{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T14:24:08Z","timestamp":1770906248273,"version":"3.50.1"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T00:00:00Z","timestamp":1639440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Mixed hearing loss associated with a sensorineural component and an impaired conductive mechanism for sound from the external ear canal to the cochlea represents a challenge for rehabilitation using either surgery or traditional hearing amplification. Direct stimulations of the ossicular chain and the round window (RW) membrane have allowed an improved hearing in this population. The authors review the developments in basic and clinical research that have allowed the exploration of new routes for inner ear stimulation. Similar changes occur in the electrophysiological measures in response to auditory stimulation through the traditional route and direct mechanical stimulation of the RW. The latter has proven to be very effective as a means of hearing rehabilitation in a group of patients with significant difficulties with hearing and communication.<\/jats:p>","DOI":"10.3389\/fneur.2021.777010","type":"journal-article","created":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T05:11:11Z","timestamp":1639458671000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Round Window Stimulation of the Cochlea"],"prefix":"10.3389","volume":"12","author":[{"given":"Herman A.","family":"Jenkins","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathaniel","family":"Greene","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel J.","family":"Tollin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/S0030-6665(20)30393-5","article-title":"Titanium-anchored prostheses in otology","volume":"29","author":"Burton","year":"1996","journal-title":"Otolayngol Clin North Am."},{"key":"B2","volume-title":"Traite de l'organe de Pouie","author":"DuVerney","year":"1683"},{"key":"B3","author":"Schelhammer","year":"1684","journal-title":"De auditu liber unus, quo pleorumque omnium doctorum sententiae examinantur, et auditus ratio, nova methodo, ex ipsius naturae legibus, explicatur, Lugd"},{"key":"B4","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1001\/archotol.1949.03760070043004","article-title":"Round window membrane of the cochlea, experiments demonstrating its physical responses","volume":"49","author":"Kobrak","year":"1949","journal-title":"Arch Otolaryngol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1177\/000348943204100202","article-title":"Immobilization of the round window membrane: a further experimental study","volume":"41","author":"Hughson","year":"1932","journal-title":"Ann Otol Rhinol Laryngol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1177\/000348944805700301","article-title":"The functions of the round window","volume":"57","author":"Wever","year":"1948","journal-title":"Ann Otol Rhinol Laryngol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1121\/1.1906628","article-title":"The acoustic pathways to the cochlea","volume":"22","author":"Wever","year":"1950","journal-title":"J Acoust Soc Am."},{"key":"B8","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1177\/000348945206100319","article-title":"Sound conduction in the cochlea","volume":"61","author":"Wever","year":"1952","journal-title":"Ann Otol Rhino Laryngol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1159\/000318523","article-title":"The esteem system: a totally implantable hearing device","volume":"69","author":"Maurer","year":"2010","journal-title":"Adv Otorhinolaryngol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1177\/000348948609500401","article-title":"Clinical assessment of ossicular mobility by a ceramic vibrator designed for implantable hearing aids","volume":"95","author":"Gyo","year":"1986","journal-title":"Ann Otol Rhinol Laryngol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000318516","article-title":"The vibrant soundbridge: design and development","volume":"69","author":"Ball","year":"2010","journal-title":"Adv Otorhinolaryngol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/S0030-6665(05)70345-5","article-title":"The otologics MET ossicular stimulator","volume":"34","author":"Kasic","year":"2001","journal-title":"Otolaryngol Clin North Am."},{"key":"B13","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1159\/000339214","article-title":"Assessment of a direct acoustic cochlear stimulator","volume":"17","author":"Chatzimichalis","year":"2012","journal-title":"Audiol Neurotol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1016\/S0030-6665(05)70340-6","article-title":"Total implantation of the Implex TICA hearing amplifier implant for high frequency sensorineural hearing loss: the T\u00fcbingen University experience","volume":"34","author":"Zenner","year":"2001","journal-title":"Otolaryngol Clin North Am."},{"key":"B15","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/S0030-6665(20)30576-4","article-title":"The round window electromagnetic implantable hearing aid approach","volume":"28","author":"Spindel","year":"1995","journal-title":"Otolaryngol Clin North Am."},{"key":"B16","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/S0030-6665(20)30575-2","article-title":"Piezoelectric middle ear implant preserving the ossicular chain","volume":"28","author":"Dumon","year":"1995","journal-title":"Otolaryngol Clin North Am."},{"key":"B17","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1001\/archotol.1961.00740020276004","article-title":"Sonoversion: a new audiosurgical system","volume":"73","author":"Garcia-Ibanez","year":"1961","journal-title":"Arch Otolaryngol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1001\/archotol.1947.00690020490003","article-title":"Lempert fenestra non-ovalis operation for the restoration of serviceable unaided hearing in patients with clinical otosclerosis: its present evolutionary status","volume":"46","author":"Lempert","year":"1947","journal-title":"Arch Otolaryngol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1080\/14992020600840903","article-title":"Treatment of mixed hearing losses via implantation of a vibratory transducer on the round window","volume":"45","author":"Colletti","year":"2006","journal-title":"Int J Audiol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1097\/MAO.0b013e318206fda1","article-title":"Impact of floating mass transducer coupling and positioning in round window vibroplasty","volume":"32","author":"Rajan","year":"2011","journal-title":"Otol Neurotol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1177\/0194599811430808","article-title":"Electrocochleography in round window Vibrant Soundbridge implantation","volume":"146","author":"Colletti","year":"2012","journal-title":"Otol Neurotol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"e906","DOI":"10.1097\/MAO.0000000000002484","article-title":"A quantitative approach for the objective assessment of coupling efficiency for an active middle ear implant by recording auditory steady-state responses","volume":"41","author":"Frohlich","year":"2020","journal-title":"Otol Neurotol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"369","DOI":"10.3109\/00016489.2014.990582","article-title":"Cone beam computed tomography after round window vibroplasty: do the radiological findings match the auditory outcome?","volume":"135","author":"Barbara","year":"2015","journal-title":"Acta Otolaryngol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"E926","DOI":"10.1002\/lary.28514","article-title":"Clinical experience of vibroplasty with direct coupling to the oval window without use of a coupler","volume":"130","author":"Kwak","year":"2020","journal-title":"Laryngoscope."},{"key":"B25","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1159\/000318521","article-title":"The Vibrant Soundbridge for conductive and mixed hearing losses: European multicenter study results","volume":"69","author":"Baumgartner","year":"2010","journal-title":"Adv Otorhinolaryngol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1097\/MAO.0b013e31829ce7d2","article-title":"Acoustic hearing implants for mixed hearing loss: a systematic review","volume":"34","author":"Verhaert","year":"2013","journal-title":"Otol Neurotol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1177\/0003489414534013","article-title":"Consensus statement on round window vibroplasty","volume":"123","author":"Beltrame","year":"2014","journal-title":"Ann Otol Rhino Laryngol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1007\/s00405-013-2432-1","article-title":"Direct round window stimulation with the Med-El Vibrant Soundbridge: 5 years of experience using a technique without interposed fascia","volume":"271","author":"Skarzynski","year":"2014","journal-title":"Eur Arch Otorhinolaryngol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"2843","DOI":"10.1002\/lary.26536","article-title":"Round window stimulation with the Vibrant Soundbridge: comparison of direct and indirect coupling","volume":"127","author":"Olszewski","year":"2017","journal-title":"Laryngoscope."},{"key":"B30","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1097\/MAO.0000000000000943","article-title":"Long-term stability of the active middle-ear implant with floating-mass transducer technology: a single-center study","volume":"37","author":"Schraven","year":"2016","journal-title":"Otol Neurotol."},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.21053\/ceo.2020.01851","article-title":"Results of the active middle ear implantation in patients with mixed hearing loss after the middle ear surgery: prospective multicenter study (ROMEO Study)","author":"Song","year":"2021","journal-title":"Clin Exp Otorhinolaryngol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1602","DOI":"10.1121\/1.416062","article-title":"Is the pressure difference between the oval and round windows the effective acoustic stimulus for the cochlea?","volume":"100","author":"Voss","year":"1996","journal-title":"J Acoust Soc Am."},{"key":"B33","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1159\/000101474","article-title":"Testing a method for quantifying the output of implantable middle ear hearing devices","volume":"12","author":"Rosowski","year":"2007","journal-title":"Audiol Neurotol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/j.heares.2009.08.009","article-title":"Electrocochleographic and mechanical assessment of round window stimulation with an active middle ear prosthesis","volume":"263","author":"Koka","year":"2010","journal-title":"Hear Res."},{"key":"B35","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1121\/1.1639903","article-title":"Fluid volume displacement at the oval and round windows with air and bone conduction stimulation","volume":"115","author":"Stenfelt","year":"2004","journal-title":"J Acoust Soc Am."},{"key":"B36","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1177\/0194599811409674","article-title":"Physiological assessment of active middle ear implant coupling to the round window in Chinchilla lanigera","volume":"145","author":"Lupo","year":"2011","journal-title":"Otolaryngol Head Neck Surg."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1679","DOI":"10.1097\/MAO.0b013e31826dbabb","article-title":"Effect of cochlear window fixation on air- and bone-conduction thresholds","volume":"33","author":"Nageris","year":"2012","journal-title":"Otol Neurotol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.1097\/MAO.0b013e3181bc3c06","article-title":"Koka K, Holland NJ, Jenkins HA, Tollin DJ. Prospective electrophysiologic findings of round window stimulation in a model of experimentally induced stapes fixation","volume":"30","author":"Lupo","year":"2009","journal-title":"Otol Neurotol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1097\/MAO.0b013e318245cecb","article-title":"Third-window vibroplasty with an active middle ear implant: assessment of physiologic responses in a model of stapes fixation in Chinchilla lanigera","volume":"33","author":"Lupo","year":"2012","journal-title":"Otol Neurotol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"e0160819","DOI":"10.1371\/journal.pone.0160819","article-title":"Direct acoustic stimulation at the lateral canal: an alternative route to the inner ear?","volume":"11","author":"Verhaert","year":"2016","journal-title":"PLoS One."},{"key":"B41","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1097\/MAO.0b013e318299aa37","article-title":"Vibromechanical assessment of active middle ear implant stimulation in simulated middle ear effusion: a temporal bone study","volume":"35","author":"Lupo","year":"2014","journal-title":"Otol Neurotol."},{"key":"B42","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.heares.2014.04.003","article-title":"Comparison of auditory responses determined by acoustic stimulation and by mechanical round window stimulation at equivalent stapes velocity","volume":"314","author":"Lee","year":"2014","journal-title":"Hear Res."},{"key":"B43","doi-asserted-by":"publisher","first-page":"4122","DOI":"10.1121\/1.5134770","article-title":"Finite element analysis of round-window stimulation of the cochlea inpatients with stapedial otosclerosis","volume":"146","author":"Zhang","year":"2019","journal-title":"J Acoust Soc Am."},{"key":"B44","doi-asserted-by":"publisher","first-page":"e50","DOI":"10.1097\/MAO.0000000000001385","article-title":"Round and oval window anatomic variability: its implication for the vibroplasty technique","volume":"38","author":"Manche\u00f1o","year":"2017","journal-title":"Otol Neurotol."},{"key":"B45","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1097\/MAO.0b013e3181e8fc21","article-title":"Analysis of Vibrant Soundbridge placement against the round window membrane in a human cadaveric temporal bone model","volume":"31","author":"Pennings","year":"2010","journal-title":"Otol Neurotol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1159\/000283006","article-title":"Round window membrane implantation with an active middle ear implant: a study of the effects on the performance of round window exposure and transducer tip diameter in human cadaveric temporal bones","volume":"15","author":"Tringali","year":"2010","journal-title":"Audio Neurotol."},{"key":"B47","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1111\/coa.13017","article-title":"Influence of backside loading on the floating mass transducer: an in vitro experimental study","volume":"43","author":"Gostian","year":"2018","journal-title":"Clin Otolaryngol."},{"key":"B48","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1177\/0954411920987960","article-title":"Research on coupling effects of actuator and round window membrane on reverse stimulation of human cochlea","volume":"235","author":"Xue","year":"2021","journal-title":"Proc Inst Mech Eng H."},{"key":"B49","doi-asserted-by":"publisher","first-page":"103918","DOI":"10.1016\/j.compbiomed.2020.103918","article-title":"Effect of stimulation sites on the performance of electromagnetic middle ear implant: a finite element analysis","volume":"124","author":"Liu","year":"2020","journal-title":"Comput Biol Med."},{"key":"B50","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1097\/MAO.0b013e3181c34ee0","article-title":"Factors improving the vibration transfer of the floating mass transducer at the round window","volume":"31","author":"Arnold","year":"2009","journal-title":"Otol Neurotol."},{"key":"B51","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.heares.2012.11.005","article-title":"Comparison of forward (ear-canal) and reverse (round-window) sound stimulation of the cochlea","volume":"301","author":"Stieger","year":"2013","journal-title":"Hear Res."},{"key":"B52","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/s10162-008-0150-y","article-title":"Differential intracochlear sound pressure measurements in normal human temporal bones","volume":"10","author":"Nakajima","year":"2009","journal-title":"J Assoc Res Otolaryngol."},{"key":"B53","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1097\/MAO.0b013e3181c0ea9f","article-title":"Evaluation of round window stimulation using the floating mass transducer by intracochlear sound pressure measurements in human temporal bones","volume":"31","author":"Nakajima","year":"2010","journal-title":"Otol Neurotol."},{"key":"B54","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1007\/s10162-014-0477-5","article-title":"Measurement of basilar membrane motion during round window stimulation in guinea pigs","volume":"15","author":"Chen","year":"2014","journal-title":"J Assoc Res Otolaryngol."},{"key":"B55","doi-asserted-by":"publisher","first-page":"1184","DOI":"10.1002\/lio2.495","article-title":"Implantable hearing aids: where are we in 2020?","volume":"5","author":"Banakis Hartl","year":"2020","journal-title":"Laryngoscope Investig Otolaryngol"},{"key":"B56","doi-asserted-by":"publisher","first-page":"967","DOI":"10.1016\/j.otc.2014.08.007","article-title":"Otologics active middle ear implants","volume":"47","author":"Jenkins","year":"2014","journal-title":"Otolaryngol Clin North Am."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.777010\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T05:11:15Z","timestamp":1639458675000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.777010\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,14]]},"references-count":56,"alternative-id":["10.3389\/fneur.2021.777010"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2021.777010","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,14]]},"article-number":"777010"}}