Abstract
Prostheses replacing the incus in its normal position and equipped with two joints might transfer sound as effectively as the intact ossicular chain and allow adjustment to quasi-static pressure changes. A prerequisite for prostheses development is the access to dimensions and distances of the ossicular chain which are necessary to conceptualize shape and size. Fifteen cadaveric human temporal bone specimens were investigated by means of micro-CT followed by 3D analysis. Each specimen was scanned three times: after removal of incus, after additional removal of the malleus head, and after approaching the umbo to the promontory. Artificial umbo medialization as a surrogate for quasi-static pressure changes leads to relevant variations in the distance between the upper part of the malleus and the stapes. Prostheses replacing the incus in its normal position should be equipped with a sliding ball joint or similar construction to allow adjustment to quasi-static pressure changes.
Similar content being viewed by others
References
Manley GA (2010) An evolutionary perspective on middle ears. Hear Res 263:3–8
Puria S, Steele C (2010) Tympanic-membrane and malleus-incus-complex co-adaptions for high-frequency hearing in mammals. Hear Res 263:183–190
Hol MKS, Nguyen DQ, Schlegel-Wagner C, Pabst G, Linder TE (2010) Tympanoplasty in chronic otitis media patients with an intact, but severely retracted malleus: a treatment challenge. Otol Neurotol 31:1412–1416
Lord RM, Mills RP, Abel EW (2000) An anatomically shaped incus prosthesis for reconstruction of the ossicular chain. Hear Res 145:141–148
Dirckx JJ, Buytaert JA, Decraemer WF (2006) Quasi-static transfer function of the rabbit middle ear, measured with a heterodyne interferometer with high-resolution position decoder. J Assoc Res Otolaryngol 7:339–351
Hüttenbrink KB (1988) The mechanics of the middle-ear at static air pressures: the role of the ossicular joints, the function of the middle-ear muscles and the behaviour of stapedial prostheses. Acta Otolaryngol Suppl 451:1–35
Morris DP, Bance M, van Wijhe RG, Kiefte M, Smith R (2004) Optimum tension for partial ossicular replacement prosthesis reconstruction in the human middle ear. Laryngoscope 114:305–308
Arechvo I, Bornitz M, Lasurashvili N, Zahnert T, Beleites T (2011) New total ossicular replacement prostheses with a resilient joint: experimental data from human temporal bones. Otol Neurotol 33:60–66
Beutner D, Luers JC, Bornitz M, Zahnert T, Hüttenbrink KB (2011) Titanium clip ball joint: a partial ossicular reconstruction prosthesis. Otol Neurotol 32:646–649
Lee DH, Chan S, Salisbury C, Kim N, Salisbury K, Puria S, Blevins NH (2010) Reconstruction and exploration of virtual middle-ear models derived from micro-CT datasets. Hear Res 263:198–203
Kaftan H, Böhme A, Martin H (2015) Geometric parameters of the ossicular chain as a function of its integrity: a micro-CT study in human temporal bones. Otol Neurotol 36:178–183
Kaftan H, Böhme A, Martin H (2014) Is the prosthesis length in malleostapedotomy for otosclerosis revision surgery predictable? Otol Neurotol 35:1150–1155
Kaftan H, Blaurock M, Kaftan S (2015) Design-dependent calculation of the prosthesis length in malleostapedotomy. Ann Otol Rhinol Laryngol 124:728–733
Arensburg B, Harell M, Nathan H (1981) The human middle ear ossicles: morphometry, and taxonomic implications. J Hum Evol 10:199–205
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Kaftan, H., Böhme, A. & Martin, H. Parameters for novel incus replacement prostheses. Eur Arch Otorhinolaryngol 273, 2411–2417 (2016). https://doi.org/10.1007/s00405-015-3810-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-015-3810-7