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New Prostheses for Tympanoplasty: Assessment in Cadaveric Temporal Bones

Presenting Author: Mansour Alshamani

Published online by Cambridge University Press:  03 June 2016

Mansour Alshamani ,
Jaehoon Sim ,
Michail Chatzimichalis ,
Christof Röösli ,
Alexander M Huber  and
Ivo Dobrevo
Mansour Alshamani
Affiliation:
Zurich University hospital
Jaehoon Sim
Affiliation:
University of Zürich, University Hospital Zürich, Deptement of Otorhinolaryngology, Head and Neck Surgery,Frauenklinikstr. 24, CH- 8091 Zürich, Switzerland
Michail Chatzimichalis
Affiliation:
Dorset County Hospital NHS Foundation Trust, ENT Department, Williams Avenue, Dorchester, DT12JY,United Kingdom, michail.chatzimichalis@dchft.nhs.uk
Christof Röösli
Affiliation:
University of Zürich, University Hospital Zürich, Deptement of Otorhinolaryngology, Head and Neck Surgery,Frauenklinikstr. 24, CH- 8091 Zürich, Switzerland
Alexander M Huber
Affiliation:
University of Zürich, University Hospital Zürich, Deptement of Otorhinolaryngology, Head and Neck Surgery,Frauenklinikstr. 24, CH- 8091 Zürich, Switzerland
Ivo Dobrevo
Affiliation:
University of Zürich, University Hospital Zürich, Deptement of Otorhinolaryngology, Head and Neck Surgery,Frauenklinikstr. 24, CH- 8091 Zürich, Switzerland
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Abstract

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Learning Objectives: The experimental assessments of the new prostheses (PORP and TORP) in cadaveric temporal measurements provide objective ways to predict their functional outcomes and benefits prior to their clinical application.

The middle-ear in human ear converts and transmits acoustically-induced sound stimuli to the inner ear. The middle-ear structures can be damaged by various middle-ear pathologies. The damaged middle-ear structures are frequently reconstructed by surgical procedures to rearrange or to replace the impaired middle-ear structures with an implantable prosthesis. Especially, the partial ossicular reconstruction prosthesis (PORP) and total ossicular reconstruction prosthesis (TORP) are used to provide direct connection between the tympanic membrane and the stapes. While such tympanoplasty surgeries are common these days, stable positioning of the prosthesis and reliable connection between the prosthesis and the remaining ossicular structure are still difficult to achieve.

In this study, four newly-introduced prostheses for tympanoplasty were assessed in cadaveric temporal bones; two PORPs with a ball joint and a notch for placement under the malleus and two supplemental devices for TORP, Omega Connector and TotalOption Connector. All the prostheses were implanted to the temporal bones in sequence, and time for implantation was measured for each of the prostheses.

With each of the prostheses implanted, motion of the stapes footplate and the volume displacement at the round window membrane were measured using a laser Doppler vibrometer (LDV).

The measured quantities were assessed as the functional outcomes of the surgical reconstruction with the corresponding prosthesis, in comparison with sound transmission in normal ears Preliminary results indicate that middle-ear reconstructions with the newly-developed prostheses resulted in surgical outcomes comparative to normal middle-ear. Further, they provide relatively easy handling of the prostheses during the surgeries and relatively secure connection between the prostheses and the remaining middle-ear structures and thus relatively small risk of postoperative dislocation compared to current prostheses for tympanoplasty.