Peter K Gottlieb1, Xiping Li2, Ashkan Monfared3, Nikolas Blevins4, Sunil Puria5,6. 1. Department of Mechanical Engineering, Stanford University, Stanford, California, U.S.A. 2. Department of Otolaryngology-Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. 3. Department of Otology and Neurotology, George Washington University Hospital, Washington, District of Columbia, U.S.A. 4. Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, U.S.A. 5. Department of Mechanical Engineering, Stanford University, Stanford, California, U.S.A.. puria@stanford.edu. 6. Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, U.S.A.. puria@stanford.edu.
Abstract
OBJECTIVES/HYPOTHESIS: The performance of an ossicular replacement prosthesis (ORP) is influenced by its alignment and appropriate tension between the tympanic membrane and the stapes footplate. A novel ORP with a flexible element that potentially allows for length adjustment in situ is presented and tested for acoustic performance. STUDY DESIGN: Laser Doppler vibrometry in fresh human cadaveric temporal bones was used to test the acoustic performance of the adjustable ORP relative to standard prostheses used for ossiculoplasty. METHODS: The three-dimensional (3D) velocity of the stapes posterior crus was measured in the 0.2- to 20-kHz range using a Polytec CLV-3D laser Doppler vibrometer. The middle ear cavity was accessed through a facial recess approach. After measuring the normal response, the incus was removed and stapes velocity was measured in the disarticulated case, then after insertion of the new prosthesis, a conventional prosthesis (Kurz BELL Dusseldorf type), and a sculpted autologous incus prosthesis in each temporal bone. The 3D stapes velocity transfer function (SVTF) was calculated for each case and compared. RESULTS: The novel ORP design restored stapes velocity to within 6 dB (on average) of the intact response. No significant differences in 3D-SVTF were found between the new, conventional, or autologous ORPs. CONCLUSIONS: The inclusion of an in situ adjustable element into the ORP design did not adversely affect its acoustic performance. The adjustable element may increase the ease of achieving optimal ORP placement, especially through a facial recess approach. LEVEL OF EVIDENCE: NA Laryngoscope, 126:2559-2564, 2016.
OBJECTIVES/HYPOTHESIS: The performance of an ossicular replacement prosthesis (ORP) is influenced by its alignment and appropriate tension between the tympanic membrane and the stapes footplate. A novel ORP with a flexible element that potentially allows for length adjustment in situ is presented and tested for acoustic performance. STUDY DESIGN: Laser Doppler vibrometry in fresh human cadaveric temporal bones was used to test the acoustic performance of the adjustable ORP relative to standard prostheses used for ossiculoplasty. METHODS: The three-dimensional (3D) velocity of the stapes posterior crus was measured in the 0.2- to 20-kHz range using a Polytec CLV-3D laser Doppler vibrometer. The middle ear cavity was accessed through a facial recess approach. After measuring the normal response, the incus was removed and stapes velocity was measured in the disarticulated case, then after insertion of the new prosthesis, a conventional prosthesis (Kurz BELL Dusseldorf type), and a sculpted autologous incus prosthesis in each temporal bone. The 3D stapes velocity transfer function (SVTF) was calculated for each case and compared. RESULTS: The novel ORP design restored stapes velocity to within 6 dB (on average) of the intact response. No significant differences in 3D-SVTF were found between the new, conventional, or autologous ORPs. CONCLUSIONS: The inclusion of an in situ adjustable element into the ORP design did not adversely affect its acoustic performance. The adjustable element may increase the ease of achieving optimal ORP placement, especially through a facial recess approach. LEVEL OF EVIDENCE: NA Laryngoscope, 126:2559-2564, 2016.
Authors: Jae Hoon Sim; Michail Chatzimichalis; Michael Lauxmann; Christof Röösli; Albrecht Eiber; Alexander M Huber Journal: J Assoc Res Otolaryngol Date: 2010-02-18
Authors: Mark Praetorius; Sabrina S Kirchenbauer; Stefanie Buss; Christoph Klingmann; Peter K Plinkert; Ingo Baumann Journal: Acta Otolaryngol Date: 2010-11 Impact factor: 1.494
Authors: Wesley W O Krueger; Joseph G Feghali; Clough Shelton; J Douglas Green; Charles W Beatty; David F Wilson; Bradley S Thedinger; David M Barrs; John T McElveen Journal: Otol Neurotol Date: 2002-11 Impact factor: 2.311
Authors: Peter Luke Santa Maria; Peter Gottlieb; Chloe Santa Maria; Sungwoo Kim; Sunil Puria; Yunzhi Peter Yang Journal: Tissue Eng Part A Date: 2017-02-24 Impact factor: 3.845