Related Experiment Video
Updated: May 17, 2026
09:07
Techniques of Endoscopic Ossiculoplasty
Published on: January 26, 2024
Titanium ball joint total ossicular replacement prosthesis--experimental evaluation and midterm clinical results
A O Gostian1, D Pazen, J C Luers
1Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany.
Hearing Research
|November 13, 2012
Summary
A modified titanium ossicular replacement prosthesis with a micro ball joint compensates for tympanic membrane movements, offering similar stapes footplate movement to standard prostheses. Clinical results show encouraging audiological outcomes and no adverse events.
Area of Science:
- Biomedical Engineering
- Otolaryngology
- Medical Device Design
Background:
- Middle ear reconstruction requires addressing pressure variations and tympanic membrane movements.
- Standard rigid prostheses bypass the natural malleoincudal joint, affecting pressure control.
- Existing ossicular chain reconstruction methods face challenges with dynamic pressure compensation.
Purpose of the Study:
- To describe and evaluate a modified total titanium ossicular replacement prosthesis with a micro ball joint.
- To compare the performance of the modified prosthesis against a standard rigid prosthesis in laboratory and clinical settings.
- To assess the audiological and morphological outcomes of the novel prosthesis in patients.
Main Methods:
- Temporal bone experiments using Laser vibrometry to measure stapes footplate movements.
- Comparison of sound-induced stapes footplate motion between the modified and standard prostheses.
- Clinical evaluation of twelve patients with the modified prosthesis, assessing audiological outcomes (air-bone gap) and adverse events over a mean follow-up of 32 months.
Main Results:
- In vitro experiments showed no significant difference in sound-induced stapes footplate movements between the modified and standard prostheses.
- Intraoperative insertion of the modified prosthesis required more delicate handling due to its variable headplate angle.
- Clinical follow-up revealed a mean pure tone average air-bone gap of 18.8 dB, with no observed extrusion or dislocation.
Conclusions:
- The modified ossicular replacement prosthesis with an integrated micro ball joint demonstrates comparable in vitro performance to standard rigid prostheses.
- The mobile headplate design shows promise for physiological middle ear implantation by adapting to tympanic membrane movements.
- Encouraging audiological and morphological results suggest this prosthesis is a step forward in middle ear reconstruction.
