Kelly, D. J.; Prendergast, P. J. and Blayney, A. W. ‘The effect of prosthesis design on vibration of the reconstructed ossicular chain: a comparative finite element analysis of four prostheses’ in Otology and Neurotology, 24, (1), 2003, pp 11-19
Otology & Neurotology: Official Publication Of The American Otological Society, American Neurotology Society [And] European Academy Of Otology And Neurotology 24 1
Hypothesis: We hypothesize that the differences in the bioacoustic performance of
ossicular replacement prosthesis designs, and insertion positions, can be quantified using
finite element analysis.
Background: Many designs of prosthesis are available for middle ear surgery.
Materials used, and the shape of the implants, differ widely. Advances in computer simulation
technologies offer the possibility of replicating the in vivo behavior of the different
prostheses. If this can be achieved, insight into the design attributes required for improved
biofunctionality may be determined.
Methods: Micro CT scanning and NMR imaging were used to obtain geometric
information that was translated into a finite element model of the outer and middle ear. The
forced frequency response across the hearing range of the normal middle ear was compared to
the middle ear reconstructed with partial and total ossicular replacement prostheses (Xomed,
Jacksonville, FL and Kurz, Dusslingen Germany).
Results: The amplitude of vibration of the footplate was more similar to the normal
ear when a Kurz TORP was implanted compared to when a Xomed TORP was implanted;
this may be attributed to the latter’s titanium link. PORP prostheses were stiffest and had
lower umbo vibrations and higher stapedial footplate vibrations. In all cases bar one the
vibration of the prostheses had resonances that caused the vibration of the stapes footplate to
be noticeably different from normal.
Conclusion: We confirmed the hypothesis that finite element modelling can be used
to predict the differences in the response of ossicular replacement prostheses. This study
shows that computer simulation can potentially be used to test or optimize the vibro-acoustic
characteristics of middle ear implants.
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