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The study records OSPL90 for 90 dB input, RTG60, and high-frequency RTG averages across Samba 2 Hi, Samba 2 Lo, and AP404 processors in a test box over 0–10 mm spacing. Results show OSPL90 and RTG decrease linearly with distance, with the strongest reduction for Samba 2 Lo, supporting clinical consideration of thick skin flaps in VSB outcomes.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/influence-of-skin-flap-thickness-on-the-transmission-characteristics-of-middle-ear-implant-audio-processors-clinical-significance-for-vsb-treatment/437546/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/influence-of-skin-flap-thickness-on-the-transmission-characteristics-of-middle-ear-implant-audio-processors-clinical-significance-for-vsb-treatment/437546.png","ImageObject",300,407,{"name":92,"@type":93},"Elsa","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-04","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What does the study define as skin flap thickness in the context of the audio processor?","Question",{"text":112,"@type":113},"Skin flap thickness refers to the distance between the audio processor and the implant’s receiver coil.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were transmission characteristics measured across different audio processor models?",{"text":117,"@type":113},"The study measured OSPL90 for a 90 dB input level, RTG60 as a function of frequency, and RTG high-frequency averages in a hearing aid test box with the processors placed 0–10 mm from the receiver coil.",{"name":119,"@type":110,"acceptedAnswer":120},"What was the main finding regarding the effect of distance on output and gain?",{"text":121,"@type":113},"For all audio processors, OSPL90 and RTG decreased linearly as distance increased, with the largest reduction observed for the Samba 2 Lo processor.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},437546,1791135970,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46,"preview_page_count":4},137455077381,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Influence of skin flap thickness on the transmission characteristics of middle ear implant audio processors  \nLaura Fr¨ohlicha,⇑, Torsten Rahneb, Alexander M¨uller c, Oliver Dziembad  \na University Medical Center Bonn, Department of Otorhinolaryngology, Bonn, Germany  \nb University Medicine Halle, Department of Otorhinolaryngology, Head and Neck Surgery, Halle (Saale), Germany c ORL Department Friedrichshain Clinic, Vivantes Hearing Center, Berlin, Germany  \nd Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Greifswald, Greifswald, Germany  \nReceived 13 June 2024; accepted 26 August 2024  \nAbstract  \nObjective: To measure signal transmission characteristics for audio processors of an active middle ear implant as afunction of skin flap thickness, i.e., distance between audio processor and the implant’s receiver coil.  \nMethods: Output sound pressure levels for 90 dB input sound pressure level (OSPL90), reference test gains as function of frequency for an input sound pressure level of 60 dB (RTG60), and reference test gains (RTG-high frequency averages) were recorded in a hearing aid test box for Samba 2 Hi, Samba 2 Lo, and AP404 audio processors (MED-EL, Innsbruck, Austria) positioned on an implant-in-the-box and distances of 0–10 mm between audio processors and the receiver coil. Results: For all audio processors, the OSPL90 and RTG decreased linearly with increasing distance. The effect was dependent on audio processor type and the strongest reduction was observed for Samba 2 Lo. Between distances of 0 mm and 10 mm, the relative change of RTG was -9,9 dB for Samba 2 Hi, 􀀁10,3 dB for AP404, and 􀀁27,7 dB for Samba 2 Lo.  \nConclusions: Skin thickness is a clinically significant factor which has to be considered in VSB treatment. In combination with insufficient transducer coupling or in patients with hearing thresholds close to the indication criteria limit, a thick skin flap could lead to loss of transmitted energy resulting in insufficient audiological outcome with the active middle ear implant.  \nKeywords: Middle ear implant; Audio processor; Samba 2; Output; OSPL90  \nIntroduction  \nIf conventional hearing aids cannot be used due to patient-related issues like recurrent infections ofthe auditory canal or large air-bone gaps, active middle ear implants have become an appropriate solution [1] . The Vibrant Soundbridge (VSB) (MED-EL, Innsbruck, Austria) is a frequently  \nused active middle ear implant which is comprised of two primary components. An external audio processor consisting of a microphone, signal processing electronics, telemetry coil, and a battery for power supply, receives and processes incoming acoustical signals. Signals are then amplitude modulated and sent to the internal part, i.e., the surgically implanted vibrating ossicular replacement prosthesis  \n⇑ Corresponding author: Laura Fröhlich, Department of Otolaryngology, Head and Neck Surgery, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany  \nE-mail: [laura.froehlich@ukbonn.de](laura.froehlich@ukbonn.de) (L. Fröhlich).  \nURL: [https://www.ukbonn.de/hno/](https://www.ukbonn.de/hno/) (L. Fröhlich).  \nZ Med Phys 35 (2025) 483–490  \n[https://doi.org/10.1016/j.zemedi.2024.08.002](https://doi.org/10.1016/j.zemedi.2024.08.002)  \n[www.elsevier.com/locate/zemedi](www.elsevier.com/locate/zemedi)  \n􀀁 2024 The Author(s) . Published by Elsevier GmbH on behalf of DGMP, ÖGMP and SSRMP. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)).  \n(VORP), where the signal is demodulated and sent to the miniature floating mass transducer (FMT) [2,3] . According to anatomical and audiological criteria the FMT can be coupled to the ossicles (long process of the incus, incus body, stapes suprastructure) [4,5], to the round window (RW) membrane [6] , or the oval window (OW), i.e., the stapes footplate [7,8] . Coupling quality is ","cbCaihkcsqm2XZM9","https://ap.wps.com/l/cbCaihkcsqm2XZM9","pdf",352941,"English","# Abstract\n## Objective\n## Methods\n## Results\n## Conclusions\n# Introduction","[{\"question\":\"What does the study define as skin flap thickness in the context of the audio processor?\",\"answer\":\"Skin flap thickness refers to the distance between the audio processor and the implant’s receiver coil.\"},{\"question\":\"How were transmission characteristics measured across different audio processor models?\",\"answer\":\"The study measured OSPL90 for a 90 dB input level, RTG60 as a function of frequency, and RTG high-frequency averages in a hearing aid test box with the processors placed 0–10 mm from the receiver coil.\"},{\"question\":\"What was the main finding regarding the effect of distance on output and gain?\",\"answer\":\"For all audio processors, OSPL90 and RTG decreased linearly as distance increased, with the largest reduction observed for the Samba 2 Lo processor.\"}]","Influence of skin flap thickness on the transmission characteristics of middle ear implant audio processors - Clinical significance for VSB treatment | PDF",1790682316]