Experimentelle Untersuchungen zu Mittelohrimplantaten mit integriertem mikromechanischem Gelenk

Abstract

The insertion of the new silicone bordered micro joint into a TORP shaft provides an effective method to decrease the potentially damaging stapes footplate excursions after complete ossicular reconstruction. Limited deflections of the prosthesis shaft reduce the occurring forces on the stapes footplate as they partly bore the quasi static pressure changes. Thus, the micro joint can reduce the risk of prostheses dislocation and annular ligament damage and is additionally providing a proper sound transmission through the reconstructed middle ear. Moreover, the bionic modification of a TORP reflects the remaining possibilities for further improvements in prosthetic reconstruction.

Tympanoplasty – news and new perspectives

“…The integration of a joint in the prosthesis strut is another possibility to avoid the rigid coupling between the eardrum and the footplate for compensation of atmospheric pressure variations and thus protection of the inner ear and of dislocations [ 96 ], [ 108 ]. The static prosthesis stem, following the biological example of the joint-like columella of birds, is replaced by a resilient joint.…”

“…In cases of atmospheric pressure changes, the extra-columella is shifted to the inside with the eardrum and thus protects the inner ear from pressure-related damage (Figure 8 (Fig. 8) ) [ 108 ], [ 109 ], [ 110 ].…”

Passive and active middle ear implants

“…Under consideration here is a ball-and-socket type connection between the prosthetic plate and shaft, or the integration of a silicon microjoint into the shaft of the prosthesis. As with a bird columella the shaft is deflected with atmospheric pressure fluctuation, and the risk of a trauma of the inner ear with unrestricted acoustic properties is minimised [ 138 ].…”

A Partial Ossicular Replacement Prosthesis With a Concentric Ball Joint in the Headplate

“…To avoid dislocations of prostheses, it is essential to consider the forces and loads acting on the ossicular chain, which are mainly due to non‐acoustic, air pressure changes 6,7 . This aspect was considered in the development of recent middle‐ear prostheses 8–11 . Using a ball joint has become increasingly popular, as it combines the beneficial properties of a rigid prosthesis with good coupling properties, whereas still ensuring stability during pressure changes 11–13 .…”