Patent Publication Number: US-2023147143-A1

Title: Convertibility of a bone conduction device

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a Continuation-In-Part application of application Ser. No. 13/114,633 filed May 24, 2011, the contents of which are incorporated herein by reference in their entirety. 
    
    
     BACKGROUND 
     The present invention relates generally to bone conduction devices, and more particularly, to convertibility of bone conduction devices. 
     Hearing loss, which may be due to many different causes, is generally of two types: conductive and sensorineural. Sensorineural hearing loss is due to the absence or destruction of the hair cells in the cochlea that transduce sound signals into nerve impulses. Various hearing prostheses are commercially available to provide individuals suffering from sensorineural hearing loss with the ability to perceive sound. For example, cochlear implants use an electrode array implanted in the cochlea of a recipient to bypass the mechanisms of the ear. More specifically, an electrical stimulus is provided via the electrode array to the auditory nerve, thereby causing a hearing percept. 
     Conductive hearing loss occurs when the normal mechanical pathways that provide sound to hair cells in the cochlea are impeded, for example, by damage to the ossicular chain or ear canal. Individuals suffering from conductive hearing loss may retain some form of residual hearing because the hair cells in the cochlea may remain undamaged. 
     Individuals suffering from conductive hearing loss typically receive an acoustic hearing aid. Hearing aids rely on principles of air conduction to transmit acoustic signals to the cochlea. In particular, a hearing aid typically uses a component positioned in the recipient&#39;s ear canal or on the outer ear to amplify a sound received by the outer ear of the recipient. This amplified sound reaches the cochlea causing motion of the perilymph and stimulation of the auditory nerve. 
     In contrast to hearing aids, certain types of hearing prostheses commonly referred to as bone conduction devices, convert a received sound into mechanical vibrations. The vibrations are transferred through the skull to the cochlea causing generation of nerve impulses, which result in the perception of the received sound. Bone conduction devices may be a suitable alternative for individuals who cannot derive sufficient benefit from acoustic hearing aids, cochlear implants, etc. 
     SUMMARY 
     In accordance with one aspect of the present invention, there is an external component of a bone conduction device, comprising a vibrator, and a platform configured to transfer vibrations from the vibrator to skin of the recipient, wherein the vibrator and platform are configured to quick release and quick connect from and to, respectively, one another. 
     In accordance with another aspect of the present invention, there is a method of converting a removable component of a percutaneous bone conduction device to an external component of a transcutaneous bone conduction device, the method comprising obtaining a vibrator configured to connect to a percutaneous abutment implanted in a recipient, and connecting a platform to the vibrator. 
     In accordance with another aspect of the present invention, there is a method of converting an external component of a transcutaneous bone conduction device including a vibrator to a removable component of a percutaneous bone conduction device, the method comprising, obtaining the vibrator, wherein the vibrator is configured to be detachably attached to pressure plate of the transcutaneous bone conduction device, and uncouplably coupling the vibrator to an implanted percutaneous abutment implanted in a recipient. 
     In accordance with another aspect of the present invention, there is an external platform for a passive transcutaneous bone conduction device, comprising a pressure plate configured to transmit hearing percept evoking vibrations, generated by an external vibrator of an external component of a bone conduction device and transmitted to the pressure plate, into skin of a recipient to input the vibrations into an implanted vibrating component attached to bone of a recipient, wherein the platform is configured to quick release and quick connect from and to, respectively, the external vibrator. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Embodiments of the present invention are described below with reference to the attached drawings, in which: 
         FIG.  1    is a perspective view of an exemplary bone conduction device in which embodiments of the present invention may be implemented; 
         FIGS.  2 A and  2 B  are schematic diagrams of exemplary bone fixtures with which embodiments of the present invention may be implemented; 
         FIG.  3    is a schematic diagram illustrating an exemplary passive transcutaneous bone conduction device in which embodiments of the present invention may be implemented; 
         FIG.  4    is a schematic diagram illustrating an exemplary active transcutaneous bone conduction device in which embodiments of the present invention may be implemented; 
         FIG.  5 A  is a schematic diagram illustrating an exemplary portion of the implantable component of a passive transcutaneous bone conduction device according to an embodiment of the present invention; 
         FIG.  5 B  is a schematic diagram illustrating another exemplary portion of the implantable component of a passive transcutaneous bone conduction device according to an embodiment of the present invention; 
         FIG.  5 C  is a schematic diagram illustrating another exemplary portion of the implantable component of a passive transcutaneous bone conduction device according to an embodiment of the present invention; 
         FIG.  5 D  is a schematic diagram illustrating another exemplary portion of the implantable component of a passive transcutaneous bone conduction device according to an embodiment of the present invention; 
         FIG.  6    depicts a flow chart detailing a method of converting a percutaneous bone conduction device to a transcutaneous bone conduction device according to an embodiment of the present invention; 
         FIG.  7    is a schematic diagram illustrating a percutaneous bone conduction device with which an embodiment of the present invention may be used; 
         FIG.  8    is a schematic diagram illustrating an exemplary portion of the external device of a passive transcutaneous bone conduction device according to an embodiment of the present invention; 
         FIG.  9    is a schematic diagram illustrating an exemplary external device of a passive transcutaneous bone conduction device according to an embodiment of the present invention. 
         FIG.  10    is a functional diagram illustrating a exemplary external device of a passive transcutaneous bone conduction device according to an embodiment of the present invention; 
         FIGS.  11 A- 11 C  are schematic diagrams illustrating an exemplary external device of a passive transcutaneous bone conduction device according to an embodiment of the present invention; 
         FIG.  12    is a schematic diagram illustrating an exemplary external device of a passive transcutaneous bone conduction device according to an embodiment of the present invention; 
         FIG.  13    is a schematic diagram illustrating an exemplary external device of a passive transcutaneous bone conduction device according to an embodiment of the present invention; 
         FIG.  14    is a schematic diagram illustrating an exemplary external device of a passive transcutaneous bone conduction device according to an embodiment of the present invention; 
         FIG.  15    is a schematic diagram illustrating an exemplary platform of a passive transcutaneous bone conduction device according to an embodiment of the present invention; 
         FIGS.  16 A and  16 B  are schematic diagrams illustrating an exemplary coupling apparatus utilized in an exemplary external device of a passive transcutaneous bone conduction device according to an embodiment of the present invention; 
         FIG.  17    depicts a flow chart detailing a method of converting a removable component of a percutaneous bone conduction device to an external component of a transcutaneous bone conduction device according to an embodiment of the present invention; 
         FIG.  18    depicts a flow chart detailing a method of converting the implantable portion of a percutaneous bone conduction device to an implantable component of a transcutaneous bone conduction device according to an embodiment of the present invention; 
         FIG.  19    depicts a flow chart detailing a method of converting a percutaneous bone conduction device to a transcutaneous bone conduction device according to an embodiment of the present invention; 
         FIG.  20    depicts a flow chart detailing a method of converting an external component of a transcutaneous bone conduction device to a removable component of a percutaneous bone conduction device according to an embodiment of the present invention; 
         FIG.  21    depicts a flow chart detailing a method of converting the implantable component of a transcutaneous bone conduction device to an implantable portion of a percutaneous bone conduction device according to an embodiment of the present invention; and 
         FIG.  22    depicts a flow chart detailing a method of converting a transcutaneous bone conduction device to a percutaneous bone conduction device according to an embodiment of the present invention. 
     
    
    
     DETAILED DESCRIPTION 
     Aspects of the present invention are generally directed to a bone conduction device that can be converted from a percutaneous bone conduction device to a passive transcutaneous bone conduction device, and visa-versa. 
       FIG.  1    is a perspective view of a transcutaneous bone conduction device  100  in which embodiments of the present invention may be implemented. As shown, the recipient has an outer ear  101 , a middle ear  102  and an inner ear  103 . Elements of outer ear  101 , middle ear  102  and inner ear  103  are described below, followed by a description of bone conduction device  100 . 
     In a fully functional human hearing anatomy, outer ear  101  comprises an auricle  105  and an ear canal  106 . A sound wave or acoustic pressure  107  is collected by auricle  105  and channeled into and through ear canal  106 . Disposed across the distal end of ear canal  106  is a tympanic membrane  104  which vibrates in response to acoustic wave  107 . This vibration is coupled to oval window or fenestra ovalis  110  through three bones of middle ear  102 , collectively referred to as the ossicles  111  and comprising the malleus  112 , the incus  113  and the stapes  114 . The ossicles  111  of middle ear  102  serve to filter and amplify acoustic wave  107 , causing oval window  110  to vibrate. Such vibration sets up waves of fluid motion within cochlea  139 . Such fluid motion, in turn, activates hair cells (not shown) that line the inside of cochlea  139 . Activation of the hair cells causes appropriate nerve impulses to be transferred through the spiral ganglion cells and auditory nerve  116  to the brain (not shown), where they are perceived as sound. 
       FIG.  1    also illustrates the positioning of bone conduction device  100  relative to outer ear  101 , middle ear  102  and inner ear  103  of a recipient of device  100 . As shown, bone conduction device  100  is positioned behind outer ear  101  of the recipient. Bone conduction device  100  comprises an external component  140  and implantable component  150 . The bone conduction device  100  includes a sound input element  126  to receive sound signals. Sound input element  126  may comprise, for example, a microphone, telecoil, etc. In an exemplary embodiment, sound input element  126  may be located, for example, on or in bone conduction device  100 , on a cable or tube extending from bone conduction device  100 , etc. Alternatively, sound input element  126  may be subcutaneously implanted in the recipient, or positioned in the recipient&#39;s ear. Sound input element  126  may also be a component that receives an electronic signal indicative of sound, such as, for example, from an external audio device. For example, sound input element  126  may receive a sound signal in the form of an electrical signal from an MP3 player electronically connected to sound input element  126 . 
     Bone conduction device  100  comprises a sound processor (not shown), an actuator (also not shown) and/or various other operational components. In operation, sound input device  126  converts received sounds into electrical signals. These electrical signals are utilized by the sound processor to generate control signals that cause the actuator to vibrate. In other words, the actuator converts the electrical signals into mechanical vibrations for delivery to the recipient&#39;s skull. 
     In accordance with embodiments of the present invention, a fixation system  162  may be used to secure implantable component  150  to skull  136 . As described below, fixation system  162  may be a bone screw fixed to skull  136 , and also attached to implantable component  150 . 
     In one arrangement of  FIG.  1   , bone conduction device  100  is a passive transcutaneous bone conduction device. That is, no active components, such as the actuator, are implanted beneath the recipient&#39;s skin  132 . In such an arrangement, the active actuator is located in external component  140 , and implantable component  150  includes a magnetic plate, as will be discussed in greater detail below. The magnetic plate of the implantable component  150  vibrates in response to vibration transmitted through the skin, mechanically and/or via a magnetic field, that are generated by an external magnetic plate. 
     In another arrangement of  FIG.  1   , bone conduction device  100  is an active transcutaneous bone conduction device where at least one active component, such as the actuator, is implanted beneath the recipient&#39;s skin  132  and is thus part of the implantable component  150 . As described below, in such an arrangement, external component  140  may comprise a sound processor and transmitter, while implantable component  150  may comprise a signal receiver and/or various other electronic circuits/devices. 
     Aspects of the present invention may also include the conversion of an implanted percutaneous bone conduction device to a transcutaneous bone conduction device. To this end, an exemplary percutaneous bone conduction device will be briefly described below. 
     As previously noted, aspects of the present invention are generally directed to a bone conduction device including an implantable component comprising a bone fixture adapted to be secured to the skull, a vibratory element attached to the bone fixture, and a vibration isolator disposed between the vibratory element and the recipient&#39;s skull.  FIGS.  2 A and  2 B  are cross-sectional views of bone fixtures  246 A and  246 B that may be used in exemplary embodiments of the present invention. Bone fixtures  246 A and  246 B are configured to receive an abutment as is known in the art, where an abutment screw is used to attach the abutment to the bone fixtures, as will be detailed below. 
     Bone fixtures  246 A and  246 B may be made of any material that has a known ability to integrate into surrounding bone tissue (i.e., it is made of a material that exhibits acceptable osseointegration characteristics). In one embodiment, the bone fixtures  246 A and  246 B are made of titanium. 
     As shown, fixtures  246 A and  246 B each include main bodies  4 A and  4 B, respectively, and an outer screw thread  5  configured to be installed into the skull. The fixtures  246 A and  246 B also each respectively comprise flanges  6 A and  6 B configured to prevent the fixtures from being inserted too far into the skull. Fixtures  246 A and  246 B may further comprise a tool-engaging socket having an internal grip section for easy lifting and handling of the fixtures. Tool-engaging sockets and the internal grip sections usable in bone fixtures according to some embodiments of the present invention are described and illustrated in U.S. Provisional Application No. 60/951,163, entitled “Bone Anchor Fixture for a Medical Prosthesis,” filed Jul. 20, 2007. 
     Main bodies  4 A and  4 B have a length that is sufficient to securely anchor the bone fixtures into the skull without penetrating entirely through the skull. The length of main bodies  4 A and  4 B may depend, for example, on the thickness of the skull at the implantation site. In one embodiment, the main bodies of the fixtures have a length that is no greater than 5 mm, measured from the planar bottom surface  8  of the flanges  6 A and  6 B to the end of the distal region  1 B. In another embodiment, the length of the main bodies is from about 3.0 mm to about 5.0 mm. 
     In the embodiment depicted in  FIG.  2 A , main body  4 A of bone fixture  246 A has a cylindrical proximate end  1 A, a straight, generally cylindrical body, and a screw thread  5 . The distal region  1 B of bone fixture  246 A may be fitted with self-tapping cutting edges formed into the exterior surface of the fixture. Further details of the self-tapping features that may be used in some embodiments of bone fixtures used in embodiments of the present invention are described in International Patent Application WO 02/09622. 
     Additionally, as shown in  FIG.  2 A , the main body of the bone fixture  246 A has a tapered apical proximate end  1 A, a straight, generally cylindrical body, and a screw thread  5 . The distal region  1 B of bone fixtures  246 A and  246 B may also be fitted with self-tapping cutting edges (e.g., three edges) formed into the exterior surface of the fixture. 
     A clearance or relief surface may be provided adjacent to the self-tapping cutting edges in accordance with the teachings of U.S. Patent Application Publication No. 2009/0082817. Such a design may reduce the squeezing effect between the fixture  246 A and the bone during installation of the screw by creating more volume for the cut-off bone chips. 
     As illustrated in  FIGS.  2 A- 2 B , flanges  6 A and  6 B have a planar bottom surface for resting against the outer bone surface, when the bone fixtures have been screwed down into the skull. In an exemplary embodiment, the flanges  6 A and  6 B have a diameter which exceeds the peak diameter of the screw threads  5  (the screw threads  5  of the bone fixtures  246 A and  246 B may have an outer diameter of about 3.5-5.0 mm). In one embodiment, the diameter of the flanges  6 A and  6 B exceeds the peak diameter of the screw threads  5  by approximately 10-20%. Although flanges  6 A and  6 B are illustrated in  FIGS.  2 A- 2 B  as being circumferential, the flanges may be configured in a variety of shapes. Also, the size of flanges  6 A and  6 B may vary depending on the particular application for which the bone conduction implant is intended. 
     In  FIG.  2 B , the outer peripheral surface of flange  6 B has a cylindrical part  120 B and a flared top portion  130 B. The upper end of flange  6 B is designed with an open cavity having a tapered inner side wall  17 . The tapered inner side wall  17  is adjacent to the grip section (not shown). 
     It is noted that the interiors of the fixtures  246 A and  246 B further respectively include an inner bottom bore  151 A and  151 B having internal screw threads for securing a coupling shaft of an abutment screw to secure respective abutments to the respective bone fixtures as will be described in greater detail below. 
     In  FIG.  2 A , the upper end  1 A of fixture  246 A is designed with a cylindrical boss  140  having a coaxial outer side wall  170  extending at a right angle from a planar surface  180 A at the top of flange  6 A. 
     In the embodiments illustrated in  FIGS.  2 A and  2 B , the flanges  6 A and  6 B have a smooth, open upper end and do not have a protruding hex. The smooth upper end of the flanges and the absence of any sharp corners provides for improved soft tissue adaptation. Flanges  6 A and  6 B also comprises a cylindrical part  120 A and  120 B, respectively, that together with the flared upper parts  130 A and  130 B, respectively, provides sufficient height in the longitudinal direction for internal connection with the respective abutments that may be attached to the bone fixtures. 
       FIG.  3    depicts an exemplary embodiment of a transcutaneous bone conduction device  300  according to an embodiment of the present invention that includes an external device  340  and an implantable component  350 . The transcutaneous bone conduction device  300  of  FIG.  3    is a passive transcutaneous bone conduction device in that a vibrating actuator  342  is located in the external device  340 . Vibrating actuator  342  is located in housing  344  of the external component, and is coupled to plate  346 . Plate  346  may be in the form of a permanent magnet and/or in another form that generates and/or is reactive to a magnetic field, or otherwise permits the establishment of magnetic attraction between the external device  340  and the implantable component  350  sufficient to hold the external device  340  against the skin of the recipient. 
     In an exemplary embodiment, the vibrating actuator  342  is a device that converts electrical signals into vibration. In operation, sound input element  126  converts sound into electrical signals. Specifically, the transcutaneous bone conduction device  300  provides these electrical signals to vibrating actuator  342 , or to a sound processor (not shown) that processes the electrical signals, and then provides those processed signals to vibrating actuator  342 . The vibrating actuator  342  converts the electrical signals (processed or unprocessed) into vibrations. Because vibrating actuator  342  is mechanically coupled to plate  346 , the vibrations are transferred from the vibrating actuator  342  to plate  346 . Implanted plate assembly  352  is part of the implantable component  350 , and is made of a ferromagnetic material that may be in the form of a permanent magnet, that generates and/or is reactive to a magnetic field, or otherwise permits the establishment of a magnetic attraction between the external device  340  and the implantable component  350  sufficient to hold the external device  340  against the skin of the recipient. Accordingly, vibrations produced by the vibrating actuator  342  of the external device  340  are transferred from plate  346  across the skin to plate  355  of plate assembly  352 . This may be accomplished as a result of mechanical conduction of the vibrations through the skin, resulting from the external device  340  being in direct contact with the skin and/or from the magnetic field between the two plates. These vibrations are transferred without penetrating the skin with a solid object such as an abutment as detailed herein with respect to a percutaneous bone conduction device. 
     As may be seen, the implanted plate assembly  352  is substantially rigidly attached to bone fixture  246 B in this embodiment. As indicated above, bone fixture  246 A or other bone fixture may be used instead of bone fixture  246 B in this and other embodiments. In this regard, implantable plate assembly  352  includes through hole  354  that is contoured to the outer contours of the bone fixture  246 B. This through hole  354  thus forms a bone fixture interface section that is contoured to the exposed section of the bone fixture  246 B. In an exemplary embodiment, the sections are sized and dimensioned such that at least a slip fit or an interference fit exists with respect to the sections. Plate screw  356  is used to secure plate assembly  352  to bone fixture  246 B. As can be seen in  FIG.  3   , the head of the plate screw  356  is larger than the hole through the implantable plate assembly  352 , and thus the plate screw  356  positively retains the implantable plate assembly  352  to the bone fixture  246 B. The portions of plate screw  356  that interface with the bone fixture  246 B substantially correspond to an abutment screw detailed in greater detail below, thus permitting plate screw  356  to readily fit into an existing bone fixture used in a percutaneous bone conduction device. In an exemplary embodiment, plate screw  356  is configured so that the same tools and procedures that are used to install and/or remove an abutment screw (described below) from bone fixture  246 B can be used to install and/or remove plate screw  356  from the bone fixture  246 B. 
       FIG.  4    depicts an exemplary embodiment of a transcutaneous bone conduction device  400  according to another embodiment of the present invention that includes an external device  440  and an implantable component  450 . The transcutaneous bone conduction device  400  of  FIG.  4    is an active transcutaneous bone conduction device in that the vibrating actuator  452  is located in the implantable component  450 . Specifically, a vibratory element in the form of vibrating actuator  452  is located in housing  454  of the implantable component  450 . In an exemplary embodiment, much like the vibrating actuator  342  described above with respect to transcutaneous bone conduction device  300 , the vibrating actuator  452  is a device that converts electrical signals into vibration. 
     External component  440  includes a sound input element  126  that converts sound into electrical signals. Specifically, the transcutaneous bone conduction device  400  provides these electrical signals to vibrating actuator  452 , or to a sound processor (not shown) that processes the electrical signals, and then provides those processed signals to the implantable component  450  through the skin of the recipient via a magnetic inductance link. In this regard, a transmitter coil  442  of the external component  440  transmits these signals to implanted receiver coil  456  located in housing  458  of the implantable component  450 . Components (not shown) in the housing  458 , such as, for example, a signal generator or an implanted sound processor, then generate electrical signals to be delivered to vibrating actuator  452  via electrical lead assembly  460 . The vibrating actuator  452  converts the electrical signals into vibrations. 
     The vibrating actuator  452  is mechanically coupled to the housing  454 . Housing  454  and vibrating actuator  452  collectively form a vibrating element. The housing  454  is substantially rigidly attached to bone fixture  246 B. In this regard, housing  454  includes through hole  462  that is contoured to the outer contours of the bone fixture  246 B. Housing screw  464  is used to secure housing  454  to bone fixture  246 B. The portions of housing screw  464  that interface with the bone fixture  246 B substantially correspond to the abutment screw detailed below, thus permitting housing screw  464  to readily fit into an existing bone fixture used in a percutaneous bone conduction device (or an existing passive bone conduction device such as that detailed above). In an exemplary embodiment, housing screw  464  is configured so that the same tools and procedures that are used to install and/or remove an abutment screw from bone fixture  246 B can be used to install and/or remove housing screw  464  from the bone fixture  246 B. 
     More detailed features of the embodiments of  FIG.  3    and  FIG.  4    will now be described. 
     Referring back to  FIGS.  3  and  4   , the through hole  354  depicted in  FIG.  3    for plate screw  354  and through hole  462  depicted in  FIG.  4    for housing screw  464  may include a section that provides space for the head of the screw (e.g.,  354 A as illustrated in  FIG.  5 A ). This permits the top of the respective screws to sit flush with, below or only slightly proud of the top surface of the plate  355  or housing  454 , respectively. However, in other embodiments, the entire head of the plate screw  356  or housing screw  456  sits proud of the top surface of the respective plate assembly  352  and housing  454 . 
     As noted above, implanted plate assembly  352  is substantially rigidly attached to bone fixture  246 B to form the implantable component  350 . The attachment formed between the implantable plate assembly  352  and the bone fixture  246 B is one that inhibits the transfer of vibrations of the implantable plate assembly  352  to the bone fixture  246 B as little as possible. Moreover, an embodiment of the present invention is directed towards vibrationally isolating the implantable plate assembly  352  from the skull  136  as much as possible. That is, an embodiment of the present invention is directed to an implantable component  340  that, except for a path for the vibrational energy through the bone fixture, the vibratory element is vibrationally isolated from the skull. In this regard, an embodiment of the implantable plate assembly  352  includes a silicon layer  353 A or other biocompatible vibrationally isolating substance interposed between an implantable plate  355 , corresponding to a vibratory element, and the skull  136 , as may be seen in  FIG.  5 A . Thus, in the embodiment of  FIG.  5 A , the plate assembly  352  includes implantable plate  355  and silicon layer  352 A. The silicon layer  353 A corresponds to a vibration isolator and attenuates some of the vibrational energy that is not transmitted to the skull  136  through the bone fixture  246 B. In some embodiments, a silicon layer  353 A is in the form of a coating that covers only the bottom surface (i.e., the surface facing the skull  136 ) of the implantable plate  355  as shown in  FIG.  5 A , while in other embodiments, silicon covers the sides and/or the top of the implantable plate  355 . The silicon layer is attached to the outer surface of the implantable plate  355 . In some embodiments, silicon only covers portions of the bottom, sides and/or top, as is depicted by way of example in  FIG.  5 B , where a plurality of separate silicon pillars  353 B are located on the bottom surface of the implantable plate  355 . In some embodiments, the vibration isolator comprises a substantially planar ring disposed substantially around the outer surface of the bone fixture. This ring may be a single piece or may be formed by multiple sections linked together. Accordingly, an embodiment of the vibration isolator includes a plurality of projections extending from the surface of the isolator abutting the skull. Any arrangement of a vibrationally isolating substance that will permit embodiments of the present invention to be practiced may be used in some embodiments. It is noted that in most embodiments, little or no silicon is located between the implantable plate  355  and the bone fixture  246 B. That is, there is direct contact between the implantable plate  355  and the bone fixture  246 B. In some embodiments, this contact is in the form of a slip fit or is in the form of a slight interference fit. 
     Moreover, in some embodiments, some or all of the implantable plate is held above the skull  136  so that there is little to no direct contact between the skull  136  and the implantable plate assembly  352 .  FIG.  5 C  depicts an exemplary implantable plate assembly  352 A that includes an implantable plate  355 A. In some such embodiments, tissue other than bone that is a poor conductor of vibration is encouraged to grow in the resulting space between the skull  136  and the implantable plate  355 A. Also, a layer of silicon may be interposed between the implantable plate  355 A and the skull  136 , to further isolate the vibrations in a manner consistent with that detailed above. In this regard,  FIG.  5 D  depicts an exemplary implantable plate assembly  352 B that includes implantable plate  355 A and silicon layer  353 C. Silicon layer  353 C may inhibit the build-up of material and/or inhibit the growth of tissue between the implantable plate  355 A and the skull  136  that might otherwise create an alternate path for vibrational energy to be transmitted from the implantable plate  355 A to the skull  136 . As would be understood, such build-up of material/growth of tissue that provides an alternate path for vibrational energy from the implantable plate  355 A might negatively affect the long-term performance of the bone conduction device. For example, continued build-up of material/growth of tissue might create, at a certain point in time after implantation, a bridge between the skull  136  and the implantable plate  355 A. This might result in a relatively sudden change in the performance characteristics of the bone conduction device. Using silicon layer  353 C (or other applicable vibration isolator) thus may provide an immediate improvement of the bone conduction device while also preserving that performance in the long-term. In some embodiments, the vibration isolator may include a substance that inhibits bone growth. The use of the vibration isolator to inhibit the build-up of material and/or to inhibit the growth of tissue between the vibratory element and the skull may be applicable to any of the embodiments disclosed herein and variations thereof. 
     In some exemplary embodiments, the vibration isolator is positioned in such a manner to reduce the risk of infection resulting from the presence of a gap between the skull  136  and the implantable plate  355 . The vibration isolator may also be used to eliminate cracks and crevices that may exist in the plate  355  and/or the skull  136  that sometimes trap material therein, resulting in infections. It is to be understood that while the following description is directed to the embodiment of  FIG.  3   , the description is also applicable to the other embodiments disclosed herein and variations thereof. In an exemplary embodiment, the vibration isolator is configured to substantially completely fill the gap between the implantable plate  355  and the skull  136  and/or crevices therein. In some embodiments, the vibration isolator is configured to closely conform to the bone fixture  246 B, such as is depicted in  FIGS.  3  and  4   , to reduce the risk of infection. Along these lines, the vibration isolator may have elastic properties permitting it to stretch around bone fixture  246 B, thereby snugly conforming to the bone fixture  246 B. The vibration isolator may include a material that is known to reduce the risk of infection and/or may be impregnated with an antibiotic. In an exemplary embodiment of the invention, the vibration isolator is a drug eluding device that eludes an antibiotic for a period of time after implantation. 
     In some embodiments of the present invention, the vibration isolator is configured such that once it is positioned between the skull  136  and the implantable plate assembly  352 , the outer periphery of the vibration isolator extends away from the skull in a direction normal to the skull, as may be seen in  FIG.  3   . In some embodiments, the outer periphery extends from the skull in a substantially uniform manner, also as may be seen in  FIG.  3   . In other embodiments, the outer periphery of the vibration isolator extends away from the skull at an angle other than an angle normal to the surface of the skull, thereby establishing a less-abrupt transition/smoother transition that that depicted in  FIG.  3   . In some embodiments, the outer periphery of the vibration isolator extends away from the skull in a curved manner (e.g., semi-circular, parabolic, etc.). Any configuration that will permit the vibration isolator to smoothly extend from the skull may be used in some embodiments of the present invention. 
     Accordingly, the implantable component  350  is configured, in at least some embodiments, to deliver as much of the vibrational energy of implantable plate assembly  352  as possible into the skull  136  via transmission from the implantable plate assembly  352  through bone fixture  246 B. Also, the implantable component  350  is configured, in at least some embodiments, to deliver as little of the vibrational energy of implantable plate assembly  352  directly into the skull  136  from the implantable plate assembly  352  as possible. An embodiment of such an implantable component  350  alleviates, at least in part, the wave propagation effect that is present as an acoustic wave propagates through a human skull, as will now be detailed. 
     Implantable component  350  limits the conductive channel through which vibrations enter the skull to a small area. With respect to implantable plate assembly  352 , this is the area taken up by bone fixture  246 B as measured on a plane tangential to the skull  136  centered at about the longitudinal axis of the bone fixture  246 B. This area has a diameter that is smaller than the wavelength of the vibrations. By way of example, for vibrations having a wavelength of about 10-20 cm, the diameter of the area of the conductive channel (area taken up by bone fixture  246 B) is about 3-20% of the wavelength. By comparison, if the vibrations were conducted into the skull directly from the implantable plate assembly  352 , the diameter of the area of the conductive channel (area taken up by implantable plate assembly  352  as measured on a plane tangential to the skull  136  centered at about the longitudinal axis of the implantable plate assembly  352 ), would be a higher percentage than that of the implantable component  350  of  FIG.  3   , thus reducing efficiency. This is also the case with implantable plate assembly  352 B, which utilizes the silicon layer  353 C. 
     With regard to implantable plate assembly  352 A, the conductive channel through which vibrations enter the skull is also limited to a small area. However, this area is the area taken up by bone fixture  246 B and the portion of plate  355 A that contacts skull  136 , again as measured on a plane tangential to the skull  136  centered at about the longitudinal axis of the bone fixture  246 B. In some embodiments, this area has a diameter that is smaller than the wavelength of the vibrations. Again by way of example, for vibrations having a wavelength of about 10-20 cm, the diameter of the area of the conductive channel (area taken up by bone fixture  246 B plus the portion of plate  355 A) is about 3-20% of the wavelength, notwithstanding the fact that the implantable plate assembly  352 A may have an outer periphery that encompasses an area that is larger than this. That is, the implantable plate assembly  352 A has a maximum outer periphery that has a corresponding maximum outer peripheral diameter, and with respect to the embodiment of  FIG.  5 C , where plate  355 A is a circular disk, the outer periphery is the outer diameter of the disk. The implantable plate assembly  352 A also includes a maximum bone contact surface area having a maximum contact surface diameter. This is the surface area of the plate  355 A that directly contacts the skull  136 . That is, the plate  355 A only contacts the skull  136  at the maximum bone contact surface area. With respect to the embodiment of  FIG.  5 C , the maximum contact surface diameter is equal to or less than about half of the maximum outer peripheral diameter of the implantable plate assembly  352 A. In some embodiments, the maximum outer peripheral diameter of the implantable plate assembly  352 A is equal to or less than about a quarter of the maximum outer peripheral diameter of the implantable plate assembly  352 A. 
     Accordingly, an embodiment of the present invention includes an implantable component  350  as described above configured to deliver more, substantially more and/or substantially all of the vibrational energy from an implanted vibratory element to the skull through the bone fixture  246 B than directly from the implanted vibratory element to the skull. 
     As detailed above, the implantable plate assembly  352  may also be used to magnetically hold the external component  340  to the recipient, either as a result of the implantable plate assembly  352  comprising a permanent magnet or as a result of the implantable plate assembly  352  comprising a ferromagnetic material that reacts to a magnetic field (such as, for example, that generated by a permanent magnet located in the external component  340 ). Accordingly, some embodiments of the implantable plate assembly  352  should include a sufficient amount of the ferromagnetic material (and/or a sufficient area facing the external component  340 ) to magnetically hold the external component  340  to the recipient. In an exemplary embodiment, referring to  FIG.  5 A , the implantable plate assembly  352  is substantially circular, having an outer diameter of about 40 mm and having a thickness of about 4-5 mm, of which about 0.5 to 1.0 mm is silicon on the bottom and/or on the top. Also, in some embodiments, the implantable plate assembly  352  may be strengthened with ribs, either formed as an integral part of implantable plate  355  or in the form of a composite plate assembly. In other embodiments, the implantable plate assembly  352  is oval or substantially rectangular in shape (square or a rectangle having a length greater than a width). It is noted that in other embodiments of the present invention, the external device  340  or external device  440  is held in place via a means other than a magnetic field. By way of example, the external devices may be held in place via a harness such as a band that extends about the head of the recipient. In some such embodiments, the implanted plates may or may not be made of a magnetic material. In some embodiments of the passive bone conduction devices, the implanted plates may be any plate that vibrates as a result of the mechanical conduction of the vibrations from the external device to the implanted plate. 
     With respect to the embodiment of  FIG.  4   , as noted above, housing  454  is substantially rigidly attached to bone fixture  246 B. The attachment formed between the housing  454  and the bone fixture  246 B is one that inhibits the transfer of vibrations from the vibrating actuator  452  through the housing  454  to the bone fixture  246 B as little as possible. Moreover, an embodiment of the present invention is directed towards vibrationally isolating the housing  454  from the skull  136  as much as possible, as is the case with the implantable plate assembly  352  detailed above. In this regard, an embodiment of the housing  454  includes a silicon layer  454 A or other biocompatible vibrationally isolating substance interposed between the housing  454  and the skull  136 . In some embodiments, a silicon layer  454 A covers only the bottom surface (i.e., the surface facing the skull  136 ) of the housing  454  as shown in  FIG.  4   , while in other embodiments, silicon covers the sides and/or the top of the housing  454 . In some embodiments, silicon only covers portions of the bottom, sides and/or top, in a manner analogous to that described above with respect to the implantable plate assembly  352 . Any arrangement of a vibrationally isolating substance that will permit embodiments of the present invention to be practiced may be used in some embodiments. 
     It is noted that in most embodiments, little or no silicon is located between the housing  454  and the bone fixture  246 B. That is, there is direct contact between the housing  454  and the bone fixture  246 B. In some embodiments, this contact is in the form of a slip fit or is in the form of a slight interference fit. Further, it is noted that in some embodiments, the vibrating actuator  452  is mechanically coupled to the housing in such a manner as to increase the vibrational energy transferred from the vibrating actuator  452  to the bone fixture  246 B as much as possible. In an exemplary embodiment, the vibrating actuator  452  is coupled to the walls of the hole  462  in a manner that enhances vibrational transfer through the walls and/or is vibrationally isolated from other portions of the housing  452  in a manner that inhibits vibrational transfer through those other portions of the housing  452 . 
     Moreover, in some embodiments, some or all of the housing  452  is held above the skull  136  so that there is less or no direct contact between the skull  136  and the housing  452 . In this regard, embodiments of the housing  452  may take an outer form corresponding to that detailed above with respect to implantable plate assembly  352 A. 
     Accordingly, as with the implantable plate assembly  352  described above, the housing  452  is configured, in at least some embodiments, to channel as much of the vibrational energy of the vibrating actuator  452  as possible into the skull  136  via transmission from the housing  454  through bone fixture  246 B. Also, as with the implantable component  350  described above, the housing  454  is configured, in at least some embodiments, to channel as little of the vibrational energy of the vibrating actuator  452  directly into the skull  136  from the housing  454  as possible. An embodiment of such housing  454  alleviates, at least in part, the wave propagation effect that is present as an acoustic wave propagates through a human skull detailed above. 
     It is noted that in some embodiments, housing  454  is not present and/or is not directly connected to bone fixture  246 B as depicted in  FIG.  4   . Instead, a vibrating actuator is directly attached to the bone fixture  246 B, and any components that need be shielded from body fluids are contained in a separate housing and/or the vibrating actuator does not include components that need shielding. In an exemplary embodiment, such a vibrating actuator may be a piezoelectric actuator. 
     In view of the various bone conduction devices detailed above, embodiments of the present invention include methods of enhancing hearing by delivering vibrational energy to a skull via an implantable component such as implantable components  300  and  400  detailed above. In an exemplary embodiment, as a first step the method comprises capturing sound with, for example, sound capture device  126  detailed above. In a second step, the captured sound signals are converted to electrical signals. In a third step, the electrical signals are outputted to a vibrating actuator configured to vibrate a vibratory element. Such a vibrating actuator may be, for example, vibrating actuator  342  of  FIG.  3    configured to vibrate implantable plate assembly  352 , or vibrating actuator  452 , which is implanted in a recipient and where the vibratory element is part of the vibrating actuator  452 . In a subsequent step, a majority of the vibrational energy from the vibrating device is conducted to the skull via an artificial pathway comprising implanted structural components extending from the vibrational device to and into the skull, thereby enhancing hearing. 
     In an exemplary embodiment, the artificial pathway includes any of the bone fixtures detailed herein. As may be seen in  FIG.  3    and as detailed above, where the vibrating device is the implanted plate assembly  352 , the artificial pathway of this method includes a section having a maximum outer diameter when measured on a first plane tangential to and on the surface of the skull at the location where the artificial pathway extends to and into the skull, of about 1% to about 20% of the wavelength of the vibrations producing the vibrational energy. In an exemplary embodiment, this diameter may correspond to the outer diameter of the bone fixture where the bone fixture enters the skull. Moreover, in an embodiment of this method, the implanted plate assembly  352  has a maximum outer diameter when measured on a second plane substantially parallel to the first plane, where the maximum outer diameter of the artificial pathway is about 5% to about 35% of the maximum outer diameter of the implanted plate assembly  352 . The act of conducting a majority of the vibrational energy from the vibrating device to the skull via the artificial pathway, as opposed to, for example, directly conducting the vibrational energy from the implanted plate assembly  352  to the skull, is achieved by vibrationally isolating the implanted plate assembly  352  from the skull and rigidly coupling the implanted plate assembly  352  to the bone fixture  246 B as detailed above. 
     It is noted that in some embodiments of this method, substantially more of the vibrational energy from the implanted plate assembly is conducted to the skull through the artificial pathway than is conducted to the skull outside of the artificial pathway. In yet other embodiments, substantially all of the vibrational energy from the implanted plate assembly is conducted to the skull through the artificial pathway. 
     In some embodiments, the silicon layers detailed herein inhibit osseointegration of the implantable plate  355  and the housing  454  to the skull. This permits the implantable plate  355  and/or housing  454  to be more easily removed from the recipient. Such removal may be done in the event that the implantable plate  355  and/or the housing  454  are damaged and a replacement is necessary, or simply an upgrade to those components is desired. Also, such removal may be done in the event that the recipient is in need of magnetic resonance imaging (MRI) of his or her head. Still further, if it is found that the transcutaneous bone conduction devices are insufficient for the recipient, the respective implantable plate  355  and/or the housing may be removed and an abutment may be attached to the bone fixture  246 B in its place, thereby permitting conversion to a percutaneous bone conduction system. In summary, the interposition of the silicon layer between the implanted component and the skull reduces osseointegration, thus rendering removal of those components easier. 
     Also, the reduction in osseointegration resulting from the silicon layer may also add to the cumulative vibrational isolation of the implantable plate  355  and/or housing  454  because the components are not as firmly attached to the skull as they would otherwise be in the absence of the osseointegraiton inhibiting properties of the silicon layer. That is, osseointegration of the implantable plate  355  and/or housing  454  to the skull  136  may result in a coupling between the respective components and the skull  136  through which increased amounts of vibrational energy may travel directly to the skull  136  therethrough. This increased amount is relative to the amount that would travel from the respective components to the skull  136  in the absence of osseointegration. Further along these lines, some embodiments of the present invention include controlling the surface roughness of the implantable plate  355  and/or the housing  454  of the surfaces that might contact the skull  136 . This is pertinent, for example, to embodiments that do not utilize a vibration isolator. In such embodiments, there may be direct contact between the vibratory element and the skull, such as, for example, embodiments consistent with that of  FIG.  5 C , and other embodiments where the vibratory element is raised above the skull, but the absence of the vibration isolator may permit bone tissue to grow between the vibratory element and the skull, thereby providing an alternate path for the vibration energy as detailed above. Such embodiments include implantable plate assemblies that are absent the vibration isolator (e.g., the implantable plate assembly  352  without silicon layer  353 A) and housings that are absent the vibration isolator (e.g., the housing  452  without silicon layer  454 A). 
     By way of example, the surface roughness of the bottom surface of implantable plate  355  and/or housing  452  may be polished, after the initial fabrication of the respective components, to have a surface roughness that is less conducive to osseointegration than is the case for other surface roughness values. For example, a surface roughness Ra value of less than 0.8 micrometers, such as about 0.4 micrometers or less, about 0.3 micrometers or less, about 2.5 micrometers or less and/or about 2 micrometers or less may be used for some portions of a surface or an entire surface of the implantable plate  355  that may come into contact with skull  136 . This should reduce the amount of osseointegration and thus the amount of vibrational energy that is directed transferred from the implantable plate  355  to the skull  136  at the areas where the plate  355  contacts the skull  136 . 
     Also, a reduction in osseointegration/the absence of osseointegration between the implantable plate  355  and/or the housing  454  may improve the likelihood that soft tissue and/or tissue that is less conducive to the transfer of vibrational energy than bone may grow between the respective components and the skull  136 . This non-bone tissue may act as a vibration isolator having some or all of the performance characteristics of the other vibration isolators detailed herein. Additionally, the reduction in osseointegration/the absence of osseointegration between the implantable plate  355  and/or the housing  454  may likewise permit these components to be more easily removed from the recipient, such as in the case of an MRI scan of the recipient as detailed above. 
     In an exemplary embodiment, at least some of the surface roughness detailed above may be achieved through the use of electropolishing and/or by paste polishing. These polishing techniques may be used, for example, to reduce the surface roughness Ra of a titanium component to at least about 0.3 micrometers and 0.2 micrometers, respectively. Other methods of polishing a surface to achieve the desired surface roughnesses may be utilized in some embodiments of the present invention. 
     Some embodiments may include an implantable plate assembly  352  that includes both a ferromagnetic plate and a titanium component. In such an embodiment, the titanium component may be located between the ferromagnetic plate and the skull when the implantable plate assembly is fixed to the skull. For example, element  353 A of  FIG.  3   , element  454 A of  FIG.  4    and/or element  353 C of  FIG.  5 D  may be made from titanium instead of silicon. The titanium component of these alternate embodiments may be polished to have one or more of the above surface roughnesses to inhibit osseointegration as detailed above. 
     As mentioned above, embodiments of the present invention may be implemented by converting a percutaneous bone conduction device to a transcutaneous bone conduction device. The following presents an exemplary embodiment of the present invention directed towards a method of converting a bone fixture system configured for use with a percutaneous bone conduction device to a bone fixture system configured for use with a transcutaneous bone conduction device. 
     In an exemplary embodiment, a surgeon or other trained professional including and not including certified medical doctors (hereinafter collectively generally referred to as a physicians) is presented with a recipient that has been fitted with a percutaneous bone conduction device, where the bone fixture system utilizes bone fixture  246 B to which an abutment is connected via an abutment screw as is know in the art. More specifically, referring to  FIG.  6   , at step  610 , the physician obtains access to a bone fixture of a percutaneous bone conduction device implanted in a skull, wherein an abutment is connected to the bone fixture  246 B and extends through the skin of the recipient. At step  620 , the physician removes the abutment from the bone fixture  246 B. In the scenario where the abutment is attached to the bone fixture  246 B via an abutment screw that extends through the abutment and is screwed into the bone fixture, this step further includes unscrewing the abutment screw from the bone fixture to remove the abutment from the bone fixture. At step  630 , a vibratory element, such as the implanted plate assembly  352  in the case of a passive transcutaneous bone conduction device, is positioned beneath the skin of the recipient. In an exemplary embodiment, the vibratory element is slip fitted or interference fitted onto the bone fixture  246 B, and screw  354  is screwed into the bone fixture to secure the vibratory element to the bone fixture, thereby at least one of maintaining or establishing the rigid attachment of the vibratory element to the bone fixture. It is noted that in some embodiments, the vibratory element includes a silicon layer already attached thereto. Thus, the method may effectively end at step  630 . In other embodiments, the silicon layer is added later. Accordingly, an embodiment includes an optional later step, step  640 , which entails positioning a vibration isolator between the vibratory element and the skull adjacent the bone fixture. In other embodiments, step  640  is performed before step  630  (the vibration isolator is first positioned on the skull and then the vibratory element is positioned on the vibration isolator). 
     Another exemplary embodiment of the present invention includes a method of converting a percutaneous bone conduction device such as the removable component of a percutaneous bone conduction device  720  used in a percutaneous bone conduction device to an external device  140  for use in a passive transcutaneous bone conduction device. The removable component of percutaneous bone conduction device  720  of  FIG.  7    includes a coupling apparatus  740  configured to attach the bone conduction device  720  to an abutment connected to a bone fixture implanted in the recipient. The abutment extends from the bone fixture through muscle  134 , fat  128  and skin  132  so that coupling apparatus  740  may be attached thereto. Such a percutaneous abutment provides an attachment location for coupling apparatus  740  that facilitates efficient transmission of mechanical force from the bone conduction device  700 . A screw holds the abutment to the bone fixture. As illustrated, the coupling apparatus  740  includes a coupling  741  in the form of a snap coupling configured to “snap couple” to a bone fixture system on the recipient. 
     In an embodiment, the coupling  741  corresponds to the coupling described in U.S. patent application Ser. No. 12/177,091 assigned to Cochlear Limited. In an alternate embodiment, a snap coupling such as that described in U.S. patent application Ser. No. 12/167,796 assigned to Cochlear Limited is used instead of coupling  741 . In yet a further alternate embodiment, a magnetic coupling such as that described in U.S. patent application Ser. No. 12/167,851 assigned Cochlear Limited is used instead of or in addition to coupling  241  or the snap coupling of U.S. patent application Ser. No. 12/167,796. 
     The coupling apparatus  740  is mechanically coupled, via mechanical coupling shaft  743 , to a vibrating actuator (not shown) within the removable component of the percutaneous bone conduction device  720 . In an exemplary embodiment, the vibrating actuator is a device that converts electrical signals into vibration. In operation, sound input element  126  converts sound into electrical signals. Specifically, the bone conduction device provides these electrical signals to the vibrating actuator, or to a sound processor that processes the electrical signals, and then provides those processed signals to vibrating actuator. The vibrating actuator converts the electrical signals (processed or unprocessed) into vibrations. Because vibrating actuator is mechanically coupled to coupling apparatus  740 , the vibrations are transferred from the vibrating actuator to the coupling apparatus  740  and then to the recipient via the bone fixture system (not shown). 
     Once the abutment is removed from the bone fixture  246 A or  246 B (pursuant to, for example, the method detailed above with respect to  FIG.  6   ), there is no abutment to which the coupling  741  of the removable component of the percutaneous bone conduction device  720  can couple. However, an embodiment of the present invention includes a pressure plate assembly  810  as seen in  FIG.  8    that, when coupled to the removable component of the percutaneous bone conduction device  720 , results in an external device that corresponds to an external device of a passive transcutaneous bone conduction device  940 , as may be seen in  FIG.  9   . 
     Specifically, pressure plate  820  of pressure plate assembly  810  functionally corresponds to plate  346  detailed above with respect to  FIG.  3   , and percutaneous bone conduction device  720  functionally corresponds to vibrating actuator  342  detailed above with respect to  FIG.  3   . An abutment  830  is attached to pressure plate  820  via abutment screw  848 , as may be seen in  FIG.  8   . In an exemplary embodiment, abutment  830  is an abutment configured to connect to bone fixture  246 A and/or  246 B as detailed above. In alternate embodiments, abutment  830  is attached to pressure plate  820  by other means such as, for example, welding, etc., or is integral with the pressure plate  820 . Any system that will permit vibrations from the percutaneous bone conduction device  720  to be transmitted to the pressure plate  820  may be used with some embodiments of the present invention. As may be seen in  FIG.  9   , the abutment  830  permits the percutaneous bone conduction device  720  to be rigidly attached to the pressure plate assembly  810  in a manner the same as or substantially the same as the percutaneous bone conduction device  720  is attached to a bone fixture system. Thus, the existing percutaneous bone conduction device  720  can be reused in an external device of a transcutaneous bone conduction device. 
       FIG.  10    depicts a functional diagram of the external component of a bone conduction device  940  of  FIG.  9   . Specifically,  FIG.  10    depicts an external component of a passive transcutaneous bone conduction device  1040  that comprises a vibrator  1050 , such as the removable component of the percutaneous bone conduction device  720 , and a platform  1060  configured to transfer vibrations from the vibrator to the skin of the recipient (thus corresponding to, in at least some embodiments, a pressure plate of a passive transcutaneous bone conduction device), such as, for example, pressure plate  820 , wherein the vibrator  1050  and platform  1060  are configured to quick connect and/or quick release from one another, as represented by the double headed arrow. 
     In an exemplary embodiment, a quick connect/release coupling is utilized to enable the quick connect and quick release feature just detailed. The snap-coupling described above is one example of such a quick connect/release coupling. It is noted that the art often refers to a coupling that meets the quick release and quick connect features as a quick release coupling (or fitting) or a quick connect coupling (or fitting). That is, the art utilizes a naming convention that refers to only the connection or only the release feature for a device that satisfies both features. Such couplings (or fittings) are encompassed by the phrase “quick connect/release coupling” and quick release/connect coupling.” In this regard, any device, system or method, regardless of naming convention, that will enable the feature of the quick connect and/or quick release to be achieved may be used in some embodiments. 
     It is further noted that embodiments detailed below that are disclosed as coupling one component to another, unless otherwise noted, encompass embodiments that both couple and decouple to and from, respectively, one another and embodiments that quick connect and quick release to and from, respectively, one another. It is also noted that embodiments detailed below that are disclosed as coupling one component to another, unless otherwise noted, encompass embodiments where the coupling is established by a quick connect/release coupling/quick release/connect coupling. 
     In some embodiments, vibrator  1050  and platform  1060  are configured to couple to one another in a manner that permits them to be uncoupled using applications of substantially equal force and/or torque to the pertinent components (albeit in at least some instances applied in opposite directions) and/or without the components experiencing any effective acceleration relative to one another during either operation. It is noted that additional operations may be associated with coupling and uncoupling such components. It is noted that embodiments detailed below that are disclosed as coupling one component to another, unless otherwise noted, can encompass embodiments that utilize a male threaded bolt screwed into a female threaded receptacle to couple components together, where the torque required to decouple the components is substantially the same as the torque required to couple the components together. That is, such an embodiment would be such that substantially no “breaking torque” need be applied to one of the components to decouple the components from one another (which may be the case if thread-locking compound or the like is used and/or if the male portion is driven into the female portion, or visa-versa, the full distance possible and/or if a lock collar is used or the like). 
     Some exemplary embodiments of the passive transcutaneous bone conduction device  1040  will now be described, along with exemplary coupling mechanisms configured to couple the vibrator  1050  to platform  1060 . 
     In an exemplary embodiment, the system used to quick release and quick connect components together comprises a system that includes only two components that interface with one another to establish the coupling (e.g., such as that depicted in the embodiment of  FIG.  9   ). This as contrasted to a system which may utilize, for example, two or more screws and corresponding bores to couple components together. 
     Platform  1060  may functionally correspond to a pressure plate of a passive transcutaneous bone conduction device or otherwise be configured to transmit hearing percept evoking vibrations, generated by the vibrator  1050  of an external component of a bone conduction device and transmitted to the pressure plate, into skin of a recipient to input the vibrations into an implanted vibrating component attached to bone of a recipient (e.g., pursuant to the operation of the embodiment of  FIG.  3    detailed above, with or without the vibration isolation components detailed above). Additional details of platform  1060  are provided below. 
       FIG.  11 A  depicts an exemplary embodiment of a passive transcutaneous bone conduction device  1140  that corresponds to the functional passive transcutaneous bone conduction device  1040  of  FIG.  10   . As with the embodiment of  FIG.  9   , vibrator  1150 , which corresponds to a removable component of a percutaneous bone conduction device, platform  1160 , are configured to snap-couple to one another. The embodiment of  FIG.  11 A  depicts a passive transcutaneous bone conduction device  1140  that includes a snap coupling having a first sub-component (vibrator coupling apparatus  1152 ) that is part of vibrator  1150  and a second sub-component (platform coupling apparatus  1162 ) that is part of platform  1160 . The snap coupling is configured to snap-couple vibrator  1150  to platform  1160  via movement of the sub-components relative to one another in a direction of longitudinal axis  1101  of the snap coupling. 
       FIG.  11 A  depicts cross-sectional views of platform  1160  and a portion of vibrator coupling apparatus  1152  of vibrator  1150 . Coupling apparatus  1152  corresponds to coupling apparatus  740  detailed above with respect to  FIG.  7   . As may be seen in  FIG.  11 A , platform  1160  includes a housing  1161  in which a platform coupling  1162  is located. Housing  1161  functionally corresponds to pressure plate  820  detailed above with respect to  FIG.  8   . Further, platform coupling apparatus  1162  functionally corresponds to the coupling portion of abutment  830  detailed above with respect to  FIG.  8   . Also as may be seen in  FIG.  11 A , platform  1160  includes a magnet  1164  in the form of a ring magnet. In an exemplary embodiment, magnet  1164  is located entirely within housing  1161  and has a through-hole  1165  in which platform coupling  1162  is located. In an alternate embodiment, housing  1161  may not be present. Instead, magnet  1164  may directly interface with platform coupling apparatus  1162  or a connecting structure may connect the two components, and, optionally, a skin compatible coating may be applied about at least a portion of magnet  1164 . 
     The embodiment of  FIG.  11 A  differs in some respects to that of  FIG.  9    in that instead of a skin-penetrating abutment bolted or otherwise mechanically connected to a pressure plate  820  such that abutment  830  and the entire coupling apparatus  740  stand proud of pressure plate  820 , a portion of the vibrator coupling apparatus  1152  of vibrator  1150  extends into the housing  1161 . That is, platform  1160  includes a cavity within the base of the platform. This as compared to the platform of  FIG.  8    (i.e., pressure plate assembly  810 ), where the cavity of platform coupling apparatus  1162  into which vibrator coupling apparatus  1152  fits is located within structure (e.g., the abutment  830 ) that is proud of the base of the platform. 
     More specifically, with respect to  FIG.  11 B , which depicts a close-up view of the snap-coupling between vibrator  1150  and platform  1160 , it can be seen that platform coupling apparatus  1162  is essentially located within an extrapolated outer profile of housing  1161 . In the embodiment of  FIG.  11 A , housing  1161  is a base of the platform, whereas pressure plate  820  of  FIG.  8    corresponds to the base of that platform (i.e., pressure plate assembly  810 ). Thus, the overall distance between the skin-facing side of housing  1161  and various geometric locations on vibrator  1150  (e.g., center of gravity, point furthest from the skin-facing side of housing  1161 , sides, etc.) is minimized as compared to, for example, the distance to those same geometric locations with respect to the configuration of  FIG.  9   . This reduces the torque that may result between platform  1160  and vibrator  1150  in the event that a force is applied to the vibrator as compared to application of the same force on the arrangement of  FIG.  9   . Additional details to this minimization of the aforementioned distances is described below. 
       FIG.  11 C  depicts a close-up view of the portion of platform  1160  about platform coupling apparatus  1162 . In an exemplary embodiment, diameter  1166  of the constriction of the female portion of platform coupling apparatus  1162  is about five millimeters and is located a distance  1167  of about two-thirds of a millimeter below the upper surface of platform coupling apparatus  1162 . (The constriction of the female portion is a component of platform coupling apparatus  1162  with which male vibrator coupling apparatus  1152  interferes to form the snap-coupling.) It is noted that the embodiments of  FIGS.  11 A- 11 C , as well as those of other figures herein, should be considered drawn to scale or at least about to scale, although in other embodiments, the components depicted in the figures may have different proportions. 
     As will be understood from the configurations of  FIGS.  9 - 11 C , some exemplary embodiments are directed to an external component (e.g.,  1140 ), that includes a snap coupling having a male component (e.g.,  1152 ) that is part of the vibrator (e.g.,  1150 ) and a female component (e.g.,  1162 ) that is part of the platform (e.g.,  1160 ), the snap coupling being configured to snap-couple the vibrator to the platform. Conversely,  FIG.  12    depicts an alternate embodiment of an external component of a passive transcutaneous bone conduction device  1240  including a vibrator  1250  and a platform  1260  functionally corresponding to the vibrators and platforms detailed above. The embodiment of  FIG.  12    differs from that of  FIGS.  11 A- 11 C  in that instead of the male component of the snap coupling being part of the vibrator, the female component is part of the vibrator, and instead of the female component of the snap coupling being part of the platform, the male component is part of the platform. Specifically, as may be seen, vibrator coupling apparatus  1252  of vibrator  1250  substantially corresponds to platform coupling apparatus  1162  of the embodiment of  FIGS.  11 A- 11 C , and platform coupling apparatus  1262  of platform  1260  substantially corresponds to vibrator coupling apparatus  1152  of the embodiment of  FIGS.  11 A- 11 C , with the exception of possible variations to fit those components to the respective mating components of the vibrator and platform. In some embodiments, housing  1261  may correspond to housing  1161 . Indeed, the outer profile of platform coupling apparatus  1262  that interfaces with housing  1261  may correspond to that of platform coupling apparatus  1162 , thus permitting a standardized housing to be utilized for both embodiments. In the same vein, magnet  1264  may correspond to magnet  1164 . Of course, different housings and magnets may likewise be used. Any configuration of any part of the vibrator and/or the platform may be used in some embodiments detailed herein and/or in variations thereof in at least some embodiments of the present invention. 
     Further, as may be seen from  FIGS.  11 A- 12    platform coupling apparatus  1162 / 1262  is located within housing  1161 / 1261 . In an exemplary embodiment, platform coupling apparatus  1162 / 1262  is press-fitted into housing  1161 / 1261  and is thus located in the through-hole of magnet  1164 / 1264 . It is noted that in an exemplary embodiment of external components of percutaneous bone conduction devices that include a platform having a magnet with a through-hole, the ferro-magnetic component (e.g., magnet) of the implantable component with which the external component is utilized may likewise have a through-hole. Indeed, in some embodiments of the percutaneous bone conduction devices detailed herein and/or variations thereof, the magnet of the external component is substantially identical to the magnet of the internal component. Thus, an exemplary embodiment relating to a method of converting the transcutaneous bone conduction device to a percutaneous bone conduction device includes obtaining a platform having a magnet corresponding or at least substantially corresponding in size, shape and/or geometry to that of the implantable component of the bone conduction device that is already implanted in the recipient. Additional details on such a method are provided below. 
     In the same vein, in some embodiments of the external component of the passive transcutaneous bone conduction devices, the magnet in the platform may not have a thorough-hole, such as may be the case when being used with an implantable component that likewise utilizes a magnet that does not have a through-hole (i.e., surfaces of the magnet form an enclosed magnet body, as opposed to that depicted in  FIGS.  11 A- 11 C , where surfaces of the magnet for an open magnet body) Accordingly, while the embodiments of  FIGS.  11 A- 12    depicts magnets  1164  and  1264  as having a through-hole, other embodiments may have a magnet that does not have such a through-hole. Along these lines,  FIG.  13    depicts a platform  1360  having such a configuration (housing  1361  holds platform coupling apparatus  1362  above magnet  1364  such that the cavity  1363  of the platform coupling apparatus  1362  is entirely above the magnet  1364 ) that is part of an external component of a passive transcutaneous bone conduction device  1340 . As may be seen, bone conduction device  1340  utilizes the same vibrator  1150  as that of the embodiment of  FIGS.  11 A- 11 C . However, the platform  1360  utilizes a magnet  1364  where the surfaces thereof form a closed magnet body (e.g., there is no thorough-hole as with the magnet of  FIGS.  11 A- 11 C ). 
     The embodiment of  FIG.  13    depicts a snap coupling having a first sub-component (i.e., vibrator coupling apparatus  1152 ) that is part of the vibrator  1150  and second sub-component (i.e., the platform coupling apparatus  1362 ) that is part of the platform  1360 , where the second sub-component is located between the magnet and the first sub-component.  FIG.  14    depicts an alternate configuration of such an embodiment, where the magnet  1464  of housing  1461  of platform  1460  of the external component of the passive transcutaneous bone conduction device  1440  thereof has a recess in which the platform coupling apparatus  1462  (the second sub-component) is at least partially located. This as compared to the embodiment of  FIGS.  11 A- 11 C , in which the platform coupling apparatus  1162  sits in and is vertically aligned with the through-hole  1165 , where the inner diameter of the through hole  1165  is greater than that of the platform coupling apparatus  1162 , as well as the embodiment of  FIG.  12   . 
     Accordingly, the embodiment of  FIG.  13    includes a snap coupling having a first sub-component  1152  that is part of the vibrator  1150  and a second sub-component  1362  that is part of the platform  1360 , the snap coupling being configured to snap-couple the vibrator  1150  to the platform  1360  via movement of the sub-components relative to one another in a direction of a longitudinal axis  1301  of the snap coupling. Relative to position along the longitudinal axis  1301 , the second sub-component  1362  is located completely above the magnet  1364  along a vector on the longitudinal axis  1301  extending away from the platform  1360  to the vibrator  1350 . Note further that in the embodiment of  FIG.  13   , relative to position along the longitudinal axis, the cavity  1363  of the platform coupling apparatus  1362  into which a portion (the male portion) of the vibratory coupling apparatus  1152  is located completely above the magnet along a vector on the longitudinal axis extending away from the platform towards the vibrator. 
     In contrast to the embodiment of  FIG.  13   , the embodiment of  FIG.  14    includes a snap coupling having a first sub-component  1152  that is part of the vibrator  1150  and a second sub-component  1462  that is part of the platform  1460 , the snap coupling being configured to snap-couple the vibrator  1150  to the platform  1460  via movement of the sub-components relative to one another in a direction of a longitudinal axis  1401  of the snap coupling. Relative to position along the longitudinal axis  1401 , at least a portion of the second sub-component  1462  overlaps with the magnet  1462  along a vector on the longitudinal axis. The embodiments of  FIGS.  11 A- 12    share this feature as well, as may be seen. Note further that in the embodiment of  FIG.  14   , relative to position along the longitudinal axis, at least a portion of the cavity  1463  of the platform coupling apparatus  1462  into which a portion (the male portion) of the vibratory coupling apparatus  1152  is located overlaps with the magnet  1464 . 
     Embodiments detailed above have been described as having a platform that includes a single magnet. In some alternate embodiments, the platform may include two or more magnets. The magnets may be of substantially similar configuration (including the same configuration) or may be different from one another.  FIG.  15    depicts a platform  1560  having such a configuration, with a portion of vibrator coupling apparatus  1152  depicted as being coupled to the platform coupling apparatus  1162 . As may be seen, with reference to the orientation of  FIG.  15   , the platform  1560  includes a magnet  1164   a  to the left of the platform coupling apparatus  1162 , and a magnet  1164   b  to the right of platform coupling apparatus  1162 . In an exemplary embodiment, the platform  1560  includes a fixation structure  1561  that substantially fixes the spatial location of the first magnet relative to the second magnet and visa-versa. This fixation structure is fixed to the platform coupling apparatus  1162 . In an exemplary embodiment, the fixation structure may comprise a polymer in which the magnets and the platform coupling apparatus are embedded (hence the depiction of these components in dashed lines), such that it fixes these components locationally together. In an alternate embodiment, the fixation structure may be one or more brackets or the like that fix the magnets to one another and/or to the platform coupling apparatus. In an exemplary embodiment, a housing may be used that is configured to hold the magnet to the platform, such as, by way of example, retaining the magnets in the housing with the platform coupling apparatus  1162  fixed to a housing wall thereof. It is noted that alternate embodiments of the fixation structure/housing may be used in cases where there is one magnet (applicable to such embodiments of  FIGS.  11 A- 11 C ). Any device, system and/or method that fixes the spatial location of the magnets relative to one another and/or to the platform coupling apparatus may be used in some embodiments. 
     Embodiments of the coupling apparatus used to couple the vibrator to the platform have been generally detailed above with respect to a snap-coupling (e.g., the embodiment of  FIGS.  11 A- 15   ). Alternate coupling apparatuses may be used to couple the vibrator to the platform. For example,  FIG.  16 A  depicts a screw-couple apparatus having a male threaded portion corresponding to vibratory coupling apparatus  1652   a  including threads  1653   a  and a female threaded portion corresponding to platform coupling apparatus  1662   a  including threads  1663   a . In use, to couple the vibrator to the platform, the vibrator coupling apparatus  1652   a  is screwed into the platform coupling apparatus  1662   a . One or both components are rotated relative to the other (e.g., by application of such rotation to the vibrator and/or the platform, respectively) so that the vibrator coupling apparatus  1652   a  is screwed into the platform coupling apparatus  1662   a . This rotation is continued until deformable stub  1654   a , which is elastically deformable under the conditions of use associated with this embodiment, is received in recess  1664   a . This has the result of rotationally aligning the vibrator relative to the platform at a desired alignment and/or vertically positioning the vibrator relative to the platform at a desired vertical position. This also has the result of providing a minimum torque that must be applied to the vibrator and/or platform to uncouple the two coupled components, thereby providing a safeguard against certain levels of inadvertent uncoupling. That is, to uncouple the two components, torque at or above that which is necessary to sufficiently deform stub  1654   a  so as to remove stub  1654   a  from recess  1664   a  is applied to the vibrator and/or platform. Torque applied below this level will not permit the two components to be uncoupled from one another. 
     It is noted that the pitch of the threads  1663   b  and  1653   a  may be such that the screw-couple apparatus is a quick release/attach coupling. 
     While the embodiment of  FIG.  16 A  has been presented in terms of a deformable stub  1654   a , in an alternate embodiment, stub  1654   a  may be replaced with a ball-detent arrangement. While the embodiment depicted in  FIG.  16 A  shows the male portion of the stub-recess feature as part of the vibrator coupling apparatus  1652   a , in other embodiments, the male portion may be on the platform coupling apparatus  1662   a.    
       FIG.  16 B  depicts an alternate coupling apparatus used to couple the vibrator to the platform. As may be seen, there is male portion corresponding to vibratory coupling apparatus  1652   b  including a magnet  1656  and a female portion corresponding to platform coupling apparatus  1662   b  including magnet  1666 . In use, to couple the vibrator to the platform, the vibrator coupling apparatus  1652   b  is inserted into the platform coupling apparatus  1662   b . Owing to the fact that the poles of the magnets  1656  and  1666  are aligned as depicted in  FIG.  16 B , the magnets attract to one another, thus coupling the components together. To uncouple the two components from each other, force is applied to the vibrator in one direction and force is applied to the platform in an opposite direction sufficient to overcome the magnetic attraction between the two components. It will be understood that if the components are not firmly held or otherwise if proper reaction forces are not applied to the components during the coupling operation, the components will be drawn together and coupled as a result of the magnetic attraction between the two components. Thus, the force needed to couple the two components together may be much lower than that to uncouple the components. By application of sufficient force to the two components during the coupling operation to avoid any effective acceleration relative to one another, the force necessary to avoid such acceleration will be substantially the same as the force necessary to uncouple the two components. In this regard, it may be useful to utilize a testing machine or the like that can control the accelerations of the components to determine whether components meet the requirements. 
     In an embodiment, the magnetic attraction between magnets  1656  and  1666  falls within a range to establish the vibratory coupling apparatus  1652   b  as a quick release/attach coupling. 
     A range of materials may be used to implement embodiments detailed herein and/or variations thereof. In an exemplary embodiment, the platform coupling apparatuses and/or the vibrator coupling apparatuses detailed herein and/or variations thereof may be made entirely or substantially out of PEEK, titanium, stainless steel, aluminum, or other metal alloys. Alternatively, acrylic, epoxy or other polymers can be used to form the above apparatuses. In an exemplary embodiment, the housing of the platform/fixation structure of the platform/portions of the platform that interface with the skin of the recipient may be made entirely or substantially out of PEEK, acrylic, epoxy or other polymers. 
     The embodiments of  FIGS.  9 - 15    may have utilitarian value in that they may, alone and/or with additional components, allow for at least some methods of converting a removable component of a percutaneous bone conduction device (e.g., removable component  720  of  FIG.  7   , vibrator  1150  of  FIGS.  11 A- 11 C,  13  and  14   , vibrator  1250  of  FIG.  12   , etc.) to an external component of a transcutaneous bone conduction device (e.g., functionally corresponding to external device  340  of  FIG.  3   ). In this regard,  FIG.  17    depicts an exemplary flow chart for such a method. Specifically, flow chart  1700  includes method step  1710 , which entails obtaining a vibrator configured to connect to a percutaneous abutment implanted in a recipient, such as, for example, vibrator  1150 . Upon obtaining such a vibrator, the method proceeds from step  1710  to step  1720 , which entails connecting a platform (e.g., platform  1160 ,  1260 ,  1360 ,  1460  or  1560 ) to the vibrator. In at least some embodiments, the configuration of the vibrator is such that after attaching the platform thereto, no further modifications to the device are performed. In other embodiments, control circuitry of the vibrator may be replaced and/or control programming may be reprogrammed. 
     It is noted that there may be, in some embodiments, an intervening step between steps  1710  and  1720 . More specifically, this intervening step may entail removing a first coupling component from the vibrator, the coupling component being configured to quick release and quick attach the vibrator from and to, respectively, a percutaneous abutment. This first coupling component may be in the form of the vibrator coupling apparatus  1152  of  FIGS.  11 A- 11 C  (i.e., a snap-lock coupling). Alternatively or in addition to this, the intervening step may include attaching an attachment component, which may correspond to a second coupling component (which may be in the form of the vibrator coupling apparatus  1152  of  FIGS.  11 A- 11 C  (i.e, a snap-lock coupling) to the vibrator at the location previously occupied by the first coupling component. This attachment component may conversely be in the form of, for example, screws, bolts, interference fit components. Further, the second coupling component may correspond to, for example, any of those detailed above with respect to  FIGS.  16 A- 16 D  and/or variations thereof. In an exemplary embodiment, the attachment component is configured to attach the vibrator at least one of directly to the platform or to an attachment component of the platform. In an exemplary embodiment, the second coupling component is configured to couple the vibrator at least one of directly to the platform or to a coupling component of the platform. 
     In an exemplary embodiment, the just-described intervening steps may be executed to shorten a distance between the body of the vibrator and the platform, such as, for example, the distance between a center of gravity of the vibrator and a center of gravity of the platform. That is, changing a portion of or all of the coupling system of the prior bone conduction device when converting to the new device may result in shorter distances between the vibrator and the platform. In this regard, the new coupling system may reduce the overall distance between the skin-facing side of the housing and various geometric locations on the vibrator (e.g., center of gravity, point furthest from the skin-facing side of the housing  1161 , sides, etc.). 
     The method of  FIG.  17    may be applicable to a vibrator that has been previously connected to a percutaneous abutment implanted in a recipient and utilized to evoke a hearing percept in the recipient via percutaneous bone conduction. That is, the vibrator need not be a new/unused vibrator. In an exemplary embodiment, the method of  FIG.  17    permits a recipient currently furnished with a percutaneous bone conduction device (e.g., having a percutaneous bone conduction abutment fixed to bone of the recipient via a bone fixture (e.g., fixture  246 A of  FIG.  2 A ) and a vibrator coupled to the abutment) to be furnished with a passive transcutaneous bone conduction device without obtaining a new vibrator (i.e., by reusing the vibrator that is part of the furnished percutaneous bone conduction device) because the vibrator can be converted as detailed in flow chart  1700 .  FIG.  18    details an exemplary flowchart  1800  for such a scenario. Specifically, at step  1810 , an abutment is explanted from an implanted bone fixture in a recipient. This may entail unscrewing an abutment screw that extends through the abutment into the bone fixture such that the abutment is removably attached to the bone fixture. 
     Upon sufficiently unscrewing the abutment, the abutment is removed from the bone fixture. Step  1820  entails attaching a totally implantable vibratory element to the bone fixture, thereby implanting the totally implantable vibratory element in the recipient. In an exemplary embodiment, the totally implantable vibratory element corresponds to implanted plate assembly  352  of  FIG.  3   , although in other embodiments, the totally implantable vibratory element may be of a different configuration (e.g., it may not include the silicon layer  353 A). Step  1820  may entail inserting a screw that extends through the totally implantable vibratory element into the bone fixture into a bore in the bone fixture into which the abutment screw previously was inserted and screwing the screw therein to attach the totally implantable vibratory element to the bone fixture. In such an exemplary embodiment, the same bone fixture to which the abutment was attached may be the bone fixture to which the totally implantable vibratory element is attached. This may have utility in that the bone fixture may already be osseointegrated to the bone and the ability for use as a fixture for a bone conduction device is known and/or its performance capabilities are known or otherwise easily estimated. This may permit the now furnished passive transcutaneous bone conduction device to be regularly utilized to evoke a hearing percept within a shorter post-surgery time period/substantially shorter post-surgery time period than that which may be the case if there was a need or otherwise prudent reason to wait for a new bone fixture to osseointegrate to the bone. 
     The implanted vibratory element implanted in step  1820  may include an implantable magnetic component, which may be in the form of an implantable magnetic plate. Such magnetic components may correspond to those detailed herein and/or variations thereof. In an exemplary embodiment, the platform connected to the vibrator in step  1720  may also include a magnetic component, which may also be in the form of a magnetic plate. Such magnetic components may also correspond to those detailed herein and/or variations thereof.  FIG.  19    presents a flow chart  1900  which details additional features of an exemplary method. Method step  1910  entails performing the method of flow chart  1800 , and method step  1920  entails performing the method of flow chart  1700 . It is noted that steps  1920  and  1910  may be performed in any order (i.e., step  1920  may be performed prior to  1910 , etc.) Step  1930  entails positioning the platform coupled to the vibrator obtained by performing the method of flow chart  1700  on the skin of the recipient proximate the implanted totally implantable vibratory element implanted by performing the method of flow chart  1800 . In embodiments where magnetic components are located in the platform/are part of the platform and are in the implanted vibratory element/part of the implanted vibratory element, the platform and thus the vibrator will be magnetically held to the recipient and, in at least some embodiments, aligned with the implanted vibratory element such that passive transcutaneous bone conduction may be practiced to evoke a hearing percept. 
     In an exemplary embodiment, the magnetic component of the platform may correspond to the magnetic component of the implantable vibratory element. In this regard, as noted above, in some embodiments of the passive bone conduction devices detailed herein and/or variations thereof resulting from conversion from a percutaneous bone conduction device, the magnet of the external component is substantially identical to the magnet of the internal component. For example, if the magnet of the external component has no through-hole, the magnet of the implantable component may likewise have no through-hole, and visa-versa. The outer diameter of the magnets may be the same/substantially the same. If the external component utilizes two or more magnets having a given location relative to one another, the external component may utilize the same number of magnets and may also have the same/substantially the same location relative to one another. 
     Accordingly, step  1930  of flow chart  1900  may include the action of establishing a magnetic field between the platform and the totally implantable vibratory element sufficient to hold the platform coupled to the vibrator against the skin of the recipient via the magnetic field. 
     Exemplary methods according to some embodiments may include converting an external component of a transcutaneous bone conduction device (e.g., functionally corresponding to external device  340  of  FIG.  3   ) to a removable component of a percutaneous bone conduction device (e.g., removable component  720  of  FIG.  7   , vibrator  1150  of  FIGS.  11 A- 11 C,  13  and  14   , vibrator  1250  of  FIG.  12   , etc.). In this regard,  FIG.  20    depicts an exemplary flow chart for such a method. Specifically, flow chart  2000  includes method step  2010 , which entails obtaining a vibrator of a passive transcutaneous bone conduction device which is configured to detachably attach to a pressure place of the device. It is noted that while in some embodiments the obtained passive transcutaneous bone conduction device utilizes a snap-coupling or the like, and is thus configured to quick connect and disconnect to and from, respectively, the pressure plate, other embodiments may utilize more permanent manners of detachably attaching the pressure plate to the vibrator. Upon obtaining such a vibrator, the method proceeds from step  2010  to step  2020 , which entails modifying the vibrator such that it can couple to an abutment of a percutaneous bone conduction device. This may entail removing a platform from the vibrator. In at least some embodiments, the configuration of the vibrator is such that after modifying the vibrator in step  2020 , no further modifications to the device are performed. In other embodiments, control circuitry of the vibrator may be replaced and/or control programming may be reprogrammed. 
     It is noted that there may be, in some embodiments, an intervening step between steps  2010  and  2020 . More specifically, this intervening step may entail removing an attachment component from the vibrator, the attachment component being configured to attach the vibrator to the pressure plate. This attachment component may be a first coupling component in the form of the vibratory coupling apparatus  1152  of  FIG.  11 A- 11 C  (i.e., a snap-lock coupling). It also may be in the form of a screw, bolt, interference fit components, etc. Alternatively or in addition to this, the intervening step may include attaching a coupling component to the vibrator at the location previously occupied by the attachment component. This coupling component may correspond to, for example, the snap-lock couplings detailed above, or any of those detailed above with respect to  FIGS.  16 A- 16 B  and/or variations thereof. In an exemplary embodiment, the coupling component is configured to couple the vibrator at least one of directly to an abutment or to a coupling component of an abutment. 
     In an exemplary embodiment, the just-described intervening steps may be executed to shorten a distance between the body of the vibrator and the abutment when coupled thereto, such as, for example, the distance between a center of gravity of the vibrator and a center of gravity of the abutment. That is, changing a portion of or all of the coupling system of the prior bone conduction device when converting to the new device may result in shorter distances between the vibrator and the abutment during use. 
     The method of  FIG.  20    may be applicable to a vibrator that has been previously part of an external component of a passive transcutaneous bone conduction device utilized to evoke a hearing percept in the recipient via passive transcutaneous bone conduction. That is, the vibrator need not be a new/unused vibrator. In an exemplary embodiment, the method of  FIG.  20    permits a recipient currently furnished with a passive transcutaneous bone conduction device (e.g., having a totally implantable vibrator element fixed to bone of the recipient via a bone fixture (e.g., fixture  246 A of  FIG.  2 A ) and a vibrator with a pressure plate configured to interface with skin of the recipient and be held thereto via a magnetic field between the external component and the implantable component) to be furnished with a percutaneous bone conduction device without obtaining a new vibrator (i.e., by reusing the vibrator that is part of the furnished passive transcutaneous bone conduction device) because the vibrator can be converted as detailed in flow chart  2000 .  FIG.  21    details an exemplary flowchart  2100  for such a scenario. Specifically, at step  2110 , a totally implantable vibratory element is explanted from an implanted bone fixture in a recipient. This may entail unscrewing a screw that extends through the totally implantable vibratory element or that is otherwise attached to the totally implantable vibratory element from a bore in the bone fixture such that the totally implantable vibratory element is removably attached to the bone fixture. 
     It is noted that in an alternate embodiment, a method need not entail modification of the external component. In this regard, there may be embodiments where the external component of the passive transcutaneous bone conduction device is configured to couple to a pressure plate utilizing a mechanism that also corresponds to a mechanism that permits the vibrator of the external component to be coupled to an abutment. Thus, an exemplary method may entail obtaining the vibrator, wherein the vibrator is configured to be coupled to a platform that functions as a pressure plate of the passive transcutaneous bone conduction device. The method further entails uncouplably coupling the vibrator to an implanted percutaneous abutment implanted in a recipient. The just-described method may further include an intervening step which includes uncoupling the platform from the vibrator. 
     Once the totally implantable vibratory element is detached from the bone fixture, it is removed therefrom. Step  2120  entails attaching an abutment to the bone fixture, thereby implanting the totally implantable vibratory element in the recipient. Step  2120  may entail inserting a screw that extends through the abutment into a bore in the bone fixture into which the screw that held the totally implantable vibratory element to the bone fixture was previously inserted and screwing the screw therein to attach the abutment to the bone fixture. In such an exemplary embodiment, the same bone fixture to which the totally implantable vibratory element was attached may be the bone fixture to which the abutment is attached. This may have utility in that the bone fixture may already be osseointegrated to the bone and the ability for use as a fixture for a bone conduction device is known and/or its performance capabilities are known or otherwise easily estimated. This may permit the now furnished percutaneous bone conduction device to be regularly utilized to evoke a hearing percept within a shorter post-surgery time period/substantially shorter post-surgery time period than that which may be the case if there was a need to wait for a new bone fixture to osseointegrate to the bone. 
       FIG.  22    presents a flow chart  2200  which details additional features of an exemplary method. Method step  2210  entails performing the method of flow chart  2100 , and method step  2220  entails performing the method of flow chart  2000 . It is noted that steps  2220  and  2210  may be performed in any order (i.e., step  2220  may be performed prior to  2210 , etc.) Step  2230  entails uncouplably coupling the vibrator obtained by performing the method of flow chart  2000  to the abutment implanted by performing the method of flow chart  2100 . It is noted that in embodiments where the external component of the passive transcutaneous bone conduction device obtained in method step  2010  is configured to couple to a pressure plate utilizing a mechanism that also corresponds to a mechanism that permits the vibrator of the external component to be coupled to an abutment, the full method of flow chart  2100  may not be performed. Thus, an exemplary method may entail an alternate step to step  2210  that instead corresponds to obtaining a vibrator, wherein the vibrator is configured to be coupled to a platform that functions as a pressure plate of the passive transcutaneous bone conduction device. Steps  2220  and  2230  may be the same as detailed above. 
     While various embodiments of the present invention have been described above, it should be understood that they have been presented by way of example only, and not limitation. It will be apparent to persons skilled in the relevant art that various changes in form and detail can be made therein without departing from the spirit and scope of the invention. Thus, the breadth and scope of the present invention should not be limited by any of the above-described exemplary embodiments, but should be defined only in accordance with the following claims and their equivalents.