Titanium ball joint total ossicular replacement prosthesis – Experimental evaluation and midterm clinical results

Gostian, Antoniu Oreste; Pazen, David; Lüers, Jan-Christoffer; Hüttenbrink, Karl-Bernd; Beutner, Dirk

doi:10.1016/j.heares.2012.10.009

Cited by 16 publications

(16 citation statements)

References 15 publications

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“…Experimentelle Untersuchungen an einer Titan-Partialprothese mit kugelgelenk-gelagertem Prothesenkopf konnten zeigen, dass unter physiologischen Bedingungen kein Materialabrieb im Bereich des Titan-Kugelgelenks auftritt und die Übertragungseigenschaften mit denen der intakten Ossikelkette vergleichbar sind [103]. Die Integration des Kugelgelenks ist auch für Totalprothesen mit ähnlich guten Übertragungseigenschaften beschrieben [104]. Die experimentell dargestellten Eigenschaften konnten in ersten klinischen Studien mit 60 Patienten [105]…”

Section: Kopfplatteunclassified

Tympanoplastik – Neues und neu Beleuchtetes

Neudert

Zahnert

2017

Laryngo-Rhino-Otol

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Techniques and biomaterials for reconstructive middle ear surgery are under steady, ongoing development. At the same time, clinical post-surgery results are evaluated to determine success or failure of the therapy. Routine quality assessment and assurance is of growing importance in the medical field, and therefore also in middle ear surgery. The exact definition and acquisition of outcome parameters is essential for both a comprehensive and detailed quality assurance. These parameters are not the audiological results alone, but also additional individual parameters which influence the postoperative outcome after tympanoplasty. Selection of patients and the preoperative clinical situation, the extent of the ossicular chain destruction, the chosen reconstruction technique and material, the audiometric frequency selection and the observational interval are only some of them. If these parameters are not well documented comparative analyses between different studies are of limited value. The present overview aims to describe, compare and evaluate some of the existing assessment and scoring systems for middle ear surgery. Additionally, new methods for an intraoperative quality assessment in ossiculoplasty and the postoperative evaluation of suboptimal hearing results with imaging techniques are available. In the area of implant development functional elements were integrated in prostheses to enable not only good sound transmission but also compensation of occurring atmospheric pressure changes. In combination with other components for ossicular repair they can be used in a modular manner which, so far show experimentally and clinically promising results.

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Section: Kopfplatteunclassified

Tympanoplastik – Neues und neu Beleuchtetes

Neudert

Zahnert

2017

Laryngo-Rhino-Otol

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“…Experimental trials with titanium prostheses with prostheses heads installed in ball-joints could show that under physiological conditions no material abrasions occur in the area of the titanium ball-joint and the transmission properties are comparable to those of the intact ossicular chain [ 103 ]. Also for total prostheses, the integration of a ball-joint is described with similar transmission characteristics [ 104 ]. The experimentally identified properties could be confirmed in first clinical studies in 60 patients [ 105 ], in 18 patients [ 103 ] for partial prostheses, and in 12 patients [ 104 ] for total prostheses.…”

Section: Development Of Functional Elements For Middle Ear Prosthesmentioning

confidence: 99%

“…Also for total prostheses, the integration of a ball-joint is described with similar transmission characteristics [ 104 ]. The experimentally identified properties could be confirmed in first clinical studies in 60 patients [ 105 ], in 18 patients [ 103 ] for partial prostheses, and in 12 patients [ 104 ] for total prostheses. Regarding the use of total prostheses, the mobile head plate represents an additional surgical challenge that must not be underestimated because the angular variability makes a stable intraoperative positioning very difficult.…”

Section: Development Of Functional Elements For Middle Ear Prosthesmentioning

confidence: 99%

Tympanoplasty – news and new perspectives

Neudert

Zahnert

2017

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 16:Doc07

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“…Concerning the acoustic performance, none statistically significant improvement have been presented. Although these new prosthetic designs help the positioning inside the middle ear cavity, they still need the interposition of the cartilaginous buffer [20][21][22][23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

De novo topology optimization of total ossicular replacement prostheses

Milazzo

Muyshondt

Carstensen

et al. 2020

Journal of the Mechanical Behavior of Biomedical Materials

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Conductive hearing loss, due to middle ear pathologies or traumas, affects more than 5% of the population worldwide. Passive prostheses to replace the ossicular chain mainly rely on piston-like titanium and/or hydroxyapatite devices, which in the long term suffer from extrusion. Although the basic shape of such devices always consists of a base for contact with the eardrum and a stem to have mechanical connection with the residual bony structures, a plethora of topologies have been proposed, mainly to help surgical positioning. In this work, we optimize the topology of a total ossicular replacement prosthesis, by maximizing the global stiffness and under the smallest possible volume constraint that ensures material continuity. This investigation optimizes the prosthesis topology in response to static displacement loads with amplitudes that normally occur during sound stimulation in a frequency range between 100 Hz and 10 kHz. Following earlier studies, we discuss how the presence and arrangement of holes on the surface of the prosthesis plate in contact with the umbo affect the overall geometry. Finally, we validate the designs through a finite-element model, in which we assess the prosthesis performance upon dynamic sound pressure loads by considering four different constitutive materials: titanium, cortical bone, silk, and collagen/hydroxyapatite. The resultsshow that the selected prostheses present, almost independently of their constitutive material, a vibroacustic behavior close to that of the native ossicular chain, with a slight almost constant positive shift that reaches a maximum of ≈5 dB close to 1 kHz. This work represents a reference for the development of a new generation of middle ear prostheses with non-conventional topologies for fabrication via additive manufacturing technologies or ultraprecision machining in order to create patient-specific devices to recover from conductive hearing loss.

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Titanium ball joint total ossicular replacement prosthesis – Experimental evaluation and midterm clinical results

Cited by 16 publications

References 15 publications

Tympanoplastik – Neues und neu Beleuchtetes

Tympanoplastik – Neues und neu Beleuchtetes

Tympanoplasty – news and new perspectives

De novo topology optimization of total ossicular replacement prostheses

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