Abstract: An intraluminal device and method of fixation of an intraluminal device to resist distal migration in a mammalian lumen or hollow organ that is subject to peristalsis, according to an aspect of the invention, includes spaced apart wall portions connected with a connector. The wall portions are configured to the size and shape of a portion of the lumen or hollow organ and the connector is configured to be positioned against a wall of the lumen or hollow organ. The intraluminal device is positioned in a mammalian lumen or hollow organ that is subject to peristalsis. The device is fixed in the lumen or hollow organ against distal migration, wherein tissue lining the lumen or hollow organ bridges over the connector. The device is explanted after tissue bridges over the connector including separating the connector from one or both of the wall portions and withdrawing the connector axially from the tissue bridging over the connector.

Abstract: A urological device adapted for placement in a urethra of a user for treatment of incontinence includes a stem, an anchor portion connected to a distal end portion of the stem, a bladder retainer connected to a proximal end of the stem, and a urological valve connected to the proximal end of the stem. The urological valve includes a plurality of movable leaflets connected to and extending in a proximal direction way from the proximal end of the stem. The movable leaflets have an at-rest closed configuration adapted to prevent a flow of urine through the stem, and the movable leaflets are adapted to evert in a distal direction to provide the urological valve with an open configuration adapted to allow urine to flow through the stem.

Abstract: Devices, systems and/or methods for repairing soft tissue adjacent a soft tissue repair site. In one embodiment, a repair device includes an anchor member, a capture member and one or more flexible members. The anchor member includes a base with at least four legs extending integrally from the base, the at least four legs configured to be moveable from a straight first position to a formed second position. The capture member is configured to be coupled to the anchor member such that the at least four legs of the anchor member move around structural portions of the capture member with the at least four legs of the anchor member in the formed second position. The one or more flexible members are coupled to the base of the anchor member, the one or more flexible members extending at least partially along the base of the anchor member.

Abstract: A multiple energy storage device fuel gauge is described for a device having a power system with multiple heterogeneous energy storage devices. The fuel gauge keeps track of a present state of multiple heterogeneous energy storage devices simultaneously. The fuel gauge implements collective measurement of voltage and current of the multiple heterogeneous energy storage devices via shared circuitry to determine status information, such as state of charge (SOC) and internal resistance values. A controller of the fuel gauge uses various measurements and energy storage device-specific parameters to compute status values indicative of the state of each energy storage device. The status values are maintained by the fuel gauge and exposed to other system components to facilitate power management decisions. A communication bus is used to communicate between the fuel gauge and System components, and a software API may be exposed to facilitate access to various energy storage device specific information.

Abstract: A device for manipulating an implant includes a handle coupled to a guide extending from the handle to a distal end. The device includes an engagement mechanism disposed at the distal end of the guide and configured to engage an implant. The device includes a first actuator disposed on the handle and coupled to the engagement mechanism. The first actuator causes the engagement mechanism to engage the implant. The device includes an air chamber disposed in an interior chamber of the handle and configured to hold air. The device includes a lumen coupled to the air chamber and extending along the guide to the distal end. The lumen includes an air channel extending through the lumen. The device includes a second actuator disposed on the handle. The second actuator causes the air chamber to deliver the air, via the air channel, to the distal end.

Abstract: Provided herein are devices used to reconstruct a natural lens capsule after a cataract surgery. The device flexibly adapts to the tension of the lens capsule as it is relaxed or contracted. This device comprises a ring-shaped rigid component. The rigid component comprises a distal end in contact with an anterior surface of the capsule and a proximal end disposed on a posterior surface of the capsule and disposed against a Wieger's ligament of the eye. A ring-shaped flexible component substantially concentric with the rigid component is flexibly fitted against an inner surface of the capsule. The ring-shaped flexible component comprises a proximal end formed on an outer surface of a proximal end of the rigid component, and a distal end extending away from the rigid component. A groove is disposed on an inner surface of the rigid component configured to receive haptics on an intraocular lens.

Abstract: There is provided an intraocular lens injector configured to inject an intraocular lens having an optical portion 8 and a pair of support portions 9a, 9b, including: an injector main body 2 having a lens setting portion 6 on which the intraocular lens 7 is set; a pushing member 5 that pushes out the intraocular lens 7 from the lens setting portion 6 by moving in a direction of a central axis of the injector main body 2; and a guide slope 11 that guides the movement of the pushing member 5 when the pushing member 5 moves in the direction of the central axis of the injector main body 2, wherein when the pushing member 5 moves in the direction of the central axis of the injector main body 2, a tip end part of the pushing member 5 comes into contact with the support portions 9b of the intraocular lens 7, and comes into contact with the optical portion 8 while pushing the support portions 9b, and the guide slope 11 guides the movement of the pushing member 5 so that the tip end part of the pushing member 5 is disp

Abstract: A replacement heart valve system may include an expandable docking station configured for implantation within a native heart valve. The expandable docking station may include a plurality of sacrificial valve leaflets disposed within a braided anchoring element defining a lumen extending through the braided anchoring element. The replacement heart valve system may include a replacement heart valve implant configured to be disposed within the lumen of the expandable docking station. The replacement heart valve implant may include a plurality of valve leaflets disposed within a tubular anchor member defining a lumen extending through the tubular anchor member.

Abstract: A system is in various embodiments configured to treat a native heart valve, such as to secure a prosthetic heart valve within a native valve. Embodiments of the system include a docking device with different coil portions, such as an upper coil and a lower coil, where the device is configured to assume an axially expanded state and an axially compressed state. In the axially expanded state, the entire upper coil can be positioned on a first side of the lower coil relative to the central axis and/or the entire upper coil and the entire lower coil have a positive pitch relative to each other. In the axially compressed state, at least a portion of the upper coil can be positioned on a second side of at least a portion of the lower coil opposite to the first side relative to the central axis and/or at least a portion of the upper coil has a negative pitch relative to at least a portion of the lower coil.

Abstract: A prosthetic mitral valve includes a collapsible and expandable stent extending from an inflow end to an outflow end. A collapsible and expandable valve assembly is disposed within the stent. The valve assembly includes a plurality of anterior leaflets and one posterior leaflet. The posterior leaflet has a larger surface area than any of the anterior leaflets. When implanted in the native mitral valve annulus, the smaller size of the anterior leaflets and the corresponding smaller size of an anterior portion of the stent reduce the likelihood of interference with blood flowing through the native aortic valve, while also reducing the likelihood of ventricular fibrillation.

Abstract: Methods for manufacturing or sewing a prosthetic heart valve and associated systems can include an assistance system that includes an automated fixture that can comprise an articulation arm and a target device holder. The automated fixture can be configured to rotate a target device held by the holder. The assistance system can include a camera system configured to generate an enlarged image of the target device, and a display configured to display the enlarged image. The display can also display information to aid an operator in performing a procedure, for example, instructions, reference images, or a visual indicator to indicate a target position on the target device for performing a step of the procedure.

Abstract: Embodiments of the present disclosure are directed to prosthetic valves and methods of use thereof. In one implementation, a prosthetic valve may include an annular outer frame formed at least partially of struts intersecting at outer frame junctions and an inner frame situated within the outer frame. The inner frame may be formed at least partially of struts intersecting at inner frame junctions. The valve may include at least one inner frame tissue anchor extending from an inner frame junction. Outer frame junctions along a ventricular end of the outer frame may be angularly offset from inner frame junctions along a ventricular end of the inner frame.

Abstract: A differential pressure regulating device is provided for controlling in-vivo pressure in body, and in particularly in a heart. The device may include a shunt being positioned between two or more lumens in a body, to enable fluids to flow between the lumens, and an adjustable flow regulation mechanism being configured to selectively cover an opening of the shunt, to regulate the flow of fluid through the shunt in relation to a pressure difference between the body lumens. In some embodiments a control mechanism coupled to the adjustable flow regulation mechanism may be provided, to remotely activate the adjustable flow regulation mechanism.

Abstract: Disclosed are methods, systems, and devices for the endovascular repair of cardiac valves, particularly the atrioventricular valves which inhibit back flow of blood from a heart ventricle during contraction. The procedures described herein can be performed with interventional tools, guides and supporting catheters and other equipment introduced to the heart chambers from the patient's arterial or venous vasculature remote from the heart. The interventional tools and other equipment may be introduced percutaneously or may be introduced via a surgical cut down, and then advanced from the remote access site through the vasculature until they reach the heart.

Abstract: A tissue-engaging element has a distal portion configured to engage a portion of tissue of the heart. A guide member is reversibly coupled to the tissue-engaging element. An artificial chorda tendinea has a distal end and a proximal end, at least the distal end being slidably coupled to the guide member. A tool is slidable along the guide member distally toward the tissue-engaging element while (i) the tool is coupled to at least the distal end of the chorda tendinea, and (ii) the guide member is coupled to the tissue-engaging element, such that sliding of the tool along the guide member distally toward the tissue-engaging element while (i) the tool is coupled to at least the distal end of the chorda tendinea, and (ii) the guide member is coupled to the tissue-engaging element, slides at least the distal end of the chorda tendinea toward the tissue-engaging element.

Abstract: A prosthesis may have an articulating component formed via casting and a 3D printed bone anchoring component with a joint-facing side and a bone-facing side. The bone-facing side may have a bone engagement surface with a porous structure with pores selected to facilitate in-growth of the bone into the pores. The bone facing side may further have a surface layer of Titanium Dioxide nanotubes. The joint-facing side may be secured to the articulating component by melting Titanium nanoparticles at a temperature below the melting temperatures of the major constituents of the articulating component and/or the bone anchoring component, such as Cobalt, Chromium, and/or Titanium, so as to avoid significantly modifying the crystalline structures of the articulating component and/or the bone anchoring component. The melting temperature of the Titanium nanoparticles may be about 500° C.

Abstract: An orthopedic implant includes a first portion including at least one feature modified to be patient-specific and match the anatomy of a specific patient from a three-dimensional digital image of a patient's joint using computer modeling. The orthopedic implant includes a non-custom inner bone-engaging surface including a plurality of planar surfaces configured for engagement with non-custom bone cuts.

Abstract: Methods of selecting and implanting prosthetic devices for use as a replacement meniscus are disclosed. The selection methods include a pre-implantation selection method and a during-implantation selection method. The pre-implantation selection method includes a direct geometrical matching process, a correlation parameters-based matching process, and a finite element-based matching process. The implant identified by the pre-implantation selection method is then confirmed to be a suitable implant in the during-implantation selection method. Methods of implanting meniscus prosthetic devices are also disclosed.

Abstract: A posterior cruciate ligament retaining knee implant prosthesis comprising a femoral component including a medial condyle and a lateral condyle separated from one another by an intercondylar channel adapted to accommodate throughput of a native cruciate ligament, both the medial condyle and the lateral condyle posteriorly terminate individually, the medial condyle including a medial condyle bearing surface and the lateral condyle including a lateral condyle bearing surface, the femoral component including an anterior cam, and a tibial component including a medial condyle receiver having a medial condyle receiver bearing surface, the tibial component also including a lateral condyle receiver having a lateral condyle receiver bearing surface, the tibial component also including an anterior post.

Abstract: A prosthetic humeral head component (60) comprising: a convex external head surface (62); an internal cavity (64) formed opposite to the head surface (62); and a plurality of fixation elements (70) protruding from said cavity (64) oppositely to said head surface (62) for location into a peripheral portion (17b) of an epiphyseal plate (17) of the humerus (14) to secure the component (60) to the humerus (14), wherein the component is formed as a single, unitary piece. The fixation elements may comprise pegs (70), fins (1080), or keels (2090), or combinations thereof.

Abstract: A prosthesis for replacing a joint between a first bone and a second bone in a human hand or foot includes first and second rigid blocks (110, 120) interconnected by a flexible bridging structure (130). In certain embodiments, the flexible bridging structure employs a helical spring oriented with its central axis aligned with a central axis of a bone anchor portion of the first rigid block. One or more shear-limiting element (101, 140) is deployed within an internal volume of the helical spring (130) to limit an extent of shear deformation applied to the helical spring. Other aspects of the invention relate to adjustable bone-abutment flanges, an alternative bridging structure employing a helically-twisted leaf spring, and a structure and method for bridging between the first metacarpal and the scaphoid in case of removal of the trapezium from the hand.

Abstract: The present invention relates generally to medical devices, systems, and methods for use in surgery. In particular, the disclosed system and methods relate to an intervertebral spinal implant sized and dimensioned for the lumbar spine implantable via a posterior approach. The system includes an implant, instruments for delivering the implant.

Abstract: An implant is provided for performing spinal fusion. The implant includes an implant body having a leading side and a trailing side at opposing ends along a longitudinal axis. Between the leading side and trailing side are an upper surface, a lower surface, an anterior side, and a posterior side. At least one keel structure is provided extending from the implant body for penetration into an adjacent vertebral body. A trial sizer and keel cutter may be utilized to form keel channels within the vertebral body to receive the keel structure.

Abstract: A method of implanting an intervertebral spacer may include positioning the intervertebral spacer within an intervertebral space defined by adjacent vertebral bodies. The intervertebral spacer may include a plurality of bores, and each of the plurality of bores may be configured to receive either a linear fastening element or a curvilinear fastening element. The method also may include selecting a first fastening element from a group including linear fastening elements and curvilinear fastening elements, and inserting the first fastening element into a first bore of the plurality of bores such that the first fastening element is inserted into one of the adjacent vertebral bodies to secure the intervertebral spacer within the intervertebral space.

Abstract: Implants include fixation features which slidingly receive fixation elements. The fixation features may be negative or positive features, such as undercut channels or posts. Examples include unicompartmental tibial trays having a ridge protruding from the bone-facing side, an undercut channel formed within the ridge. Instruments are disclosed for preparing a ridge-receiving feature in bone.

Abstract: A method for assisting in positioning the acetabular cup comprises orienting a cup positioning instrument with a cup thereon in an initial reference orientation relative to an acetabulum of a pelvis with the cup forming a joint with the acetabulum, the cup positioning instrument comprising an inertial sensor unit with pre-planned orientation data for a desired cup orientation based on at least one landmark of the pelvis, The cup positioning instrument is rotated to a desired abduction angle as guided by an interface of the cup positioning instrument, based on movements relative to at least one landmark. The cup positioning instrument is rotated to a desired anteversion angle as guided by the interface of the cup positioning instrument, based on movements relative to the at least one landmark. Upon reaching the desired cup orientation as indicated by the interface, the cup is impacted into the acetabulum.

Abstract: Methods, apparatus and kits for preparing a medical mixture are disclosed. A method of preparing the medical mixture includes introducing a material into a tray, transferring the material from the tray to a scooper, releasably securing the scooper to the tray, and introducing a tubular member defining a lumen into the scooper such that the material within the scooper enters the lumen. A mixing apparatus includes a tray comprising a body defining a mixing receptacle configured to receive a material, a scooper having a proximal end with a proximal opening and a distal end with a distal opening, and a connector configured to releasably secure the scooper to the tray. A kit includes a tubular member, a stylet, a tray, and a scooper.

Abstract: A mechanical grasping device where each of the segments of the finger assemblies, are individually sizeable. This allows for both a proportionately scalable grasping device as well as individual customization of geometric configurations tailored to specific use patterns. The mechanical grasping device is crushable since it has flexible and pivotable connections between digits along its length and width. It has a hollow member construction that imparts a strong lightweight design. It is modular so individual parts can be replaced for quick repair. From an aesthetics point, it is visually pleasing and can be offered in different colors, and with custom digit sleeves for specific applications. Finger assemblies can be operated individually or in groups via pairs of cables which allow operation in either voluntary open or voluntary closed modes of control. The flexible construction allows gripping of irregularly shaped objects and deforms before failing giving indication of overload prior to failure.

Abstract: The use of bifurcated catheter is disclosed for stabilizing working catheters for carotid percutaneous intervention of vessels originating from a tortuous aortic arch, which uses guide wires that used to enable the catheters accessing the left or right carotid arteries (CA). Also disclosed is the use of two independent catheters or a catheter and snare wire within a single sheath, as well as the implementations, associated problems and corrective solutions to the identified problems. Further additional uses of the bifurcated catheter/dual catheter, for access to and treatment of other exemplary tortuous locations where stability of the procedural catheter would make a difference are also disclosed in the current application.

Abstract: An endoprosthesis delivery system includes a wire holder on a distal section of an elongated shaft with a plurality of wires extending distally from the wire holder and, in a secured position, terminating in a distal receiver attached to the elongated shaft distal to the wire holder.

Abstract: An endoprosthesis delivery system includes a wire holder on a distal section of an elongated shaft with a plurality of wires extending distally from the wire holder and, in a secured position, terminating in a distal receiver attached to the elongated shaft distal to the wire holder.

Abstract: A prosthesis delivery system and method of use thereof are described. The system includes a handle, an inner cannula extending proximally from the handle, an outer sheath extending proximally from the handle, and a pull member. The outer sheath including an axially collapsible segment and a non-collapsible body. The pull member is coupled between the handle and the axially collapsible segment or the non-collapsible body of the outer sheath. The handle is operable to retract the pull member such that the axially collapsible segment is shortened. The handle may include a spool and an actuator coupled to the pull member in a manner for winding the pull member around the spool. The handle may be shorter than the retraction length of the axially collapsible segment sized for deployment of the prosthesis.

Abstract: Dynamic arm brace assemblies and methods of use are provided herein. An example device includes a torso connection member securable to a torso of a patient, a forearm support member that couples with at least a forearm of an patient, the forearm support member couples with the torso connection member so as to fix an elbow of the patient proximate the torso, the forearm support member being pivotally coupled to the torso connection member to allow for an angle between the forearm support member and a coronal plane of the patient, and a dynamic tensioning assembly that externally rotates the forearm support member and selectively sets the angle so as to stretch a shoulder capsule (capsule and adjacent tissue(s)) affected with adhesive capsulitis, reducing the adhesive capsulitis.

Abstract: A locking hinge with a first component and a second component which are mounted against each other in a pivotal manner relative to each other about a pivot axis. The first component has a latching recess, and the second component has a latching element which is designed to penetrate the latching recess in a latching position of the first component relative to the second component, thus preventing a pivoting movement of the first component relative to the second component in at least one direction. The latching element is designed to penetrate the latching recess to different depths in at least two different latching positions.

Abstract: In a preferred embodiment, the invention is a splint for use in straightening the finger of a person. It has a first cradle for receiving a part of a finger, and a second cradle for receiving another part of a finger and a screw. The first and second cradles are pivotally connected and secured to the finger. The screw is attached to a cradle and arranged so as to freely abut against a surface on the opposing cradle. The screw can be moved so as to change the angle of the finger correspondingly.

Abstract: A blister protector sticker that adheres to and protects an individual's foot, including a base layer of closed cell polyvinyl chloride foam, an adhesive layer of hypoallergenic acrylate adhesive operatively attached thereto, and a removable layer removably attached to the adhesive layer, the blister protector sticker having a shape that protects and shields a portion of skin of a foot from blisters. A method of protecting an individual's foot from blisters and irritation, by removing a removable layer from the blister protector sticker, attaching the adhesive layer of the blister protector sticker to an area of skin of an individual's foot at risk of blister formation or irritation, and protecting the area of skin covered by the blister protector sticker from forming a blister or irritation.

Abstract: A filter assembly for an enclosure, particularly for an ostomy bag, is described having an enclosure side, a first layer which is gas permeable, and an adsorbent layer comprising adsorbent particles dispersed in a fine fiber web. The enclosure side of the filter assembly includes an adhesive zone in which adhesive is present having an outer adhesive perimeter and a weld area surrounding at least a portion of the adhesive zone, where the filter assembly is heat-sealable to the enclosure at the weld area. A method of assembly is also described.

Abstract: Disclosed is a method of attaching an adhesive, such as an adhesive on an adhesive base plate of an ostomy device, to a skin surface of a user. The method involves the steps of providing an adhesive, for instance on a base plate of an ostomy device. The adhesive can be disposed on a skin-facing surface of a backing layer. Also provided is a solvent capable of at least partly dissolving the adhesive. The solvent is brought into contact with the adhesive and the adhesive is applied to the skin of the user. Also disclosed is a kit of parts including an adhesive and a solvent capable of at least partly dissolving the adhesive.

Abstract: An ostomy appliance includes a dual-chamber pouch, which can continuously drain liquids from body waste, while collecting solids in the pouch. The ostomy appliance can also include a flat output tap including a lumen, the size of which can be increased by applying pressure.

Abstract: Parastomal hernia support devices are disclosed herein. A parastomal hernia support device configured in accordance with embodiments of the present technology can include, for example, a support assembly including a generally rigid outer portion and a generally flexible inner portion having an aperture configured to be aligned with a stoma of the user. In some embodiments, the support assembly includes a tensioning assembly that can be actuated by the user to adjust the tension in a non-elastic strap that secures the support assembly against the user. For example, the user can increase the tension in the strap to add support to the peristomal tissues proximate the stoma to reduce the likelihood of the user developing a parastomal hernia.

Abstract: A personal microclimate control system for sensing cutaneous conditions on a body. The sensors are located on spatially distinct physical locations on a body, adjacent to the cutaneous layer. A controller and connected memory stores the addresses for the sensors. The controller operates the sensors based on their addresses for the purpose of improving thermal comfort. In an embodiment, the controller controls the sensors by executing multiple-input multiple output algorithms. Embodiments are further directed to controlling a plurality of individual electronic effectors as well as to improving system safety, usability and management capabilities.

Abstract: A knee and foot therapy apparatus is provided which enables heat therapy to be easily applied to the knee and foot parts of the body. The apparatus comprises a knee support member, a foot support member, a support connection member, and a heat transfer member. The support connection member is for adjustably connecting the knee support member and the foot support member together to allow the apparatus to be easily adjusted for different user leg lengths. The user will place the back of their knee or knees upon the top of the knee support member, and place the heel of their foot or feet upon the top of the foot support member. The heat transfer member has a knee cover member and a foot cover member mounted to the knee support member and to the foot support member respectively. These cover members are heated by an electrical source, and thus provide heat therapy to both the knee and foot parts of the body.

Abstract: A method, device, or system for treating eye disorders or conditions, comprising restoring or increasing blood flow or blood flow rate in an artery that supplies blood to or in the eye, thereby increasing the amount of nutrient(s) that reaches the eye or a portion thereof. The invention also includes methods, devices, or systems for treating eye disorders or conditions which use reverse flow or retrograde flow structures and systems during the treatment of the eye disease.

Abstract: A method, device, or system for treating eye disorders or conditions, comprising restoring or increasing blood flow or blood flow rate in an artery that supplies blood to or in the eye, thereby increasing the amount of nutrient(s) that reaches the eye or a portion thereof. The invention also includes methods, devices, or systems for treating eye disorders or conditions which use reverse flow or retrograde flow structures and systems during the treatment of the eye disease.

Abstract: An apparatus for ocular treatment according to the present invention comprises: a beam generation unit for generating a therapeutic beam; a beam transfer unit comprising a first lens part capable of forming an optical path through which the therapeutic beam oscillated from the beam generation unit travels in the ocular fundus, and of varying the focal length so that the beam is transferred in a predetermined spot size in the ocular fundus; and a control unit, connected to the beam transfer unit, for controlling the focal length of the therapeutic beam of the first lens part.

Abstract: A small gauge surgical instrument assembly is shown with advantages such as diminished “play” at the tip. A surgical instrument assembly is also shown with support along a length of the instrument that can be selected by the surgeon. In particular, very small and flexible instruments for vitreous surgery are shown with selectable stiffness, thus providing control as well as access to all parts of the vitreous cavity. Embodiments as shown are safer, and increase the variety of cases for which these instruments can be used.

Abstract: A vitreous body surgical probe that includes a probe main body having sufficient bending rigidity, and that can make it easy to collect vitreous bodies etc. in the vicinity of the retina which are difficult to reach using the conventional vitreous body surgical probe while securing sufficient suction efficiency. The vitreous body surgical probe includes: a probe main body having a pipe shape; an end part having an approximately tube shape, which is connected to the very end part of the probe main body, has a smaller diameter than the probe main body, and includes a sealed tip surface and an opening in the side; and a cutter, which has matching diameters to respective inner diameters of the probe main body and the end part, has a blade part on a tip, and slides along inner surfaces of the probe main body and the end part.

Abstract: A glaucoma drainage implant comprising a pressure relief valve via which aqueous humor can be drained. The pressure relief valve has a pressure relief flap which is movably connected with a base plate of the implant, which is to be embedded in a sclera, wherein the pressure relief flap has an actuation area by means of which the pressure relief flap can be mobilized non-invasively during a post-operative healing phase or thereafter. The actuation area is preferably designed as a thermomechanically active area.

Abstract: Disclosed herein is a method and a tool for making tunnel incisions of modified architecture in the cornea and sclera. The tool comprises means for making two additional backward incisions made near the side edges of the main tunnel incision. Additional incisions, made to a depth of 10 to 300 ?m, are set at an angle of from 15 to 165° relative to the plane of the main tunnel incision. Performing the additional incisions results in a partial downward incision of the tunnel floor (rear part) in its side.

Abstract: A hearing protection device for attaching to a wearable article. The device comprises a housing, a recoil assembly, a cord, and a pair of ear engaging components. The device further comprises a mounting component for attaching the device to the wearable article such as a baseball cap or a helmet. A user may extend the pair of ear engaging components out of or away from the housing for use, and retract the pair of ear engaging components back toward or into the housing when no longer needed. When not in use, the device remains attached to the wearable article so that it is convenient to access when needed.