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Experimental study on admissible forces at the incudomalleolar joint
Michael Lauxmann1, Christoph Heckeler, Dirk Beutner
1Institute of Engineering and Computational Mechanics, University of Stuttgart, Stuttgart, Germany. Michael.Lauxmann@itm.uni-stuttgart.de
Summary
This study determined the forces causing incudomalleolar joint rupture during stapes prosthesis fixation. Crimping procedures pose a significantly higher risk of incus damage compared to clip and SMA prostheses.
Area of Science:
- Otolaryngology
- Biomechanical Engineering
- Surgical Innovation
Background:
- Stapes prosthesis fixation requires careful attachment to the incus long process.
- The forces exerted during crimping can risk incudomalleolar joint damage or incus luxation.
- Understanding these forces is critical for preventing surgical complications.
Purpose of the Study:
- To quantify the forces causing micro-rupture, rupture, and short-term maximums at the incus long process.
- To compare surgical crimping forces with the incudomalleolar joint's tolerance limits.
- To assess the risk of incus luxation during stapes surgery.
Main Methods:
- Load-deflection measurements were performed on 9 temporal bones using a load cell and displacement encoder.
- Customized needles attached the incus long process to the load cell for force measurement.
- Video recordings supplemented quantitative data for visual confirmation of joint behavior.
Main Results:
- Rupture forces averaged 894 mN (anterior-posterior) and 695 mN (lateral-medial).
- Micro-ruptures occurred at approximately 568 mN (anterior-posterior) and 406 mN (lateral-medial).
- Short-term maximum forces reached 1,321 mN (anterior-posterior) and 939 mN (lateral-medial).
Conclusions:
- Accurate rupture force thresholds for the incudomalleolar joint were established.
- The findings enable risk assessment for incus luxation/subluxation in stapes surgery.
- Crimping procedures present a higher risk of incus damage than clip or SMA prostheses.
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