 1301 to i&e rscipient under fee force geserate-d by the weight of vibratory coupler 1306.
  • magsct 130S may cosiprsse s perma ⁇ est i ⁇ ag:aeL
  • 13C is cr ⁇ ss- ⁇ ectio ⁇ si view of a coup ⁇ sg system m accordance wish embodiments of ths pressai ix ⁇ vcsii ⁇ s. Similar to ike cmbodimesiis described above with reference to FIG. ⁇ 3B, a granulated snateriai 1334 bounded by a volume K136.
  • the grsmifot ⁇ d ⁇ iateria? 1322 ⁇ say asy aaaiber of dHTerem types of material ⁇ mplssted anchor 1332 futilier comprises s m&g ⁇ st 1330 adjscs ⁇ t: skuO !3CM.
  • Vibratory coupler 1306 co ⁇ risss a perm&Bem isagset 1328. Whes vibratory coupler 1306 is positioned adjacent skfo 1302, magnets 1330 and B28 cause
  • the breadth aad scope Df the presesi inv ⁇ stioa should not be limited by asy of the sbcsve-descnised exemplary emlx ⁇ ismests, b&i should be defined ox ⁇ m accordancs with the ibLfowisg claims aad their equivasems. All patents and publications discussed liere ⁇ s are i ⁇ oorporated in their entirety by reference thereto.

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Abstract

A fixation system tor a bone conduction device is disclosed. An abutment is coupled to a bone anchor such that vibrations applied to the abutment pass into the bone anchor. The abutment defines a conduction path to the bone anchor such that vibrations applied to the abutment are transferred to the bone anchor. The abutment comprises a plurality of sbearing elements disposed adjacent the bone anchor, wherein the shearing elements from part of the conduction path. The fixation system also comprises a virbratoty coupler extending from the bone conduction device, comprising a second conduction surface and a magnet, wherein the magnet attracts to the abutment so as to couple the second conduction surface to the abutment, thereby enabling vibrations to pass through the conduction path. The shearing elements are configured to slide laterally in response to tangential forces incident upon the abutment.

Description

CROSS-REFERENCE TO RELAXED APPLICATIONS fsoss] The present appllesdos claims the bεseitέ of ϋ,S. Provisional Pateai Application 61/041 j 1 SS; Sled March 31 , 200S, which, is hereby iaeørpαrMeά by retcreiics herein.
Field ϋfihe ln%ψ,ntwn
\8&®Z} The present invea&ioft relates gcsersMy to prosthetic cievices5 atsd πsore particularly, to s tang-sπtiaϊ ibres resistar^ esupling for a prosthetic device.
ωj IIeamg loss, which so&y be due to soaπy different c&us&s, is gessrally of two types. cssmiαctrve or sensorineural Is many people who axe prxjføu&diy άesf, the reason for their destfcess is ssssorme^rs! hearing loss. This iyρ« of hearing loss is άise ro ϊbs absessce or dsutractϊon oft.be hair ceils in the cochlea which traasdssce acoiisϊic sϊgsabs into serve impulses. Various prosthetic lisariag imp lasts have bess developed to provide individuals who sufer SroBi sensorineural hearing loss %¥ith the ability to perceive soutid. One such prosthetic h«-a:isg iπspbat is referred to as a cochlear implant. Cochlear inφiaαts use aa electrode array impiaisfsd is the cochlea of a rccψicm to bvp^s the xaechaπisros of tfcs? ear. More $pecϋkaUys an. clectricai stiβBiiαs is provided via she electrode array directly to dss eooblea nerve, thereby c-axisisg a hearing sensation,
[<M>δ4] Coaductive keariag loss occurs whsji the nos-ma! mechanscal pathways to provide sousd to h&ir ceils in the cocblss are impeded, fer exaraple, by damage to the ossicular chain to e-sr canal. However, indMduals who suSer irom coadsctive hearing hs& m&y still bav© some form of residual hearing fcscs&sε the hair cells ia the cochlea are generally undamaged.
\m%ι lϊxϊivkhϊsls who suifer irom coadaetive he-srόig loss Me typicaUy not candidates for a cochlear irapiaBt due to the irreversible aaiisre. of ihs cochlear impkat. Specϋϊcallyr issertioa of the «iecέτo<3e array Imo a rgcipient*s cochlea, resuhs ia the destruction of the. majority of hair cells wttkm i& cochlea. The dssJruction of the cocfsiea Jaair cells results is ths bss of all residual bearisg by the recipient. |S86S| Iiκtkcrs individuals suffering from conductive bearing loss typically receive as acoustic hearing sid, referred to as a hsarajg aid herein. Bearing aids reiy oxj principles of sir coridυetiotϊ no trsnsTsit acoustic sigaals ihro gh the outer and lϊύddie ears to thε cochlea. In particular, a hearing aid typsc&% Ϊ*S«S SE. arrasgcsnest po&iuosed fc the reoipiest's ear cssa! to ssorplifv a stnmd received by the ouser car of the reespie-tit. This smpBtϊed saissd reaches the cochlea and c&tsses rrsαiios of the cochlea fluid and sdmulauoa of the cochlea hair cells. ϋπforhssatsiy, not %Α irxάhήώs&h WIJS siiSfer irom conductive fcearisg lass iϊre able to dsrrvϊ? bεnssΩL froBi hearisg aids. Per exampfes some m&svidu&ls srs prone to chronic mEsmmstsoti m imtcthn of the ear car»aS and casaol wear hsaring aids. Other individuals h&ve rxuiUbrmed or abssat oxstsr ear asά/or car csoals as s ressM of & birth dsfecl or as a result of common πjcdical condύbiss such as Treacher CoOms syisdrøms or Microtia, Furtlϊermors, hearing sϊds sre typically unsuhable &r itxiividuals who siuTes" Som single-sided deafhass f total hβsrsig loss Ofily m " one car) or individuals who suffer from mixed hearing bsssK {ie. Cotnbinsimns of άensortrseura.' asd conductive hsaπϊϊg foss). δ! Th&5£ έsdtviduais who csiaiot benefit iτoκi hssriisg aids n\&y benefit fe>m hesriag prostheses th&t me the prisciples of bosc coMuctiotL device to provide scsausUo signals to & teclpietn. Such sesriog prostheses dirβ« vibratlous iato the boms, so ibaϊ tαe yibmtkras are cosd^cie^ into the cochlea sad result m stimulδtios of the haks SSJ the cooiύea, Tbi$ type of prosthesis is tvpic&Hy referred » as a b»se conductlo-a devio-s.
■>I Bone conduction devices function bj coavertkg & received sound signal mto s mecha-nica! vibration representative of the received sound. This vibration is thes trsnsfersd to the bone stnictxsrs of the skull, Kiusing vibration of the recψissf& skull. This skull vibration resuks is. ss»ik>s of the fluid of the cochlea, thereby stbmU&ttng the cochlea hair cells asd causing & hearing sssaatioa t» be perceived by the recipient. Vibratios ϋfcotn & boss coaductsoa device is gsssraiiy δosducted to the tecipiex«'s cochlea via s screw isnpknted Lu fes txx.ipients.^ skull. The slasli boss, at the poki of implant of the bose screw, is susceptible to dsciage from, laier&l forces at; tlie baas screw, particular Iy droig the hs&liϊig period fo [lowing the iπφkai procedure. This healing period varies &om person to parsoa. depsπdrøg upon m&ny factors associated wiϊh the patieat's overall health and geaεtics, but generally takes sis weeks or πsirs. Durisg ths hαaϋng period, the bone is so susceptible to damage that the general practice is that th« bεsae soad-αetioB device is sot eo&pied to bone screw vs&il the healing p«πod has esded. Further, while ώs botse is less suscβptjøic to damage following the healing period, damage ussy still fee possible if a large lateral ferce is applied thereto.
[SSi *! is. acconi&ncs with aspects of the present inveatioa,. s iϊxatioa syste&i for & hotm cotsduciios device is prαvi^ed The fixation system comprises: a bons aschør oo&δgupsd to be iϊϊtplsatsd in s rcclpisat; as abαimcm coupled, to the boas sachor dsfhώig a condactios path, to the bone anchor sαch that vibrations applied to die abutmeat sre
Figure imgf000004_0001
to the boxs<? aπc!»rs ■whore si tb.s abutraeαi comprises a piuraluy of shearbg elcrnsSKts femiiag pan of ths coaduction path positioned adjacent the hone anchor; snd a vibratory coiφler ejαeodmg fixsm she bosis «oadisctitsi5 devicε, cojrφrisisg s second conduction surface &πd a magaet, wh-sreiis the mag∑set stirscϊs to ths ab'usajeot such that ih& second conduction saxfass is coupled to the abutmest, thereby eαabliag vihratsoss to pfcss tbrcjugls the coπducUoa path, whcrcfc ths
Figure imgf000004_0002
eiemεsis are soti%ursd to slid© latssraily m rsspoase to tsagerxtial fcrces incident ispos the shutmαit.
1S012] Ia accordance with 0Jl3eτ aspects of the present kveatioα, an. πspiaamble aachor fcr coαpliag to a vibratory coupler extending Sx?m a bose ccaduction device, tbe vibratory coupler eeTϊipming a $ecosd conduction surface and a magnet is proyidsa. The implantable sncbor comprises: s hose aticksr coaSgurcd to be implanted vs. a recipiem; and an abutment coupled to the bens anchor de€nmg a cosduction patli to the tone asciior such that vibraisoas applied Io the abuimsst ar>s sra&sferred to the bαse aacfaors whereia ths abutment cotsrsprises & plurality of shearing eleαisπte fόrsning p&rt of the cottd«ctk>«. path positioned adjacsrif the bone anchor; wherein, when the second conduction, surface is Substantially adjacent Ike abαtoent, ths tπagset attracts to the abutϊϊϊejs such that the second conduction sirfkcs is coupled to ths abaimsm, thereby enablmg vibrations to psss tbrougls ths coaductios path, wherek-. the sb.earisχg slemejsts ur& soufsg^red to slide laterally m response to tangential forces incident ypcm ώc sbutiRεrst. BRIEF BESCMIPTION OF THE DRAWINGS
(845X31 Illustrative enobodinaests of the preseM invention are described herein with reference to the accβϊΩpssr/ϊtig drawings, m winch: i®ii$} FIG. 1 Ls a partial sectsαrsal view of a skull showing the ear canal, the cochiea, and a bone coϊ'ductios device "with the bθB« ssjchor Impiasled in ike sku.ll s∑sd the external xsodate coupled to the boue aπchsr; imts] FIG. 2 is a schematic diagram of a boss coaductba device;
$8?<jj FlG, 3 is as exploded view of an external iπøckde fer a bone coaductsoa device; pmj FlG. 4A is s partis J sectioBsi view of a iixatsot: system for a bo si© soπdudios. device;
IQ&Ϊ81 HG. 4B illiistrates the vibratcry coupler pivoted oc th& sumimast for the boss cø&ducilώ& dovJca of FJG. 4A;
|?K>Hi: FlG. 5 is a graph illustrating the
Figure imgf000005_0001
badiϊig force curve for a boss screw set into the skull boυe &s tb« bone haste over time; imwi FlG. 6 is a sectional view of a first alternative embodiment for the vibrasory coupter sssocissted with the external models of® bosc conduction device; irni.il FIG. ? is a secuoaal vi«w of & secoad aEerπative essbodtmssr fe th.& vibratory coupler associated with the external module of a boss conduction device; iwrn.} FlG. SA is a seeilosal view of a first alternative embodiment ibr the abutmsϊir of a krøe iXKiduciioiϊ device-; f§823] FlG. 88 illustrates the kreraϊ dsjbmiatios of tbe abuteiciu of FlG, 8A; imzQ FIG. 9A is & perspective view of a first alternative embodimetrt fer shearing ekrnenis ;5.s$eekϊ<td vnih the sbutmesti
|0δ2S] FIG. 9.8 Iliustraies. s scctksnal view of the couplisg besweesi shearing SLCΠISBIS of FIG. 9A; iwi&i FlCJ. 10 is a sectkm&l view of a seεotid sMenistive embodtmeπt for the sbutrrsast of a bone cosjdϊicii»n device; ϊ?\ FlG. 1 1 ss g >>sctix>B.si view of a third alternative ersbαdis-est for the abiitrnssi of a bone eosductfcs device; tsεαs] FIG, 12 is a sectkmal view of a iburth alternative embodiment for the abutment of a bosie
?! FIG, 13A is cross-sectional v;εw of a coupling system is accordance with embodiments of the present i&vs∑itkm;
[0038? FIG. 138 is erαss-seetkssal vsgw of a eoap&sg system is accordance with embodiments of the present i&vesskjn; imά
|δ03ij FIG, 13C is cross-sectkjϊsal view of a coupihig system Ia accordance with smbodsTϊsents of the ^rx;ssrst ssvession.
iWZ2\ The pteseal iiivessios is directed toward a fixation systems &r & ψtostbstic device, sash as bose coϊϋliϊctioϊϊ device. A bααs sacbor is kiiplssted iatø the skull, gϋd ss al>tιtsssx5t is wsipisd; to the- bssβs sjichor so as ts dβfesa s cαaduc-ioxi path to ϊfee boss sachor such, that viteatioϊss applied to Use abutnieat asre u-sasferred ID the boae aticbor. The abutment soπsprises a piuraHέy of sbcaπug skmssts disposed sdjaccat to fee boiie anchor that &ΠB pan of the comiuctkssi path. The festioo systesi fiiithcr
Figure imgf000006_0001
device, cQrøprisώg a second cøsduetioα sυrfacs aad & sBsgπet, wherein the -εissgjiet attracts to ibe abutmest so as to coαpie ihε second cosductϊon siirfecc to the abutrseαt. thereby eaabimg vibratsαss to pass shϊough the cssd c&n path. The shearing eiera.SH.ts are configured to slide laterally m r&spsosise to tasigestisl Sjrces incident apos the sbutoaat. s«!®33] HG, 1 is a perspective view of an sπesiϊfHary bone cøϊϊdscNoϊi device i01 with which εsnxϊdisueπfs of ihs present iisvsriioa may bs advaiuageo-asiy itnplcniented. The folly ruπcrkjTmi Imsium bearing saatoniy Is generally drvidsd up kto fee outer esr JOS, the mkkiie ear 107, aad the loser ear 109. The oaiεr ear 105 itsckdes ths auricle 111 asd the car cssa! 113. Soaad waves 115 arc- collected by auricle 1 U asd chasmεled into aad through ear easi&J 113. Ths tympanic membrass 117, which is kscated at the boundary betwesB the outer ear ! 05 SBG &e middle ear 107, vibrates in. rsspossse to the soυnd waves 107, Within the middle ear 107, vibration of the tytiψaaϊc txsembrasc H? is cøitpled to the fenestra o vails 119 tliro^gb three IxJSSS5 collectively referred to as ike ossicles 121. The ossicles 121 filter sad amplify the vibrations, thereby causing tne fesϊestø ovslis 119 to aractdate. The movement of the feassϊra ovasis 119 generates pressure waves in ths Suid mώki cochlea 123, which as tsira .induces ntowment in fee hairs Using the inside of the cochlea 123, Movement of έhs hsirs generates serve Impulses is spiral gsαglios ceils IQ -which, the hairs are casaected, aad those nerve impulses srs passed to the auditory serve 125, and tb.es to the brain (not shows;, whers they are perceived as sound.
PB4i BOΏC coϊxmctkm device 101 k shown positioned behind the auricle i l l of the recipient, although the device could also be pssitkmeά fe a variety of other positions is the stall of the recipient. Borsε coadocties device IQJ includes as external module 127, asd is coiφled to tlis skuH of the recipient via an iraplaiited. anchor, such m bone- screw 129. Sons screw 12S) b secured to the skisil boas 131 dxsrisig the implant proeednre, m&l As discussed is raore detail below, cosBceted to estemal taoduJe 127 is & vibratory coupler 133 which secures sxterasl module 12? to hoac screw 129. As should be apprcciaicd, any appro pri&re anchor system msy be used in iic« of she bose scs^w V2SK so loag as ώe anchor system conducts sujfϋcssnt Λ'ibratiotu; fbois the hsme cotKhsciksn device 101 tor the recfcieat so pci-cejve the vibrations as sonsid. For example, as discussed befow, the anchor system rsay be smplssiied xjnder skis. 135 of fee ϊeeipient, wiεhia muscia tissue 13? asd/or mx tissue 139. In additioB, the aiaterial torn wMch lhs boss sachor is coastfucted is s tssUer of desiga choice. For example, the materml may be a metal that does sot stimulate aa undesirable response of body syststϊis, or it may 'be any other type &£ biocompatible snaleπai.
[mm] The souΩd sM asgnal processing conspossnis of external module 127 are sdsem^eaHy shows is FIG. 2. Soυsd waves 203 are received by a scraad pickup device 205 and converted iϊsrø a
Figure imgf000007_0001
sigrsal} whkh. is directed jsto a signal processor 207. Sigsal processor 207 converts the represeatstiw signal ssto au ap^propriate signal adjusted, as aecessary, for the transducer drive ckvnix 209, wkich outputs a driv« signal to a traπsdiscsr TΩoduϊe 211. A4|ujstϊSis?nts ΪØ tha rspreseπtativs
Figure imgf000007_0002
may Include ϋliermg, removal of dktørtioss, reduction of bsckgKj-usd Ωoiscs, ssd the like;. Transducer snodulc 211 generates a moefmmcai vibrstiori rspres-e^tative of ths sound waves 203, and these meob&mc&l vibratbas are sondycted to the skull 'via a mcchaaics'I coupling betwesa trsnsdiicεr øsodulc 211, aaiaεly viismtory coupler 133» mύ boas screw 129. AΪI appropriate power module (sol shovrs) is iπckaed as rsaπ of the externa! ssodule to provide power to each of the various components. fδ§37] A COΏSTOI rsoάute 215, having cosfflsέ electronics therein, is electronically cosseeted to SGtmd pickup device 285, sigjial processor 207, sad trsmdticer drive circuit 209. Control taodule 215 rsay also be electronically connected to transducer medtjis 2H5 or assy other components of external module !27V Control tϊϊsdsJe 215 πsoaitors and eoi-trois operation of she electronic compoπsms arid circuits to which it is coanectsd. The amaum of control provided by control ϊ&odute 215 may very depending upon, the compoaest or cirαik ϊ^φs. Coπtol jrsodule 215 may also SΪΪΓVS as a feedback bop to prεcvide corrβctksns to εhe o^ipat of any OΏC ot more of the SOSΠJO s.tms whsre sscessarv.
Λ.Ώ iαterface asødyic 217 is somected » COΏΠΏI aκ>dule 215 to permit the recspi&at, or a skilled practitioner of the rrsedϊeal arts, to adjust preselected setfegs of cjasmal module 127, The preselected .■settings may iaciudc volume, Sϋisnsi procs&skig strategies, power oa/off the device, and tks iskSv Optiosaily, iha Interlace module aud the control module m&y bo tategraiεd αito a sstsgle module. torøj Those skiBeti Ia the art will apprsciate that, as a matter of design choice,, any of she ssgssis IxHvvses cirεuks ibrmjsg pan of sxlsfsal tnodals 127 may be transtaittsd via s wkzά corøectioπ or we'-essly. Further, ϋoέ all circuits need be housed w&hiπ. a single s^siag, Sipsal processor 20? may use one or xuore diSereΩϊ iechaiquea or strategies ts selectively prc:cαs.ss ssnptify, &sd/or Biter die sϊga&l represerststive of søisad waves 203. Is certsin etrsbodirαeats. ύpaά pmcεssor 20? may be of siibstaatiaiiy the satse as me souud processor that Ls u&xi m as sir conduction bearing aid. As aaothsr option, sigsal ]?rocessor 207 ms.y iaciade sad ssaiog tδ digital converter aad a digits! signal pracessor.
\ffltt) FKL 3 iHustrMes sa exploded view of one enibodimers of sn. external itssduie of a boae device, referred to herein as external snodule 301. Eκteraal tsodale 301 shown IB FΪG. 3 isclades an. sieetromes mod le 303, a traasducer modnte 305, and a batisjry shoe 30? ibr powering the ek-ctrosic- coπφoaests. Elecrrøiύcs rrsodute 303 and the trsα&άucer modsk 305 operate as described above, Eiectromca siodi-k 303 kscludes a printed circuit board 3OSJ (FCB) to βkotric&Hy COBBCCI gad tseeh&aically suppoa the various slectrosic cotBposeMs aisd circuits. One or rsote microphones 311 are directly attached to PCB 3€9 to fύscsion as sound piεkiψ devices. Aftetastivdy, other types of direct audio input coaldi he used as ths sound pickup devices instead o£ or in acklitkm to, πύcrophotiss 3I L Such alternatives isciude digital or analog audio input ports, & teiseoϊi, snά the !ik$, s!'M54:j The hoiisbg for the external πiodxils 301 includes a top pan: 313a asd a bottom part 31.3b. The two hoB&ϊϊig parts 313a, 3I3b trs csuSgiirsd io mats with ase smother, leaving an opesώsg fbr jssertioϊi sf baifery shoe 307. Following insertion of battery show 307s housing parts 313a, 3I3b substamisϋy sea! the internal components of external sixx&ule 301 from exterrsai eteεnssis. The top bo uss'sg past 3I3κ sickdes one or tmro ssap-oa micmpfeonc covers 315, which protect the mJcrophotsδs 311 from dust, dirt and other debris. A user iεtεrface 317 is disposed ©is one side of the toψ housing part 313A to give the recipient access to the aiter&cs rssoduie 217
iwmi The bottoϊπ housing part 313b nselsdes as αpenisg 319 tbr iascrtioe of a festesier (sot siis:s>vτ:5}. The fastener secures traasdxsccr xacκiuls 305 to the mside of the bottom bousing p&tt 313b, aad/br secures a vibratory eαiψfer, sach as o«e of the vforsiory couplers shown bebw, to jhe outside of the bottom bousώg pasi: 313b aad/or trsnsducer rrsoduJe 305. As such, a da-ect jβiϊchaaical αsssectibsi is established &r condxicdoα of vsbratfons &oτs the tϊxπssdsccr Btodufe 305 to the vϊVasoiy conϊpkr, aad Sx) oa there into the borsε anchor. Once the fesϋsner is is place, op<.ϊδJΩg 319 may be sealed against ssstersal elsϊssris by u&o of as o-ring or other seslaat. ξ«H4? FIG. 4 silii-iirstss s coupling system m accordance wfώ cmixsdimests of ihδ present iavostbB. showa, the coupling system comprises a vibratory coupler 403 and aα irsplattϊed arschor systes. Is the iliυstrated s∑ϊs'bcdkBejit, vibrasory soapier 4-03 extends fksm ais sstersal rnodxsic 401 , .■άomeϊimes refeϊTsd to Ostein as a -vibration geserstMg module 4015 and is coupled to the implanted aachor system. The lmpiastcd anchor system comprises a& sbuttnest 405 asd sn anchor 407, sudϊ &s !X>ΏS screw 407. Abutoient 405 m&y be rsisassbiy affixed to bone screw
f SHMSi As sliDvvn, abutment 405 extends above tissue 411 so that vibratory coapkr 403 may be seated os amstrsent 40S. As discussed below, tss cα∑abiaatioa of vibratory co^uplsr 403, sbuftssx-t 405, asd boae screw 407 enable vibtatsoas irom externa! module 401 to be coaducted isto boTss 409. pΗ-6! Those skilled in ihs art -will recognise &ax alternate eosiiguratioa^ fsr a boss aaeksr smy also be ased isstsad of the hose screw. One such ssusπpte is a piste secured to the bone is, at least two IOCSJSOΏS abtig the edge of the plate, such that the center portion of the piste rests sgsisst Qt is mecb&sicaily cxπφkxi to ths .sfcuiϊ krne, thereby en&Mmg vibrations applied to the boss stϊchør to pass feto the bone. With, such a bese aachor, ihe abαtrnest may extend fom the center portfos of the plats, sad lbrecs sorrsai to the skull incident ispos the abulisisra or the external mαdide would aot mipaet a surgically modified sits, but rather woaM impact an unaitersd seciios of fee skull hons,
$mi) The top pottion sf the aimteietst 405, which extends above the tissue 411 s has a regularly defecd cross-sectsju, atsd may be circular, elliptical, or any other shape according tc design preferøicεs. Iss addition, the radius about the estire cτos<s-sectio& need sot be cotesfaπt. A constant radius may !>s used is cϊroimista&ccs -wksre it Is desired to allow the esieπuύ asodule so be nsouΩted with &ny orieπcatios. On fee othtτ hand, a sojj-constam radius sn&y be ased m. cijxsimstseces v? b«rs ths external tsodule is ixiJesided to have oaiy a siagls orientation when the vibratory soapier Is seated on the abutment. im$$ hi tKs slkstπitfid esssfoodsncnt abutment 405 c-onsprises a bearmg surface 413 of which extend-s sway fks;is a eondαctios surface 415. Bcsrisg surface 413 extets_s away m>ta conducdos. surface such ύmr as acute aagie, of at laasϊ a aon-ortbogoϊjal »sgle, Ls δsrmsd along die surface of absitøssst 405, The shapes of bearing suriacs 413 aad the oosductisn s^r&ce 41 S 3ZG a matter of d«sign choice, howsv^r, the coiiductksn surfisse is preicrably plssar as iseiiϋ&le coispHsg wiili vibratory coupler 403 &;id co duction of vibrations.
Figure imgf000010_0001
If beariag sur&ce 413 is cisrved, tb« bearing surface and oossumos surSscs 4\$ aaay intersect faagentkliy.
\ts&Φ\ Io she iUαstt&ted eαibodBsisnts, as beariag sarface 413 extes&s away Scorn coadi-ctsoα surface 415, a abeif 417 is ibrmsd in the bearing surface. The p&rtkaiar geossetiy δf this shelf 417 may vary according έo ochser design, aotisideradoϊis, particuiarly the gsαmsέry of vibratory coupfcx 403. Optiomily, a d again depsading upon the geoB'setry ofvibr&tory coupler 403, shelf 41? øuy be siirirely omitted Sxjm abtstmeat 405. hx certain embodiments, ss shown m FIG. 4, 3fe.?tπx*rά 405 also includes a inagnetic mateήal 415 set iaio the abutment 405 at coaducfesi siaf&ce 415. This magnetic material 419 asay form part of caadiictkss sarface 415, or alternative!-/, It may be dispsseά bessaih She surfscs. Moreover, the magnetic sisrcrial rn&y have any geometrical coπβgarsiios thai suits other design choices that ars made concerning sbmtxnest 405 soid vibratory coupler 403, Magnetic materia! 419 is preferably msgπetiasable material, and sot s. perraaissnt taagnst, although a permanent magnet could be used.
PS^ As soled, vibrsiory coupler 403 sxtesds outward fiojn extssuai module 401 and includes & rΩ&grset 42 ! . Vibratory coupler 403 further includes a conduction, surface 423, and a leveraging sxteαsksK 425. Conduction surface 423 of vibratory coupler 403 Ms s complimentary shape to eαsάueiios sur&cs 415 of abutment 40S5 and seats directly on the conduction, surface of the abutment sues. u>at mech&asc&i contact is made between, fee two cosduotkπi surfaces 415, 423, Magϊist 421 is vibratory coupler 403 interacts with the magnetic materia! 419 In the abatmetst 405 to retsiti the two coπdwerios surfaces 415, 423 seated together under aormal use cos.ditH>i5s. The holding ϋbrce g«rssralεd hstwsεn magiiet 42.! and magøeHc materia! 419 shoyki be stiftϊcktπt to msmtahi the seating under the lores generated by lbs weight of vibratory coupler 403. In, addkkms ihe holding ferce should also be sufSciεnt to maintain the seaϊiag wheϊϊ the isssmtanesus force generated by vτbrarioαs ironi extetrsal module 40! are coupled with the weight of vibratory coupler 403. itmt] aκtεasioa 423 extøsds sway from coMuctϊoa s«r&cε 423 of vitwatory cospier 403 such, that at bast a distal edge 427 of the leveraging extension seats upon the bearisg surface 413, ssά preferably apon shelf 417. Orjliosaiiy, tbe entire isner surface of leveraging extension 425 raay seat o∑s beariag sarSsee 413, The coαSguratϊoπ. of ihs levcragisg extension 425 may vary widely. For cjasiple, the leveraging estessioa may form as amiukr ring at the distal s&cL, or shesisativefy, the aκaiiisr ris.g may "be divkfcd up fefe two, ibisr, or rrsjrs sections, each section, coissected to ih« πiaύi body of &e v3>rstory coupler via sa ;5rrss. In another alternative, the leveraging exserjsiαn may be a plurality of aπrj; sxεeridiBg sway from d&e S^iJi body of the vforatory coapbr, Ifi such as embodiment; more SJSIΠS are preter&bte, bøwevcr, as few as two iϊrπis >vii! generally sufEce.
|βos2? FIG. 4'S ilhjstratss how the vibratory cotipler 403 is decoupled frorn abistrπerit 405 when a part of the external module 401 Is subjected to a force that is tangential to the skull The tangential .force Is msrked by tisε arπsw, F5 and upos incidence of this taπgestkl ibrce on sxteπsai sϊθ<!ute 401 , conductioa surface 423 of &e -vibratory coupler 403 is pivoted up s&ά away &OS3 tke conduction surface 415 of abutmem 405. TMs pivoting action is caused by the leveraging sxt«asfosi 425 se&ted xψon die shelf 417 of abutment 405 oa fee opposite side of vibratory ooispler 403 from whers ϊhc force is incident. Upon application of the fores,. F5 leveraging extension. 425 acts as a lever arm, and assists is iiltiiig sad magnetically decoupling sjsgns 42 s fi-om mag∑iedc raatsml 419. By csasiBg the daccmpimg in this m&nmt., the amoustf of ia-sigsjitk! force to wMcb abistnaent 40S is subjected is sipiBcaxitly reduced.
[06S31 The asmusi of tangential feres tα which a boxse screw may be subjected fcllowiag i∑rφlaatatϊoa, without causing damage to the bone, is illustrated b FlG, 5, initially,, wh.es a base screw is impϊ&rϊled, the smouat of taugenti&i ksadmg ibrce to -which, if may bs subjected is λoεfsswhsi high. As tlie hea&g process begins and c-outarnss, the atϊ-soust «f tsϊigsπtkl Ssrce to which a boxse screw may bs subjected sigsiScatitly deorϊsi&es said then bsgins iacressmg to a level ths.t is higher than at the stags of the bϋial implant. Tbs decrease is at least pastiallv due to the fact that
Figure imgf000012_0001
of the l?oac structure surrounding the dassssged mm bcfore beginning to rebuild arsd hssl the bone. Thus. folfowlsg itϊφϊaffisfes of a boae screw, iiΩiil a physician detemsmes that \h» \Bipkst site is EiUy healed, sf ihers is stgi?ifϊcaπ.t risk of daniagirtg che boss at the implant sse by Wearitig the external ssod&Is, then the extent 1 rjaoduis is not gejjsπtlly worn. For prior art bou« cøϊκiisctsoa devices, (his ;s how Xnplaat patients ptx>cεed~4hey re&sin ffoss regularly using the external ssodule sad! healsng is compktc. With tbs bone cαaductioa fbεatios syssem described above, it b axϊtieψaεed th&r the exiem&l irsoduic m&y be sssted. upon aad αsεd wish the implanted bone SCJ-C-NV slsasst usiuedlareiy folio'Wffig the impiant procedure, aad cor4ismisg thmugh the cniire healmg procsss,
[«054? Aa aitaπuitivc smbodijπeat of a vibratory coupler ia accαtdaace with cπtbαdi-uents of the present isveπtias Ls shoves in ?JIG, δ, In ib& illustrated smboάiEnest a sb≥ath.603 sxteads fens bousing 605 of extsmal module 6(31. A coupHng arBi 60? is partially disposed wHhia sheath 6G3, Cmφliϊϊg srta 607 is held XQ the body of externa! ffiodule 601 via a rkstsnst 609, viϊicli eπsfeks the pαsitfcs of ootipJkg ana 60? relative to housiag 602 ta be adjusted- A sprisg 611 is also mckid&d ^vkhia shesth 603 asd biases agasst adfuscmeats Biaαs by the fas^εser 609. As the position, of lhe cøupliαg ami 60? is adjmtsd, the distal edges 613 of the sheath 603 exert PJX1SStJXe os leveraging estcmsioα 615 to cause cøBstrkfen. By constriciisg fevcragisg extejwioa 61 S5 some vsri&ϋkss xnsy be asted-acec! ia ihe amount of taagcaϋal ibre-e required to sase&i the
H vibxiαory coupler frors the abutn>est, thereby essbliag a extern fit ϋbr any partieuϊaj impkat recipient. ififmi FKJ. ? illustrates another emfeociimsut of s vibratory coupler 701 is accordance with etnbodiπϊenis of the pressm invention., Ai> shewn, vibratory coupler 701 includes s slieaέh 703 is formed csf ε\vo pasts, a fesi psrt 705 whicis extends fern body 707 of externa! modufe 701, and a second part 709 which is threaded isle Srst part 705. With, this arπmgemerϊi, th.e ovetsH length of fee sheath. 703 is sdjustsblε. Similar to the esabodimests described abovy, coupϋsg arm 711 exlescb isto sheath 7(B. However, as shown, a post 713 extends te body 707, asd the couplmg srm 711 slidiπgly fits onto post 713. A spring 715 disposed within s&esdb 7(B biases the coypϋsg srsi 71 1 iowjrji body 707 of external module 70 L Here, cαπstriαba of leveragiag «xiss3aiot; ? S 7 js eisahled Dy k;sgr.hersir:g shestb 7(17 and
Figure imgf000013_0001
the ootspimg ami teto the sheath by ι;so of sprlsg 715. Conversely, the aπioi-st of cosstncttoJi tsay be reduced by shortening shells 707,
FIG. 8 illustrates aliera&tlve embodimssis for aB abutmeai SK accordance with embodsπseats of the present ssvϋnricn, referred ro as afcytmsnt 801. As described bebwf Abuhscni SG s fαsrher reduces the amoimt of taugeittbl force to which ike teas screw 803, or other boTic anchor, might bs objected,
Figure imgf000013_0002
^irfscs 807 and tt bcansg stirface 8(K> as described above with reference to FIGS, 4A aod 4B. Outer shesth SΘ5 say be constructed of tliis walled tϊtanmTπ, or oilier smislar msterkl, which can be laser welded to the bone screw to easisre that the interface "betwees the outer skeath and ths boae sεrs^v b srs-oorh sad does sot provide crevices for the kϊdgrnsn, of debris. Outer .sheath 805 is constructed to house a phsrai-ky of shearing elemeats, ϊa tbis ease, several ssaeksά plares SI l, Υhz plates § 1 ! are ϊiot cosaected to otis anotiser, and each may slide ktersily with reaped to adjacent pkϊsss. The plates Bl I do mt aecd ro be simii^ly dimensioned. To feciϋtaie siding, the jϊϊrfkesss of Che plates 81 5 rπay be polished, or aStsπmfivcK^ & lubricanc msy be iaelyded within outer shsjsth 805. Rather, tfee material SΌØJ which plares 811 are cosssti'iicted h & saarter Qf dcslga eiϊtsiεc For s.xamples they may be constructed from s iigfe weight plastic or peiymer maieπal a biocompatible maieπal or a heavier mst&l materiaL In addttbn, ihe plates ma^ be αaϊss-ructed from. &
Figure imgf000013_0003
materia!, hut preferably αot SΌΓΏ mMeria.1 that is a perasaaetit
iZ jmgϊiet, ss such a coiisiracdoH is likely to significantly inhibit lateral sliding feehveen adjacent pistes,
C0OS8] Outer sheath 805 serves at bast a few purposes is this embodiment. PiM, outer sheath 805 saaistains each plats 81 ! within the stack is physical contact with each adjacent plate So assure that abumiest 805 is taechamcaUy stiff in a direction soratal to ihs- skull By raamiainiag such cαuEsct, assd thereby keeping the stack, of plates 80S inscksiiealiy stiff, the stack conducts vibratiøas fesα conduction surfecs 807 through to bone screw 803, AriάkbsaUy, eøstaet between pktss 81.1 keep each plats from laterally sliding wife respect to adjacent plates Λjnder ■norma! SSSQ eovAltimis. Another pmpøxe of outer sheath 805 is to liππt lateral sisdmg of" the plates Si I so thst a αsBcmctioa path, is xmms&ssed to pass vibrations from the sxter&ai module to ths boss scrøw 803. Yet another piarpαse of the otεer sheath 805 is to sssist TB retuαilπg plates SI l to the dεδaiii stack configuration folio wkg defermatioa of she stack whes subjected to lϋϊC-fal forces. søfs^] FiG, SB shows Ik; stack of plates SIl with the. sop two pistes SI Ia1 8Mb laterally iifepl&e&i as a resait of a lateral ferce F. Outer &heatb 805 ϊiefeπxss alosg with the stack of plates SIi. TQ enable outer sheath S05 to retUϊΩ the pkϊes to ths dc&αlt .stack coaSgiimios. outer sheath 805 may bs formed from s shape meπκ>ry sjarerial Alternatively, springs may be included wMm; sutsr shsath SOS to aid IB bss$mg the stack of pktεs %\ I jowsrd the default stsck coaπguratioa. Hot?-permaasni msgusts, strategicaily placed within each stacked plate, could also be used to aid sn reaU^πseat of the stacked ρiat«s ks.ϊo tbss default stack soaϋgαratioB.
|IH«? FIG. 9A shovvs ass aitwaative srraagemsst ht a plurality of άϊacksd pkεes 9ϋl wbich may be ssed in accordance ^vith ssmbodiments of the present mvsπtios. fe the ϋhsstrated enibodiΩieat, each pkse ss feterlocked with adjacent pktcs. Each plate 901a~d isciudes as outward asiendmg pin 903 aad s slot 905. Pistes 90Ia-4sre stacked so that pia 9O3a~d of sacb piste 901 a-d i$ inserted into th^ slot 905a-d of aa adjacent plate. Tbδ pis 91)3 of each .plate seats WΪ-HΪ* the slδt 'X)S of an sdjacmt pkts as shown m FlG. 9B. The pin.903 & OΏ ike esd plate M i& (as shows), having atxϊγ & single adjacent plate, ;may either be omitted fkom the coastractioa or ϊised !br soother purpose — lacking as adjacent plate, the pia 903 of the end piass 90.Ia ss sot inserted fee & corresponding slot, As shows, the slot 905a~d in each plate 90ta-d Ls curved, so tbaS wkes the stack 9Sl is subjected to a lateral force, displacement of any one or more plates will also csssc ramtioB of the displaced plates. Such rotation helps to further absorb ssy iaeidss! lateral threes. Because the pistes are interlocked, asd an outα1 sheath is not required, although ssc :ossy be used, Moreover, this embodiment might ate be impi&nted subcutaneous!}'. Suck a subcurassous abutment wosld aacessari.y couple with the external module through the skin of fee recipient sad Ml vibrafess would be transmitted through tissues, including skis, covering the inspksL Hie. pin of the srsd plate may be used to assist with the coupling.
*ø&>M Yet asαthsr alternative eiaboditnest of an abutac&t in accordance with embodiments of the present kveaiioa is illustrated m FlG, 10, In ibs illustrated embodimεst abutment Ii)Ol comprises &κ msicr sheath 1003 having as internal cavity 1005 ami s granulated material 1007 disposed therein. The grasrαiaisd materia! 100? may any number of different types of material, from sasd, rs m&gseri^eablε panicles, to ssmU beads, wheϊhεr plastic, glass, or πietai aαd the like, ϊn the ca.se- of magsetizesble particles, it is anticipated that the saagδet wftfeirs the external module would aiigs the particles to assist is foπrαng a casdκctϊoΩ, path bstweea the conduction surface sad ϊhe teas auchssr, while $x the same time permitting shearing action bstwses the paπiebs in. rssposss to iaεeral forces keidβϊst upon the outer sheaih, AdditioBϊsl materials may bε aieluded wMiis the cavity to either belts? enable she&drsg actios of the granulated panicles, i.e., uϊovsment b the lateral direct ΪØΪJ in resprasse to lateral forces tncϊdsnt upon the abυtmeϊst, or so "hatter esiabie conάiictfea of vibrstioos grom the sstemsl πiodtile, thmtigh ihs graaiύaι«d maϊcsial, to die boss sachor. For example, collages siay be included withls ihs Internal cavity, ;?Josg wir.b beads, to b§α$τ aid in the traasmissioa of vlbratioas, Tt is anticipated that c-ollsgeϊi Blight aJso sid is jjsprovkig the shcariag action of jiuch beads. As with έhc previous smbodimest, the oater sheath may be constπicted using a shape tstensory material to aid in yεήsrϊsaig iise abiirsisBS to a de&d! shape ϊ®862] Aaotber eπϊbodirseat. of sss abutmeni in accordasce with eusboάixaesis of ih& present invention, is ϋlastrated as abutment 1)01 ta FiG. .1 1. This abutment includes aii outer sheath 1193 wilh aa external proMe which, is a matter of desks choice. Outer sfee&th. .1103 may be fenced as shows, is may be fbrtπed according to asiy of the other embodimeats discussed fasrem, or it tjiay have sri entirely different shape to suit oihzv design consideratioas. Outer sheath forπss an iatcmal cavity 1105, in which is disposed a proximal plate J 107, a distal plate 1109, a wire U I i, which fαuns a fiexϋhie coadactioE. path, arsd s spring 1113. The prøxϊmal plats 1107 is disposed sdjficaπt io, and sissy l>s coupled to, the conduction surface J 1 15 of outer sheath 1 103 such Jhat vibratkHss applied ΪO CD&duetisHS surface 1 115 pass through to distal plate 1109. Similarly, the distal plats 1 )Q9 is disposed adjacent and coupled to bone anchor 1117. The wire 111 1 extends between aa<3 is coupled to both proximal plate 110? a&d distal pfee HΦ9. Likewise, spring 1113 is disposed berweea proximal aad distal platen UOT5 1109, but spring 1.H 3 biases ihs pUiies 1 107, 1109 away from one another, thereby piaeisg the wire 1111 usdsr tssissos sj;d esstbtmg the %vire 1 1 1 1 Jo conduct vihratkms applied to prnxsm! plate. I 10? through r® the proxkn&l piste 1109. &nd thus Ia to the bons anchor M il, fδ0S3] Additional wires ssay be ischxded to fbrai sddϊtjøssl coadiϊctios paths. The matena! trom which the wire or wires is constructed is a matter of design choice. Those skilled in the art ■will TzϋQgώzG th&t csttδέts rsi&terkls, such as metais aad other materials tfeaέ arc ie&s susceptible to peπn-useis- dotsnnatioa ώis to str^chi»gs are better suited for long term -use withfe the abytmeri:. Those materials that arc susceptible to permanent dslbrm&tios άus to sin,ichiag may- still be used, fei-t abtsmβMs empbyissg
Figure imgf000016_0001
materials may reqaire wars Srequsnϊ repiacsinesst.
(ϋS64j Yet another s-πfbodkπsnt of su sd>utoseat 1201 Is shown m FIG. 12, In the illustrated erabsditss-m, abutmeat !2Sl isssksdes ar: outesr sheath 1203 ibimisg ®& mteami cavity 1205. As with, other smljodsnems, oatsr shesfe 1203 is preferably constructed using a shape memory ■material to provide SOJΪΪS BsxCbxiity, l>ui at ths sa-mc tiπie be sufficiently rigid to seat a -vibratory coupler, Oat«r sheaili 1203 includes a coadactiøfi swr&ce 120? sad s distal gisriics 1209 which is coupled to boss anchor 121 1, assd vibratioss applied to distal sartscβ 1209 are δoadυeted kio bone anchor I21 L A ootJductbn axis, A, deϋαes the wsduetioϊs puth alcmg which vibratiom ρa,« irom as exxsrsa! xaodule to hone anchor 1211 once She external πsoάide is sealed øa the abuCineBt. A. spiral spring 1213 ssid a strngiiet 1215 are dsφosed withio fee cavity 1205. The spiπx? sprmg 1213 has aα outer and coupled Io disia! surface 1209, asd &e jsagnet 121 S b coupled to the cesέer end of iks spiral spπsg. The amgnet 1215 has s magaetis axis. M, dsisned by ϊhe two tsagsϊetic poles, N and S, mύ the spkal spπag 1213 biases ths m&gstst 1215 sα that the magjistic axis Is soi paraiiei to, and h preferably perpendiciiiar εo, the cosduciksti axis A- Whes the vibsratory coupler is seated on abuimemt .120L a tsagset within the vibrators' coupler, ss d&scrϊbsd is FIG. 4, iaduces siagnet 1215 m abutrsent 1201 is rotate asd align magnetic axis, M5 with the eoaductksn axis, A. Oscs the inagaet 1215 ia Ck? absitsssat 1201 estates, it k sttraaed toward the magnet in the vibratory coupler. lr: additioa^ magsst 1215 is abut3S>εat 120! will seat stgsώsϊ disάsl surface 12S9, thereby enabling vibtatioss applied to abutment 1201 to pass ϊhraagh Io bane anchor 1211, mm\ Thiss, & fixation system fer a boss soaductiots device is disclosed. WMe εjsώαάimeϊss of tfei* mv&mion have bees shown and described, a wiU Ix? apparent to those skilled is the art that ,maav more ssødifsostϊOBS are possible without departing from the iavsπ.ivg concepts herein. T!i« invention, tb.ers.fbTs, is sol to bs restricted except si the spirit of the fblkswbg cisώns*
|S84^] FKK 13A is cross-sectional view of a coupling system m accordance with ^^bodinssuts si" the prcsem Im-catfes. As shown, the coupling systsm comprises a vibratory coupler 1306 attached to, sad extending fe^ as externa! sioduic 1301 of a bone oosducrios device. Disposed vMim' vihrmory coupler 1306 is a ∑πagrsei 130S. Implanted within skin 1302 ss an iπφlaitεed ajscbor 1310, Vibration, gsaerstec by external mcxkle 1301 is coupled through isφlaated snebor 1310 ti> ths skull 1304. im&n Is ihe iilustrated smbodimenis, smpiaated anchor 1310 comprises a plurality of particles, beads, or otter efescats 1310 which are tφoted or issplanted into skis 1302, The plurality of partscks 1310 alter the rsaterial sϊiffiiess of the skis sso ihar the vibration from vibrator coupler 1306 may be
Figure imgf000017_0001
to th« sksiU 13CM wsh. little to BO less, thtis elimfsatkg the naed &r aa exposed &biϊiϊϊ>sϊϊt. ime&} Any of a vs.πety m pmicios may fee injected or impiaεtce into skin \ 302 of a recipient. Is ccstak smbodiϊneats, skin 1.302 is sifFened by injεαitig a stdϊkieBt qu&αiay of ceramic or metsllsc powder (e.g., titaoism powder, platinara powder, etc) into the skin. Is other
Figure imgf000017_0002
coϋsgcn or any other biorcsorabk siaterisi thai nay provide stiffness to skin. 1302 may be ased. For exaiisple, in ceitais smbodlmests, particles thai e&hasce fibrous tissue growth m&y be injected <?r implatjied iate skis 1302.
[tm?\ As πot«κi, in the ilimtrated emhodJBieat, a ssεgne. 1308 is disposed withia vibratory co pler 1306. Magnet 1308 is configured to provide an sttraetioa fores between vibratory cssispler 1306 ssd particles 1310. This a&racdbn retains exteraal module BOi in position -during ^orma^ ase, and is sufficient Jo ύtmh externa? -module 1301 to the recip ϊerJ LS)der the fercc gsisratcd by the weight of vibrator? coupler 1386. In addition, the attraction, force should siso be s>iiliciest to maintam the sttackneat wises 5he isstaϊjtatϊsαus force generated by vibrations lrom extend modms BQl are coupled with the weight of vibrator}- coupler 1306. Is certain embodiments,, is&gnet 1308 may comprise a peππancαt sssagset. Is. other eaibodύscϊϊts, magaet 1308 may ooϊπpriss <s sisg&etie material that is BOt a perπs&aent tsagBct.
S0S78] M ferttxϊr embodiments, particles 1310 are prsvested from, migrating frsffi. ώe ixsjsetioa sitc, Iu OBS such smbodsmsxs, the- particles may "be tied ts ose sssoifaer prtos: to ϊϊϊjδctioτs/iixψlantation. IB another such embodiment, the particles may bs coated wids collagen to prevent xsjgy&tkm. Other pariidss comprising, such as silicone panic-las, may proαsøte tissue k-grovth there
Figure imgf000018_0001
to prevssr migrstiojs.
[007i| FIG. !3B ϊs cro&s-ssctbaal view of a ecsiφlmg system in accordance with embodimssfcs of ths present lαvcmioα, Iu tills etabodimsnt- irapksted sschor 1318 comprises a granulated material 1322 bounded by & volame 1320, The granulated πsaterisl 1322 may sjxy aamber of dif&rest types of matδrid, (rouisiiad, to ssagtistfeaabk pastic;|e$, to small ixads, whether plastic, glass, w mstsl smd the like, Vo?aτne 1320 may cosψrise, fbr example, a surgically knplaiϊtsd mesh or cage 1320 -which prsvsssts sϊigralioa af granulated txsatεrial 1322. imm Smήl&t to the embodiments described above with rsfereacs to HG. 13-4, a τnag&et !3δfe is disposed waliiα vibratory eαupier 1306. Magnet 1308 is configured to provide as. aitractbis fόree bebvssa vibratory coupler 1306 snd parttcks 1310, T&ES attractioB retains external module 1301 si podtioa άvxwg notϋml uss, uiά is suSTdest to attach external πsαdule 1301 to i&e rscipient under fee force geserate-d by the weight of vibratory coupler 1306. ΪΏ addid-os, the attπsciioα force sisciiid. alϋo be sufficient to mamtak fee attsehsisai when the
Figure imgf000018_0002
force gessrased by vibrafions SXΪTΠ extersal jssoάuic 1301 are coispisd with the weight of vibratory coupler 1304 In certain etnbodjnaeats, magsct 130S may cosiprsse s permaαest iκag:aeL In other embodiments, m&fgivi BOS Biay sotrψrise a πsagiiεtic material that is tϊot a permsuenf m&gϊset. l«5] FIO. 13C is crαss-δectioøsi view of a coupϋsg system m accordance wish embodiments of ths pressai ixϊvcsiiøs. Similar to ike cmbodimesiis described above with reference to FIG. Ϊ 3B, a granulated snateriai 1334 bounded by a volume K136. The grsmifotεd πiateria? 1322 πsay asy aaaiber of dHTerem types of material ϊmplssted anchor 1332 futilier comprises s m&gαst 1330 adjscsπt: skuO !3CM. Vibratory coupler 1306 coπψrisss a perm&Bem isagset 1328. Whes vibratory coupler 1306 is positioned adjacent skfo 1302, magnets 1330 and B28 cause
1 ? graniiktsd rrsύsxia! 1334 to be substantially aligned, thereby improving the transmission of vibrsϊsoϊs &sretfarough,
|ϊ>e?4i WIJ Ue various e∑nbodisπsats of the presest invention have been described abovs, it should be usdatsKXsa ώsi they have been presented b>r way of example only, and aot HrrtkatioB, Ii will be apparent ϊε> persons skilled k the rekvast art ib&i various clisxϊgss is form, anά detail ess be trtad« εhcress without departing førs the spirit and scope of the im'satbti. Thus, the breadth aad scope Df the presesi invεstioa should not be limited by asy of the sbcsve-descnised exemplary emlxπismests, b&i should be defined oxύγ m accordancs with the ibLfowisg claims aad their equivasems. All patents and publications discussed liereύs are iπoorporated in their entirety by reference thereto.
IS

Claims

CLAIMS What i$ claimed is:
1, A Sx&iios system ibr a bose COsdϋotbrt device comprising: s bone sn.sk.3r cosiϊgated to be implanted m a recipient; as abuEinest coupled so the bans anchor defining a conduction path to the bone anchor such that vibrations applied to the abutπsesi arc transferred to the bone anchor,, wherein the gibiiimssu comprises a plurality of shesrfcg elements forming part of ike conduction path posstiooed sdjacδst the bosie asehor; and s vibratory coupler extending asm the boae ctssductioa device, comprising a secoaά coϊsdxsctfoπ surface and a magnet, wherein the magnet; attracts to the abutment such that the secQtsd eoaductioB sarfacs is c upled to the abutment, thereby enabling vibrations to pass thmugh the conduction path, wherein the shearing elements are configured to SiMe laterally is response to taπgsatiai forces meiiknt upon tbe abwimest.
2, The Sxatioxs system of claim I, ^iisress the sburmsst further eoniprises: ss first cosiductioa jsurfscs; atid a tπagactic materia at ox near the first conduction surface, whsreia the magnet sitτaεt& to the øs&gsetic αsieπal.
3, The tbcatioa syssesB of daiπs.1 , wherein the abatmsst further coisprises: a άsmτxmbϊo βlioafe disposed ovsr the plurality of shearing eieiaeBϊs,
4, Tke fustioa system of claim 3, wherein the ds&rmable sheath k adapted to πsaimak sacfe shearing eleπsent in contact with adjaccni shesrkg elesiasis,
5, Tlis &alioR system of ei&ss 1 , wherein the shearing elements comprising grasitilsr particles.
6, The ilxstion system of claim 5, wherein the grssxαisr particles eosiprise a ϊragtjetk material.
7. Ths fixation systeus of claim 1, wfacreia each shearing element is iøtercø-meeted with adjacent shearing sϊεaieats such that lateral siuiϊsg between adjace&t shearing elements is IJmiϊeά.
8. Ths ϋxaibts .system of claim L wherda (he shearing elements comprise a piarsH-y of stacked platsSj each sacked piate being adapted to slide laterally with respect to sscfe adjacent stacked plajc
9. The fixatsϋB system of elains 1; wherein the abutment iurfecr comprises one or xπore eletaests disposed there fjj to facilitate sliding of adjacent shearing eleiϊierϊts,
10. The Sxatbs systatπ of claka I. wherεm the abs^ment ftiπher cossprises a beamg $uriace ajid a fest csnduotϊoδ sui".face that &vs forøϊed as part of fee deforttsafalε sheath.
1 1. The ilxatisa systems, of claim. 1O5 wherein tbs bearizjg stjr&ctϊ is adjaeeat to the first oond^etisa surϋace and intersects ths first coaductloa sari&cs at a aoα-otlhogotsai angie.
12. The fisisϊkn-s system of claim 10. whore is the -vibrator/ coupler lurther cosiprises s leveragitsg sxse-Bsios., ami wiϊereia v/hen tli© second ootsdiicties sisrfsce is seated oα the first coaductioa surges &i least s distal edge of the iever&gπsg ssssnsioa seats upon the bsamg
13. The fixation, sysivm ofcfeltπ JO, wherein tbc bejiring surface and ths Hrst conrfuctioα suru.ee have different rsdli sf carvsturss.
ϊ 4. The fixation system of claim 1 , wherein the first coadαctioπ. suzm.es is substantially planar.
15. The tlxaJiou system of claϊm lδ; wherein She εxjarkg surface consprkes a shelf on which the Averaging «xt<snsk>n seals wtes the second conduction surface Is seated on fee grst conduction .vurfsce.
16. AΪΪ ϊϊπpbϊjϊabb anchor fer coupling to a vibratory coupler extending fern & bone coralaetson device, the vϊbr&iory coupler comprising a second conduction surface and s nsagnet, the impl&Hϊ&bk asebor EOraprissig: a bone <mchor ccsfSgursd to b« impksted m a recipient; and sui abiitmesK coupled to ώe bone anchor defining a eosductkπi path so the kmε anchor gusli ύx&t vihrsϊϊoas applied to the abutπisnt are εrssϋferrad to the bone anchor, wfc-eisi the abiJtTT.est comprises a plurality of shearing elements forming part of the comlαctioB pasii pϊϊsiiiβπ.ε-4 adjacent the bone s&efeor; whersin wbea d?.e second ooa<kcs ton suriace is svb&imά&lly adjacent the abuisnc-πL the magast attracts to tisa αbuassπt suck thai the second conduction surface is coupled ro the abutment, thereby stabling vibrdtsoϊϊ). to pass through the caseuctioB path, whersirs the shearing elements are configured to slide laterally ia respome to Eangcstial iαrees iscidotjt αpori the* sbinsicat,
17. Tlie sacaor of clsim 16, whεϊ^m the abuimeαt ferthsr cosψrises: a arst cond ction, sisriscε; ssd a juagriouε ∑nateri&ϊ at or Bear the first ςOBduoέioo ^srtlice, wherein the iπagseS attracts to the siagseiic materia!,
I S. The sϊicbor of claύa 16, wherein ϊh& abutmsat iuriher comprises: a defbnmbie sheath disposed over the phsraiky of shearing elements.
19. The aschar of daan I SN, wlssrem ilie deformabls iheath is adaptssi to tnamtshi each shearing eksnsni JΏ coΩtsct wsth adjacent shearing eiemβnts,
20. The anchor of claiπi 16, whersfe the shearing elements coiπpπsmg graaular particles.
21. The anchor of clmxn 20, wherein the gramsiar particles comprise a magnetic Ωsslsriai.
22. The anchor of etsisss 16. whsrek each shearing ckmem is iatercoBaecied with adjacssit shearing elements such thsl. iaieral sliding between adjacesi shearing «lemsτιts is liπύred.
23. The anchor of claim 16, wherein the shearing elements comprise a plurality of stacked pistes, each stacked -pints beisg adapted to slide laterally with respect to each adjacent stacked
24. The anchor of eiaan 16S wherds. the abutment Sisthsr comprises: one or siore elements disposed therein to facilitate sliding of adjacsst shearing elements.
25. The anchor of class 16, wiieraiπ the abutment further ccmjprises: a bcarώg suriace and a fest cosidaction surface ibsl aro formed as part of the de&msabk sfeeaili.
26. The arschor of claisi 25, wiierem the beaπng -jur&cø Is adjacent ^o the Sxst oonύucii&n. surface a«d istersecss tbs first cotsdactsøn surface at a aoa-orthogonal angle,
2?. The &&chor of claim 25, -svherem the vibratory coupler further carapτiscs a leveraging extension, &sd wheres whea the second cosductios sur&ce Is seated oo the first coiϊductiojϊ euriac^ aϊ basϊ a distal edge of tfce leversgiag sxtenston sears upon the bearing surface.
28. The anchor of claim 25, whereisi the bearirig aurfece aad the SrSt εxmdhietsøs same© have differsrst m&u. of curvatures.
29. Ths anchor of dsim 16, whsrsia the lϊrst condsicibn suπacε is subsέsntlaliy plasssr,
30. Ths anchor of ctsiϊs 27, wherein the bearing surface comprises a shelf on. which tiis leveragmg cχt«πsidϊi sεat$ wliaa the second cesάuction surface ϊs seated on the fsrst cowhictiosi surface.
PCT/AU2009/000363 2008-03-31 2009-03-27 Tangential force resistant coupling for a prosthetic device WO2009121109A1 (en)

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US4118508P 2008-03-31 2008-03-31
US61/041,185 2008-03-31
US12/167,851 US8216287B2 (en) 2008-03-31 2008-07-03 Tangential force resistant coupling for a prosthetic device
US12/167,851 2008-07-03

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PCT/AU2009/000355 WO2009121101A1 (en) 2008-03-31 2009-03-26 Bone conduction hearing device having acoustic feedback reduction system
PCT/AU2009/000350 WO2009121097A1 (en) 2008-03-31 2009-03-26 Mechanical fixation system for a prosthetic device
PCT/AU2009/000351 WO2009121098A1 (en) 2008-03-31 2009-03-26 Tissue injection fixation system for a prosthetic device
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
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
PCT/AU2009/000362 WO2009121108A1 (en) 2008-03-31 2009-03-27 Coupling system for a prosthetic device
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
PCT/AU2009/000374 WO2009121118A1 (en) 2008-03-31 2009-03-30 Hearing device having one or more in-the-canal vibrating extensions
PCT/AU2009/000367 WO2009121113A1 (en) 2008-03-31 2009-03-30 Alternative mass arrangements for bone conduction devices
PCT/AU2009/000373 WO2009121117A1 (en) 2008-03-31 2009-03-30 Transcutaneous magnetic bone conduction device
PCT/AU2009/000368 WO2009121114A1 (en) 2008-03-31 2009-03-30 Customizable mass arrangements for bone conduction devices
PCT/US2009/038933 WO2009124036A2 (en) 2008-03-31 2009-03-31 Manufacturing implantable medical components
PCT/US2009/038884 WO2009124008A1 (en) 2008-03-31 2009-03-31 Bone conduction device for a single sided deaf recipient
PCT/US2009/038937 WO2009124038A1 (en) 2008-03-31 2009-03-31 A bimodal hearing prosthesis
PCT/US2009/038879 WO2009124005A2 (en) 2008-03-31 2009-03-31 Bone conduction device fitting
PCT/US2009/038932 WO2009124035A2 (en) 2008-03-31 2009-03-31 Objective fiting of a hearing prosthesis
PCT/US2009/038942 WO2009124042A2 (en) 2006-05-25 2009-03-31 Pharmaceutical agent delivery in a stimulating medical device
PCT/US2009/038893 WO2010008630A1 (en) 2008-03-31 2009-03-31 Implantable universal docking station for prosthetic hearing devices
PCT/US2009/038890 WO2009124010A2 (en) 2008-03-31 2009-03-31 Bone conduction device fitting

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PCT/AU2009/000355 WO2009121101A1 (en) 2008-03-31 2009-03-26 Bone conduction hearing device having acoustic feedback reduction system
PCT/AU2009/000350 WO2009121097A1 (en) 2008-03-31 2009-03-26 Mechanical fixation system for a prosthetic device
PCT/AU2009/000351 WO2009121098A1 (en) 2008-03-31 2009-03-26 Tissue injection fixation system for a prosthetic device
PCT/AU2009/000358 WO2009121104A1 (en) 2008-03-31 2009-03-27 A mechanically amplified piezoelectric transducer

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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
PCT/AU2009/000362 WO2009121108A1 (en) 2008-03-31 2009-03-27 Coupling system for a prosthetic device
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
PCT/AU2009/000374 WO2009121118A1 (en) 2008-03-31 2009-03-30 Hearing device having one or more in-the-canal vibrating extensions
PCT/AU2009/000367 WO2009121113A1 (en) 2008-03-31 2009-03-30 Alternative mass arrangements for bone conduction devices
PCT/AU2009/000373 WO2009121117A1 (en) 2008-03-31 2009-03-30 Transcutaneous magnetic bone conduction device
PCT/AU2009/000368 WO2009121114A1 (en) 2008-03-31 2009-03-30 Customizable mass arrangements for bone conduction devices
PCT/US2009/038933 WO2009124036A2 (en) 2008-03-31 2009-03-31 Manufacturing implantable medical components
PCT/US2009/038884 WO2009124008A1 (en) 2008-03-31 2009-03-31 Bone conduction device for a single sided deaf recipient
PCT/US2009/038937 WO2009124038A1 (en) 2008-03-31 2009-03-31 A bimodal hearing prosthesis
PCT/US2009/038879 WO2009124005A2 (en) 2008-03-31 2009-03-31 Bone conduction device fitting
PCT/US2009/038932 WO2009124035A2 (en) 2008-03-31 2009-03-31 Objective fiting of a hearing prosthesis
PCT/US2009/038942 WO2009124042A2 (en) 2006-05-25 2009-03-31 Pharmaceutical agent delivery in a stimulating medical device
PCT/US2009/038893 WO2010008630A1 (en) 2008-03-31 2009-03-31 Implantable universal docking station for prosthetic hearing devices
PCT/US2009/038890 WO2009124010A2 (en) 2008-03-31 2009-03-31 Bone conduction device fitting

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