Studies on the mechanics of the reconstructed human middle ear.

Using a laser-Doppler interferometer the influence of different positions of an incus prosthesis on hearing performance was examined in human temporal bone preparations. The influence of position and tension of a malleus to footplate prosthesis (columella) was studied in the same way. It is concluded that an incus prosthesis should be placed along an imaginary line through the centre of the footplate and the head of the stapes. With a malleus to footplate prosthesis the position on the footplate is relatively unimportant. Tension between the malleus, prosthesis and footplate, however, is quite important and should be as low as possible, and compatible with a stable situation. The malleus to footplate prosthesis provides a columella type of prosthesis which for lower frequencies works better than an incus prosthesis, and occasionally even better than the normal ear.